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    Oral Squamous Cell Carcinoma

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    Ali Rahimi
    Oral squamous cell carcinoma is the most common oral malignancy, usually affecting older men who smoke and drink alcohol. The tongue is the most common site of tumors. Symptoms may include an exophytic mass, indurated ulcer, or leukoplakia. Diagnosis is made through biopsy showing dysplastic changes and invasion. Staging evaluates tumor size, lymph node involvement, and metastasis risk. Prognosis depends on grade, with poorly differentiated tumors having a worse outlook.

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    Oral Squamous Cell Carcinoma

    Uploaded by

    Ali Rahimi
    65 views31 pages
    Oral squamous cell carcinoma is the most common oral malignancy, usually affecting older men who smoke and drink alcohol. The tongue is the most common site of tumors. Symptoms may include an exophytic mass, indurated ulcer, or leukoplakia. Diagnosis is made through biopsy showing dysplastic changes and invasion. Staging evaluates tumor size, lymph node involvement, and metastasis risk. Prognosis depends on grade, with poorly differentiated tumors having a worse outlook.

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    Oral Squamous cell carcinoma

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    Oral Squamous cell carcinoma

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    Oral squamous cell carcinoma is the most common oral malignancy, usually affecting older men who smoke and drink alcohol. The tongue is the most common site of tumors. Symptoms may include an exophytic mass, indurated ulcer, or leukoplakia. Diagnosis is made through biopsy showing dysplastic changes and invasion. Staging evaluates tumor size, lymph node involvement, and metastasis risk. Prognosis depends on grade, with poorly differentiated tumors having a worse outlook.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    65 views31 pages

    Oral Squamous Cell Carcinoma

    Uploaded by

    Ali Rahimi
    Oral squamous cell carcinoma is the most common oral malignancy, usually affecting older men who smoke and drink alcohol. The tongue is the most common site of tumors. Symptoms may include an exophytic mass, indurated ulcer, or leukoplakia. Diagnosis is made through biopsy showing dysplastic changes and invasion. Staging evaluates tumor size, lymph node involvement, and metastasis risk. Prognosis depends on grade, with poorly differentiated tumors having a worse outlook.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 31

    Oral Squamous cell

    carcinoma

    Mohammad Ali Rahimi


    • The most common malignancy of the oral cavity (90%)
    • Men
    • More than 65y
    • Mostly have been existing 4 to 6 month before visiting.
    • Tonque is the most common site  esp ventral and lateral
    • After tonque  oral floor
    • Less common  gingiva / buccal mucosa / labial mucosa / hard
    palatine
    • Common sites in young patients on tonque anterior lateral and
    ventral
    • The more posterior and inferior , the weaker prognosis
    Etiology
    Multifactorial -> Intrinsic or Extrinsic

    Extrinsic: tobacco smoke, alcohol, sunlight


    Intrinsic: iron-deficiency anemia
    Different prognosis among smokers and nonsmokers

    Alcohol and tobacco  synergism depends on dose and time

    Oncogenic Viruses  HPV  specially in oropharyngeal site

    Immunosuppression
    Clinical Manifestation
    • Exophytic
    • Endophytic
    • Leukoplakic
    • Erythroplakic
    • Erythroleukoplakic
    Exophytic
    • Mass-forming
    • Verruci-form / papillary
    Irregular / fungating
    Color may vary from normal to red to white keratin and vascularity
    affect
    Surface  often ulcerated- indurated
    Gingiva carcinomas
    • Less common in comparison with tongue carcinomas
    • Painless at the first stages
    • Usually arrises in Keratinized mucosa of posterior site of mandible
    • Smoking less effect among othe oral carcinomas
    • pyogenic granuloma, gingivitis , and periodontal disease
    • Epulis granolomatosa
    Important note :
    mobility of tooth and
    surface of the lesion
    (mostly granulated)
    should be checked
    Endophytic
    • Central Depressed
    • Rolled border
    (invasion) 
    Weak prognosis
    ✤-Destruction of underlying bone, when present, may be painful or
    completely painless; it appears on radiographs as a “moth-eaten”
    radiolucency with ill-defined or ragged margins (an appearance similar
    to osteomyelitis)

    - Perineural invasion may cause paresthesia


    ✤-Diffrential diagnosis :
    Leukoplakic
    Erythroplakic
    Erythroleukoplakic
    Lip Vermilion Carcinoma
    lightskinned persons with chronic exposure to UV radiation from
    sunlight.
    outdoor occupations.
    actinic cheilosis
    Lower lip
    -clinical Manifestation:
    Crusted- Oozing – Indurated – non-tender
    Metastasis Late Event
    Less than 1 cm in greatest diameter
    Grows slowly
    12 to 16 months before diagnosis
    Metastasis
    • lymphatics to the ipsilateral cervical lymph nodes
    • stony hard, nontender
    • Fixed
    • Extracapsular spread  poor prognosis, including : increased risk for
    locoregional recurrence, distant metastasis, and shortened survival.
    • The most common sites for distant metastasis :
    Lungs / Liver / Bones
    Common Symptoms
    • Long lasting ulcer on lips and oral mucosa
    • Oral bleeding
    • Tooth mobility
    • Dysphasia
    • Neck nodes
    • Pain in ears
    • Painless ulcer
    • Hardness of the mucosa
    • Limits in moving the tongue
    • Lower lip paresthesia
    • Trismus
    Histopathologic
    • Dysplastic changes :
    • Atypia  (nuclear size-nuclear pleomorphism-cell size-cellular
    pleomorphism-atypic mitotic figures-hyperchromasia)
    • architectural  ( loss of polarity- drop shaped rete ridge – increased
    number of mitotic figures – dyscratosis)

    • Invasion and nests


    Staging
    Grading
     Grade I: Well differentiated

     Grade II: Moderately differentiated

     Grade III: Poorly differenciated

     Grade IV: Anaplastic


    • Diagnosis :

    • Based on clinical symptons


    and biopsy
    The End

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