Etiology – idiopathic (unknown). Risk factors include: tobacco use, alcohol use, sun radiation, genetic predisposition, nutritional deficiency, immunosuppression, and infections, such as candidal leukoplakia and human papillomavirus.
Typical Visual Cues – a deep-seated ulcerated mass, fungating ulcerated mass, ulcer margins commonly elevated, adjacent tissues commonly firm to palpation, and may have residual leukoplakia and/or erythroplakia.
Useful Clinical Information – more common in adult males, continuous enlargement, local pain, referred pain often to the ear, and paresthesia often of the lower lip.
Treatment Recommendations – patient should be counseled to stop tobacco use and given a referral to a local medical treatment facility for appropriate treatment (surgery, radiation therapy, chemotherapy), and a careful periodic re-evaluation.
Clinical Significance – early diagnosis is essential for cure, presence of lymph node metastasis greatly worsens the prognosis, approximately 50% of patients have evidence of lymph node metastasis at time of diagnosis (that is why the extraoral examination is so critical at the time of each intraoral examination), and patients who have had one cancer are at greater risk of having a second oral cancer.
|Squamous Cell Carcinoma
|Image courtesy of Associated Content