Malignant Epithelial tumors/variant of SCC Flashcards
(39 cards)
What is Oral Squamous Cell Carcinoma
malignant tumor originating from the keratinocyte cells (squamous cells) of the oral mucosa
Squamous Cell Carcinoma
Epidemiology
النسبه بين سرطنات الفم الاخرى
بين الابيض والاسود
بين الذكر والانثي والتريب بينهم
البلد الاكثر
6th most common cancer in males.
12th most common cancer in females.
n Male : Female = 3 : 1
in India.
n Approx. 90% of all oral malignancies are SCC.
n In white : after 25 years old.
n In blacks : middle age
What are the most common sites for oral SCC, forming a U-shape area?
is the lateral side of the posterior third of the tongue, followed by the floor of the mouth, then the soft palate, and then the anterior third of the tongue.
Lower lip > upper lip
n Upper lip is more dangerou
lining of the maxillary sinus.
What are the general clinical presentations of oral SCC
It can present as an exophytic mass كتله خارجية حاجه زي القرنبيط or an endophytic ulcerating, كتله داخليه تقرحات and fungating lesion, often with hard, indurated, rolled borders. اي ورم في احتمال ورم او غير ورم السر او غير السر دا حشو
How might oral SCC appear clinically in terms of color/texture
It can appear as a leukoplakic (white) patch, an erythroplakic (red) patch, or a speckled leukoplakic patch (mixed red and white
What are the six classic clinical characteristics of an SCC ulcer
Enverted (rolled out) edgesحواف مقلوبه , Indurated baseقاعده صلبه
. Necrotic floor,
Foul odor,
Bloody discharge,
Irregular outline.
What conditions should be considered in the differential diagnosis of an ulcerative lesion on the tongue besides SCC
Traumatic ulcer, deep fungal ulcer, syphilitic ulcer, and tuberculous ulcer
What is the typical duration of symptoms before diagnosis for SCC in different socioeconomic groups
4: 8 months in high socioeconomics.
v 8 : 24 month in low socioeconomics.
v Nearly 21% of patients present at diagnosis
with metastasis انتشار
What are the demographics الناس اللي عندهمfor SCC of the maxillary sinus?
It shows a male predilection and is typically a disease of older adults (6th to 8th decades)
Early signs:
Unilateral dull facial pain.
What are the advanced signs of SCC of the maxillary sinus (due to bone invasion
Pain, paraesthesia تنميل , nasal obstruction, hemorrhage, facial expansion (cheek), eye displacement/bulging, and oral cavity involvement (loose teeth, swelling/mass on alveolar ridge or palate
Q: What is the typical radiographic appearance of SCC of the maxillary sinus?
Clouding or opacification of the sinus cavityتغيم وتعكير
appearing as a “moth-eaten” radiolucency.
How does oral SCC typically spread
Local spread to adjacent tissues. 2. Lymphatic spread to draining lymph fixed lymphatic is bad prognosis . 3. Blood spread (uncommon
What does the TNM system stand for in SCC staging
T = Size of the primary tumor, N = Involvement of local lymph nodes, M = Distant metastasis.
Define T1, T2, T3, and T4 in oral SCC
Tx مفيش اي حاجة
T1: Tumor < 2 cm. T2: Tumor 2-4 cm. T3: Tumor > 4 cm. T4: Tumor invades adjacent structures.
الغزو
The cause may be:
1. infection with Epstein- Barr Virus.
2. Diet deficiency in vitamin- C.
3 - Tobacco use.
Define N0, N1, N2, and N3 in oral SCC staging.
Nx nde can’t evaluate
N0: No palpable ملموس nodes.
N1: Ipsilateral (ناحيه الورم )node(s) ≤ 3 cm.
N2: Ipsilateral node(s) > 3 cm but ≤ 6 cm.
N3: Node(s) > 6 cm, contralateralالناحيه العكسيه للورم , or bilateral
Define M0 and M1 in oral SCC staging.
A
Mx
: M0: No distant metastasis. M1: Clinical or radiographic evidence of distant metastasis
What are the three histologic grades of oral SCC according to WHO?
Well-differentiated, Moderately-differentiated, and Poorly-differentiated.
Describe the microscopic features of Well-differentiated SCC
Malignant invading epithelium forming nests surrounded by basement membrane, with abundant epithelial (keratin) pearls
Have the characters of organic
function and shape
Minimal signs of malignancy
Describe the microscopic features of Moderately-differentiated SCC.
Malignant invading cell nest epithelium forming epithelial nests with occasional keratin من حين لأخر
Describe the microscopic features of Poorly-differentiated SCC.
Highly malignant epithelial cells found individually in connective tissue, failing
No keratin
No, cell nests
No, no keratin pearl
Name four variants of squamous cell carcinoma mentioned
- Verrucous carcinoma,
- Spindle cell carcinoma, 3.Nasopharyngeal carcinoma, 4.Adenoid squamous cell carcinoma.
What is Verrucous Carcinoma also known as
What is Verrucous Carcinoma also known as
snuff dipping carcinoma; Ackerman’s tumor)
What are the characteristics of Verrucous Carcinoma.
Sex
Etiology
Metastasis
Low-grade variant of SCC,
Melaاكثر
often associated with snuff/tobacco use,
. Rarely metastasizes but is locally invasive.
Appears as a diffuse painless white lesion with a papillary surface.
It represent 1:10 of squamous cell carcinoma of the oral cavity.
Proliferative Verrucous Leukoplakia
- 80% are spit tobacco users.
-It may develop on the tongue due to chronic pipe
smoking.
What are the microscopic features of Verrucous Carcinoma?
Wide, enlarged exophytic rete ridges forming a papillary surface;
(broad rete processes pushing )into connective tissue; غزو بس مش بقطع ال B.m
hyperparakeratosis pluggings
Minimal degree of dysplasia.
