Squamous cell carcinoma

Definition
Etiology
Clinical Features
The metastasis
Histopathology
Treatment

1. Oral Squamous Cell Carcinoma Ahmed A. Abdulwahab Al- dawoodi UG: 1330095

2. Definition It is a Malignant neoplasm of stratified squamous epithelium in the oral cavity Capable of local destructive growth and distant metastasis Characterized by the formation of keratin and/or the presence of intercellular bridges . The eleventh most common cancer worldwide (Indian subcontinent, Australia, France, Brazil, and southern Africa) Approximately 94% of all oral malignancies. White men - after 65 years

3. Etiology Multifactorial No single causative agent or factor has been clearly defined or accepted More than a single factor is needed to produce such a malignancy Oral Squamous Cell Carcinoma Extrinsic Factors Tobacco Smoke Alcohol (for vermilion cancers only) Sunlight Smokeless Tobacco Betel Quid ( Paan ) Alcohol Occupational Exposures & Pollutants Radiation Intrinsic Factors Systemic or generalized states Malnutrition Iron-deficiency Anemia Dyskeratosis Congenita Vitamin/Mineral Deficiencies Bacteria Candida Oncogenic Viruses Immunosuppression

4. Mostly older men Minimal pain during the early growth phase Clinical presentation : Exophytic Endophytic Leukoplakic Erythroplakic Erythroleukoplakic Clinical Features

5. Clinical Features An exophytic lesion - surface that is irregular , fungating , papillary , or verruciform. color is normal to white or red Surface is often ulcerated Feels hard (indurated) on palpation An Endophytic growth pattern - central , depressed , irregularly shaped ulcer with a surrounding “rolled” border of pink, red, or white mucosa. Destruction of underlying bone, when present, may be painful or completely painless

6. Clinical Features Leukoplakic (white patch) Erythroplakic (red patch) Erythroleukoplakic (combined red-and-white patch) The leukoplakic and erythroplakic examples are probably early cases that have not yet produced a mass or ulceration.

7. The metastasis Ipsilateral cervical lymph nodes Occasionally, contralateral or bilateral metastatic deposits are seen. 2% of patients have distant metastasis at diagnosis. Most common sites of distant metastasis are the lungs, liver, and bones .

8. Squamous cell carcinoma arises from dysplastic surface epithelium Invasive islands and cords of malignant squamous epithelial cells Invasion is represented by irregular extension of lesional epithelium through the basement membrane and into subepithelial connective tissue. Histopathology

9. Treatment The clinical stage of the disease guides the treatment . Wide (radical) surgical excision Radiation therapy Chemotherapy A combination of surgery, radiation and chemotherapy. Radical or modified radical neck dissection The prognosis Survival from oral cancer depends on tumor stage The 5-year relative survival rate is 53% to 68% Small lesions Large lesions

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