Term
| What can epithelial tumors in the oral cavity be derived from? (3) |
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Definition
1) squamous epithelium
2) salivary gland epithelium
3) odontogenic epithelium |
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Term
| Are benign or malignant epithelial tumors more common? |
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Definition
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Term
| Are most epithelial tumors exophytic or endophytic? What is the surface like? Color? |
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Definition
-exophytic
-ulcerated, indurated, papillary
-red, white, speckled |
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Term
| What are some examples of benign tumors? |
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Definition
–Papilloma
–Keratoacanthoma
–Melanocyticnevi |
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Term
| What are some examples of premalignant tumors? |
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Definition
–Leukoplakia
–Erythroplakia
–Actinic keratosis |
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Term
| What are some examples of malignant tumors? |
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Definition
–Basal cell carcinoma
–Verrucouscarcinoma
–Squamouscell carcinoma
–Malignant Melanoma |
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Term
| What is a papilloma? What does it look like? |
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Definition
-An exophytic papillary lesion, usually less than 1 cm
-May be sessile or pedunculated, white or pink |
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Term
| papilloma- Where does it appear? What is the cause? Treatment? |
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Definition
-Can appear on the soft palate, uvula, tongue, gingiva, or buccal mucosa
-Cause is unclear, HPV causes many papillary growths but not all
-Treatment –surgical excision of the base and small area of surrounding normal tissue |
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Term
| How many types of HPV viruses are there? Which cause papilloma? Normal warts? |
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Definition
-over 100 types
-6 and 11 cause papilloma and gential warts
-2 and 4 cause common warts
- |
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Term
| Which HPVs have been associated with neoplastic lesions and 95% of cervical and anogenital cancers? |
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Definition
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Term
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Definition
| Endophyticlesion, sharply circumscribed, with a central keratin plug or keratin-filled crater |
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Term
| How long does it take a Keratoacanthoma to develop? What happens to it? How big does it get? |
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Definition
-Develops rapidly over a period of 1-2 months, frequently regresses spontaneously
-can get up to 2-2.5 CM |
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Term
| Where do Keratoacanthoma commonly develop? In who? |
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Definition
-Occur on sun-exposed skin of the face, lip being a common area
-Most seen in those over 50 |
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Term
| What does Acanthosis mean? |
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Definition
| a increase in stratum spinosumlayer |
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Term
| What is a Melanocytic Nevi? What is it commonly called? |
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Definition
•
-A pigmented lesion, may be exophytic, collection of melanocytes
-Commonly called a “mole” |
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Term
| WHat is the difference between a melanocytic nevi and a melanotic macule? |
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Definition
| Melanotic Macule is caused by increased production of melanin granules, other is just a collection |
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Term
| What is a melanotic macule commonly called? |
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Definition
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Term
| What is a leukoplakia? Is it malignant? |
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Definition
| white plaque that cannot be wiped off, pre-malignant |
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Term
| What COULD a leukoplakia be? (4) |
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Definition
-hyperkeratosis
-hyperplasia
-dysplasia
-squamous cell carcinoma |
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Term
| How many % of leukoplakia show dysplasia? |
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Definition
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Term
| WHat is the treatment for a leukoplakia? |
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Definition
| try to find out cause, if does not resolve take biopsy, any dysplasia or in high risk areas should be removed |
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Term
| What are some areas that are considered to be "high risk"? |
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Definition
-sides of tongue
-floor/sides of tongue
-retromolar pad
-tonsillar area |
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Term
| What is a leukoedema? Are these pre-malignant? |
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Definition
-A translucent, grayish-white, film involving the buccal mucosa
-A variant of normal, NOT pre-malignant |
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Term
| Where are leukoedema found? What happens when they are stretched? |
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Definition
-found bilaterally
-disappear when stretched |
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Term
| Who are leukoedema found in? |
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Definition
-85-95% black
-40-45% white |
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Term
| Why are leukoedema called that? What is the treatment? |
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Definition
-Called Leukoedema because fluid accumulates within the spinous cell layer of the epithelium
-no treatment |
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Term
| What is a Eythroplakia? Is it as common as a leukoplakia? |
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Definition
-clinical term to describe lesion that is smooth red patch or velvety patch
-not as common as leukoplakia but 90% of erythroplakia are dysplasia or squamous cell carcinoma |
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Term
| What must be performed on a leukoplakia? What is it called if it is red and white mixed? |
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Definition
-biopsy
-called a speckled leukoplakia |
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Term
| What is Actinic (solar) Cheilitis? |
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Definition
| Pre-neoplasticchanges seen in the epithelium of the lips in response to prolonged sun exposure |
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Term
| What does Actinic (solar) Cheilitis look like? Where does it commonly form? |
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Definition
-Vermilion border becomes fuzzy often with a puffy, rounded margin
-Vermilion zone becomes mottled with red and white patches
-Chronic ulcers frequently develop, that eventually stop healing |
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Term
| What is the most common type of precancerous lesion? |
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Definition
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Term
| What does Actinic keratosis look like? Where is it found? What causes it? |
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Definition
-Appear as scaly, crusty patches
-Most common locations are the back of the hands, cheek, forehead, ear, and lower lip
-Caused by long-term sun exposure |
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Term
| What is Basal Cell Carcinoma? |
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Definition
| A malignant tumor of hair-bearing areas of the skin –does not arise on mucous membranes |
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Term
| Where is basal cell carcinoma commonly found? How does it start? Does it generally metastasize? |
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Definition
-Most common areas are the sun-exposed areas of the face and ears
-Starts as a papule, enlarges and develops into a crusted ulcer with a rolled border
-Rarely metastasizes |
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Term
| What is the treatment and cure rate for basal cell carcinoma? |
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Definition
-Treatment –surgical removal, electrocautery
-Cure rate –95% |
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Term
| What is Verrucous Carcinoma? How does it grow? |
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Definition
-Exophytic, highly keratinized, warty, well-differentiated, superficial
-Grows slowly, unlikely to metastasize |
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Term
| What is common with Verrucous Carcinoma? Who is it seen in? Treatment? |
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Definition
-Regional lymph nodes often tender (inflammatory in nature)
-Seen in high percentage of tobacco users
-Treatment –surgical excision or laser therapy –good prognosis |
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Term
| What is the most common malignancy in the oral cavity, accounting for90% of all oral cancers? |
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Definition
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Term
| When is squamous cell carcinoma seen? What are some risk factors for it? |
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Definition
-Often the end stage of alterations seen as solar cheilitis or dysplasia
-Risk factors: age, tobacco use, alcohol consumption, viruses, sun exposure, nutritional deficiencies, chronic irritation |
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Term
| Where are the top 6 places squamous cell carcinoma is commonly found? (most common to least common) |
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Definition
1.lower lip
2.lateral/ventral tongue
3.floor of mouth
4.soft palate
5.gingival/alveolar ridge
6.buccal mucosa |
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Term
| What do early squamous cell carcinoma lesions present as? |
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Definition
| leukoplakias and erythroplakias |
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Term
| What may squamous cell carcinoma look like? |
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Definition
-painless ulcer, an exophytic mass, or a papillary growth
-If infiltrated deep, may appear as a firm, indurated area with loss of tissue mobility |
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Term
| Do squamous cell carcinoma's metastasize? How? |
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Definition
| yes, Invasion into connective tissue allows neoplastic cells to enter the blood vessels and lymphatic system and metastasize to distant sites |
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Term
| What does the prognosis of squamous cell carcinomas depend on? |
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Definition
| the location of the lesion |
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Term
| Which locations of squamous cell carcinomas are dangerous? Which are not? |
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Definition
-lower lip- good prognosis
-tongue and intraoral sites not as good, lesion in dangrous areas have <30% prognosis |
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Term
| What is a Malignant Melanoma? |
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Definition
| Neoplasm of melanocytes occuring on skin and mucosa |
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Term
| Where do malignant melanomas occur? Is the incidence of these increasing? What is the etiology of oral melanoma? |
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Definition
-On skin, develop on sun-exposed areas after prolonged exposure to strong sunlight
-Incidence is increasing
-Oral melanoma unknown etiology and is rare compared to skin melanoma |
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Term
| How do oral and skin malignant melanomas occur? How common is oral? WHat is the pronosis like? |
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Definition
-Both appear as dark brown, blue-black or black that first appear as a macule and become papular or nodular later
-Oral = 2-8% but median survival time is 18 months
-5 Year Survival Rates, Oral = 5-20%, Skin = 84% |
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Term
| What is the treatment for malignant melnomas? |
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Definition
| Surgical removal with wide margins (1–3 cm) |
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Term
| What are the 2 phases that malignant melanomas grow in? |
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Definition
-initially neoplastic cells spread laterally in the epithelium
-then begin a vertical growth phase when they invade the connective tissue |
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Term
| How does horizontal growth of malignant melanomas look? |
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Definition
| Horizontal growths appears as an irregular shaped macule which may become larger, become more pigmented, and ulcerate |
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Term
| How many malignant melanomas grow horizontally account for? Vertically? |
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Definition
horizontal- 80%
Vertical- 15% |
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Term
| How long may the initial phase of malignant melanoma last? What is the prognosis for vertical growth? What is a third type of melanotic lesion? |
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Definition
-several months to several years
-prognosis for vertical is poor
-A third type of melanoma arises in a pre-existing pigmented lesions |
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Term
| What can tumors in the oral cavity be a result of? |
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Definition
| cancer elsewhere in the body metastasizing |
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Term
| Where is the most common site of metastatic tumors? |
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Definition
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Term
| What is the treatment for metastatic tumors? Prognosis? |
|
Definition
-chemo and radiation
-prognosis is poor |
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