Chapter 14 - Oral Cavity - Part 2

Question 1

What are two types of oral proliferative lesions?

Answer 1

fibroma

Pyrogenic granuloma

Question 2

Where do fibroma MC occur?

Answer 2

buccal mucosa along the bite line

Question 3

These are a submucosa modular fibrous tissue mass .

Answer 3

fibroma

Question 4

How do fibroma’s occur?

Answer 4

Chronic irritation

Question 5

The chronic irritation (in fibroma’s) lead to what?

Answer 5

Reactive connective tissue hyperplasia (modular mass)/fibrosis

Question 6

This is a vascular mass on the gingiva.

Answer 6

Pyogenic granuloma

Question 7

Is the pyrogenic granuloma benign or CA?

Answer 7

benign

Question 8

What color is the pyrogenic granuloma? (Why?)

Answer 8

Red/purple

richly vascular

Question 9

What population does this occur most commonly in?

Answer 9

Pregnant women (and children)

Question 10

Pyogenic granuloma aka

Answer 10

Pregnancy tumor

Question 11

Is a pyogenic granuloma slow or fast growing?

Answer 11

Rapid growth

Question 12

What is the treatment for pyogenic granuloma?

Answer 12

remove irritant or excision

Question 13

A dense proliferation of immature vessels similar to that seen in granulation tissue describes:

Answer 13

Pyogenic granuloma

Question 14

A raised white patch that can’t be scraped off:

Answer 14

leukoplakia

Question 15

Leukoplakia affects what percentage of the population?

Answer 15

3%

Question 16

Who is affected more by leukoplakia and what age group?

Answer 16

Males (2x’s)

40-70 years old

Question 17

5-25% of leukoplakia are what?

Answer 17

premalignant/precancerous

Question 18

What type of CA can leukoplakia develop into?

Answer 18

Squamous cell carcinoma

Question 19

What is the most common risk factor for leukoplakia and erythroplakia?

Answer 19

Tobacco use

Question 20

What causes the white patch in leukoplakia?

Answer 20

dysplasia, epithelial hyperplasia and keratosis

Question 21

What is the difference between leukoplakia and oral candidiasis?

Answer 21

Oral candidiasis can be scraped off, leukoplakia CANNOT be scraped off.

Question 22

What are 3 leukoplakia-like conditions?

Answer 22

Erythroplakia
Hairy leukoplakia
verrucous leukoplakia

Question 23

What percentage of erythroplakia lead to CA?

Answer 23

50%!

Question 24

What does erythroplakia look like?

Answer 24

Red, velvety area with irregular borders

Question 25

What is the risk for erythroplakia?

Answer 25

Tobacco use

Question 26

What causes hairy leukoplakia?

Answer 26

EBV (Epstein Barr virus) + immunosuppression (AIDS)

Question 27

EBV also causes?

Answer 27

mono

Question 28

What causes verrucous leukoplakia?

Answer 28

HPV infection

Question 29

What does verrucous leukoplakia look like?

Answer 29

Warty appearance

Question 30

Verrucous leukoplakia, the cells are doing what?

Answer 30

hyperkeratosis

Question 31

Verrucous leukoplakia commonly progresses to what?

Answer 31

Squamous cell carcinoma

Question 32

Oral cavity cancers are most likely in men or women?

Answer 32

men

Question 33

Oral cancer develops from dysplasia caused by mutations of what?

Answer 33

TP53 mutations

Question 34

What is the treatment of oral cancer?

Answer 34

excision

Question 35

95% or all oral cancer is what kind?

Answer 35

Squamous cell carcinoma

Question 36

Are single or multiple tumors seen in oral cancer?

Answer 36

Multiple primary tumors

Question 37

What is the prognosis for oral cancer?

Answer 37

Poor

Question 38

What is the survival rate for oral cancer?

Question 39

What can improve the prognosis for oral cancer?

Answer 39

Early detection

Question 40

What are the risks for oral cancer?

Answer 40

Alcohol, tobacco, >30 years (usually 40's/50's) old, HPV -16

Question 41

SCC lesions usually resemble what?

Answer 41

leukoplakia (whitish-gray) or erythematous

Question 42

What are the 5 locations for SCC?

Answer 42

1. Central (inferior) tongue 2. Floor of mouth 3. Lower lip 4. Soft palate 5. Gingiva

Question 43

SCC has _____ borders and possible ______.

Answer 43

Irregular, | ulceration

Question 44

The lesions of SCC are _____ plaque and ____.

Answer 44

Raised | firm

Question 45

SCC is a local invasion followed by metastasis to what areas?

Answer 45

Cervical nodes mediastinal nodes Lungs liver

Question 46

What is the most common site of metastasis for SCC?

Answer 46

Cervical nodes

Question 47

SCC is most commonly associated with which virus?

Answer 47

HPV 16 (and 18)

Question 48

If the SCC is HPV-associated does it have a more favorable prognosis? If so, why?

Answer 48

Yes | Due to fewer mutations

Question 49

What are the HPV-associated SCC anatomic sites of origin?

Answer 49

Base of tongue tonsillar crypts (harder to see)