OP11 other oral malignancies Flashcards
(45 cards)
What are the names of malignancies relating to their tissues of origin?
Carcinomas - epithelial cells
Sarcomas - connective, muscle cells
Lymphomas, leukaemias - haemopoietic & immune cells
Nerve system tumours
What are benign:
Gland tumours
Cartilage tumours
Fat tissue tumours
Bone cells
Fibroblastic origin
Smooth muscle
Striated muscle
Gland tumours - adenoma
Cartilage tumours - chondroma
Fat tissue tumours - lipoma
Bone cells - osteoma
Fibroblastic origin - fibroma
Smooth muscle - leiomyma
Striated muscle - rhabdomyoma
What are malignant:
Gland tumours
Cartilage tumours
Fat tissue tumours
Bone cells
Fibroblastic origin
Smooth muscle
Striated muscle
Gland tumours - adenocarcinoma
Cartilage tumours - chondrosarcoma
Fat tissue tumours - liposarcoma
Bone cells - osteosarcoma
Fibroblastic origin - fibrosarcoma
Smooth muscle - leiomyosarcoma
Striated muscle - rhabdomyosarcoma
Tumours/neoplasms can be divided into benign or malignant. What are the properties of benign tumours?
Single mass, slow growth, expansive growth, encapsulated
Tumours/neoplasms can be divided into benign or malignant. What are the properties of malignant tumours?
Rapid growth, no capsule, local infiltration, metastatic potential
Where do tumours most likely metastasise to?
Tissues with rich blood vessels
What special diagnostic methods are there?
o Histochemical stains (melanin, glycogen, fungi)
o Immunocytochemistry (immunofluorescence, PAP, ABC)
o Electron microscopy examination
o Flow cytometry (DNA contents & proliferative activity)
o Computerised image analysis (morphometry)
o Hormone receptor analysis
o Cytogenetic analysis (chromosomal abnormalities)
o DNA-based techniques (virological diagnosis, oncogen amplification)
Why is immunohistochemistry a useful technique to determine the type of cancer?
Shows where the cancer started, the type of cell it started in, whether its likely to grow slowly or quickly, helping which treatment to choose
What things are immunohistochemical markers?
Structural antigens eg keratins, vimentin, desmin, neurofilaments, collagens
Functional antigens eg immunoglobulins, lysosymes, hormones
Viral antigens eg HPV
Cell lineage antigens
General cancer markers eg proliferation markers, oncogenes, tumour suppressor, immune checkpoint
Where are basal cell carcinomas found?
Most common skin neoplasm (not oral mucosa)
What is basal cell carcinoma associated with? (2 things)
Long UV light exposure (environmental)
Basal Cell Naevus and the Bazex syndromes (genetic)
Describe basal cell carcinomas
Slow growing nodules that eventually ulcerate at the centre (rodent ulcer)
Do not tend to metastasise
What is the histology of BCC?
Cells resemble epithelial basal cells
Scanty cytoplasm
No evident cellular bridges
What is Basal Cell Naevus syndrome or Gorlin-Goltz syndrome caused by?
Autosominal dominant disease with mutation in the PTCH gene in chromosome 9
What things present in BCN syndrome/GG syndrome?
Multiple odontogenic keratocysts
Multiple BCC’s of the skin
Skeletal abnormalities
Calcium and phosphate metabolism abnormalities
Other abnormalities: palmar pits, ovarian fibromas, medulloblastoma
What is the biggest cause of malignant melanoma?
UV radiation
Where does malignant melanoma originate from?
Melanocytes
What are the different types of malignant melanoma?
o Superficial spreading melanoma:
Most common ~70%, radial growth, brown, tan, black on sun exposed skin
o Nodular melanoma:
~13%, vertical growth, pink or black, back of the head, neck skin
o Lentigo malignant melanoma:
~10%, Hutchinson’s melanotic freckle
Elderly people, sun exposed skin, flat moles, slow growing
o Acral lentiginous (palms, soles, nailbeds, oral mucosa)
Describe oral malignant melanoma
Rare in mouth
Poor prognosis
Usually posterior maxillary alveolar ridge, palate and hard palate, dark brown to bluish/black lesions
Deeply pigmented lesions, ulcerated or haemorrhagic, uneven nodular surface, progressively increasing in size
What are the differentials for oral malignant melanoma?
Addison disease, Blue nevi, Ephelides (freckles), Kaposi sarcoma, oral nevi
What is treatment for oral malignant melanoma?
Radical surgery including block removal of portions of the jaws, lymphadenectomy
What cells of origin are malignant lymphomas from?
Cells of the lymphoreticular system
What types of malignant lymphoma are there?
Nodal or extra-nodal
Hodgkins or Non-hodgkins
Burkitts, lethal midline granuloma
Are malignant lymphomas common in the head and neck?
Uncommon in head and neck region
Either part of disseminated disease or primary lesions (cervical lymph nodes or lymphoid structures of Waldeyer’s ring)
