Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

AU'18 Oral Path II > Malignancies of Surface Epithelial Origin > Flashcards

Malignancies of Surface Epithelial Origin Flashcards

(100 cards)

Start Studying
1
Q

neoplasm

A

new and abnormal growth, specifically one in which cell multiplication is uncontrolled and progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F: neoplasms are benign

A

false; may be benign or malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

malignancies of surface epithelial origin

A
  1. basal cell carcinoma
  2. cutaneous squamous cell carcinoma
  3. squamous cell carcinoma of the lip
  4. oral squamous cell carcinoma
  5. verrucous carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where does basal cell carcinoma arise from?

A

basal cells of the epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the most common skin cancer?

A

basal cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how many basal cell carcinoma cases are diagnosed annually in the US?

A

over 1 million cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk factors of basal cell carcinoma

A
  1. age (esp. over 40 y.o.)
  2. fair complexion
  3. chronic and intermittent sun (UV) exposure
  4. frequent sunburns
  5. outdoor occupation or hobby
  6. tendency for freckling in childhood
  7. other: PUVA for psoriasis, tanning beds, immunosuppression
  8. basal cell carcinoma syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/F: females are more at risk for developing basal cell carcinoma

A

false; male>female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

where does basal cell carcinoma affect?

A

any cutaneous site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what percent of the sites basal cell carcinoma affect is head and neck?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which area on the head and neck is the most common location affected by basal cell carcinoma?

A

middle 1/3 of face (mask area)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does the mask area include?

A

includes top of the eyebrows to top of upper lip; includes ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

types of basal cell carcinoma

A
  1. nodulo-ulcerative BCC
  2. pigmented BCC
  3. sclerosing (morpheaform) BCC
  4. others: superficial BCC, BCC associated with syndromes, fibroepithelioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the most common type of BCC?

A

nodulo-ulcerative BCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the least common type of BCC?

A

sclerosing (morpheaform) BCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

clinical features of nodulo-ulcerative BCC

A
  1. firm, painless papule
  2. slow enlargement
  3. central umbilication (depression) which often ulcerates
  4. rolled borders
  5. pearly, opalescent when pressed
  6. no hair
  7. telangiectasia
  8. hx of intermittent bleeding then healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

telangiectasia

A

collection of small blood vessels near surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

histopathologic features of nodulo-ulcerative BCC

A
  1. uniform, ovoid, dark-staining basaloid cells
  2. basaloid cells appear to “drop off”
  3. large lobules of basaloid tumor cells
  4. palisading basal cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does pigmented BCC resemble?

A

melanocytic nevi (moles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

clinical features of pigmented BCC

A

hx of short duration and lack of hair support BCC vs. nevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

histopathologic features of pigmented BCC

A

most are nodulo-ulcerative pattern, with large lobules of tumor cells invading the superficial CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why are lesions of pigmented BCC pigmented?

A

colonization by BENIGN melanocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the most aggressive type of BCC?

A

sclerosing (morpheaform) BCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

clinical features of sclerosing BCC

A
  1. more firm than surrounding skin; resembles scar due to induction of collagen formation by tumor cells
  2. difficult to assess borders
  3. no hx of trauma or surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
histopathologic features of sclerosing BCC
tiny infiltrative nests of tumor cells in a collagenous background
26
why is it difficult to clinically assess borders of sclerosing BCC?
due to the infiltrative growth pattern
27
treatment for BCC
1. scalpel excision 2. electrodesiccation and curettage 3. cryotherapy 4. radiation therapy 5. Mohs micrographically controlled surgery; uses pathology and surgery
28
prognosis of BCC
generally excellent
29
what percent of patients are cured of BCC after their first treatment?
95%
30
T/F: larger BCC lesions, recurrent lesions and tumors in areas of embryonic fusion are more aggressive and require Mohs surgery
true
31
T/F: metastasis is often reported with BCC
false; metastasis is rarely
32
cicatrix
scar of a healed wound
33
types of squamous cell carcinoma (SCC)
1. cutaneous (skin) SCC 2. SCC of the lip 3. oral squamous cell carcinoma (OSCC)
34
what is the most common oral malignancy?
SCC
35
what percent of oral malignancies are SCC?
90%
36
what is the 2nd most common cutaneous malignancy?
SCC
37
where does SCC arise from?
surface epithelium/epidermis
38
on rare occasions, SCC can arise from what?
salivary ductal epithelium
39
risk factors for cutaneous SCC
1. chronic sun (UV) light exposure 2. medical ionizing radiation 3. pre-existing actinic keratosis
40
where does cutaneous SCC affect?
any sun-exposed site
41
what percent of cutaneous SCC cases affect the head and neck?
70% (i.e. face, helix of ear, scalp esp. with thinning hair)
42
clinical features of cutaneous SCC
1. non-healing ulcer 2. slow growth 3. plaque, papule or nodule 4. variable degrees of scale, ulcer or crust 5. often erythematous base
43
histopathologic features of cutaneous SCC
generally well-differentiated
44
treatment for cutaneous SCC
surgical excision
45
prognosis of cutaneous SCC
good if identified and treated early
46
common site for SCC of lip
lower lip; rare on upper lip since protected by forehead, nose and mustache
47
clinical features of SCC of lip
1. chronic (UV) sun exposure 2. rough, scaly 3. often ulcerated 4. slow growing, non-healing 5. arises in setting of actinic cheilitis
48
histopathologic features of SCC of lip
usually well-differentiated
49
treatment of SCC of lip
1. scalpel excision 2. vermilionectomy "lip shave" 3. reduce sun exposure 4. use SPF products
50
prognosis of SCC of lip
good overall if ID'd early
51
prognosis of SCC of lip for lower lip
relatively good
52
prognosis of SCC of lip for upper lip
high risk for lymph node metastasis
53
what is the most common oral malignancy
oral squamous cell carcinoma (OSCC)
54
what percent of all cancers in US is OSCC?
2-3%
55
what percent of OSCC cases are not associated with any identifiable risk factor
25%
56
OSCC usually occurs in people of what age?
usually < 40 yo
57
where does OSCC usually occur?
lateral/ventral tongue
58
etiology of OSCC
multifactorial
59
T/F: heredity plays a major role in OSCC
false, not a major role except a few heritable conditions
60
EXTRINSIC risk factors of OSCC
1. tobacco smoke 2. ETOH + TOB use 3. use of alcohol-containing mouthwash (>25%) more than 8x per day 4. hx sanguinaria dental products (Viadent) 5. use of betel quid 6. reverse smoking 7. hx radiation to head/neck 8. smokeless tobacco (dry snuff) 9. occupational exposure 10. bacteria (i.e. tertiary syphilis) 11. oncogenic viruses (HIV, small sub-set HPV) 12. biopsy proven oral epithelial dysplasia or SCC 13. presence of erythroplakia or PVL 14. leukoplakia in high-risk site
61
INTRINSIC risk factors of OSCC
1. male >50 yo 2. malnutrition 3. iron deficiency anemia 4. immunosuppression 5. heredity not major role; few heritable conditions
62
how many carcinogens does tobacco smoke have?
more than 70
63
what percent of patients dx'd with OSCC have hx TOB use?
80%
64
how many years after smoking cessation does your risk decrease to ~non-smoker?
after 10 years
65
T/F: risk of OSCC increases with amount smoked and number of years
true
66
pack year tobacco
estimate of lifetime tobacco exposure and is used as a risk factor
67
pack/year TOB
number of packs of cigarettes per day x number of years smokes
68
ETOH alone is reported to be a risk factor if how many drinks are consumed a day?
>4 drinks/day
69
clinical features of OSCC
1. older male >50 2. 2:1 male predilection 3. possibly pain (usually a late feature)
70
most common sites for OSCC
1. tongue (esp. posterior/lateral/ventral) 2. floor of mouth (often near midline) 3. gingiva 4. soft palate (esp. posterior/lateral) 5. labial and buccal mucosa 6. hard palate
71
T/F: men are more commonly seen with OSCC in their gingiva
false; women 2:1; often non-smoker
72
high risk sites for OSCC
1. ventro-lateral tongue 2. floor of mouth 3. soft palate
73
clinical features of OSCC
1. exophytic 2. endophytic 3. rolled borders esp. with endophytic 4. color from normal to white to red 5. firm, rubbery or indurated 6. often ulcerated
74
what can OSCC resemble clinically?
a non-specific ulcer infection (TB, syphilis, deep fungal) or ulcerated immune-mediated condition
75
differential diagnosis
list of diseases/disorders which could produce signs and symptoms of a condition
76
T/F: differential diagnosis is listed in descending order of most to least likely
true
77
radiographic features of OSCC
1. bone invasion usually a late feature 2. "moth-eaten" radiolucency, ill-defined margins 3. pathologic fracture possible
78
histopathologic features of OSCC
1. invasive cords and nests of malignant epithelial cells arising from dysplastic epithelium 2. increased nuclear/cytoplasmic ratio, pleomorphism, mitoses 3. varying degrees keratin production
79
treatment for OSCC
1. wide surgical excision 2. radiation therapy 3. chemotherapy 4. all/combos of above 5. neoadjuvant therapy to shrink tumor initially
80
prognosis of OSCC
depends on stage but generally poor
81
most OSCC present in what stage?
stage III or IV
82
purpose of staging OSCC
1. determines how far cancer has spread 2. guides treatment 3. guides prognosis
83
staging CATEGORIES OSCC
TNM staging system T - tumor size N - lymph nodes M - metastasis
84
stage grouping
combines TNM parameters
85
T/F: group 0 - IV in order of increasing severity when stage grouping SCC
true
86
recurrent cancer is what stage in TNM system?
NONE
87
what should be done after tx of OSCC is completed?
periodic follow-up after tx
88
what percent of patients with OSCC will develop new upper aerodigestive tract malignancies especially if carcinogenic habits are continued?
10-25%
89
what is the most uncommon form of SCC?
verrucous carcinoma
90
T/F: although verrucous carcinoma the more uncommon form of SCC, it is the most aggressive form
false; less aggressive
91
what is verrucous carcinoma associated with?
dry snuff
92
T/F: verrucous carcinoma is only seen in the oral cavity
false; was seen in multiple other sites including but not limited to soles of feet, genitals and ear canal
93
clinical features of verrucous carcinoma
1. elderly male 2. diffuse 3. usually extensive by tiem of dx 4. well-defined 5. painless 6. thick plaque, papillary verruciform projections 7. white, erythematous, pink - depends on amount of keratin
94
oral sites affected by verrucous carcinoma
1. mandibular buccal vestibule 2. buccal mucosa 3. gingiva 4. tongue 5. hard palate
95
radiographic features of verrucous carcinoma
same as conventional SCC with bone invasion
96
histopathologic features of verrucous carcinoma
1. microscopically bland 2. dx based on overall architecture, individual cells not very dysplastic 3. wide, pushing rete ridges 4. rough papillary surface 5. keratin plugging
97
treatment for verrucous carcinoma
surgical excision (neck dissection if lymph nodes +)
98
why is radiation discouraged in treating verrucous carcinoma?
due to sporadic cases transformation to a more aggressive SCC
99
prognosis of verrucous carcinoma
90% disease-free after 5 years
100
treatment failures of verrucous carcinoma is related to what?
1. underlying systemic illness prohibiting extensive surgery | 2. failure to identify conventional SCC in tumor

AU'18 Oral Path II (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions