Otolaryngology Book


Oral Squamous Cell Carcinoma

Aka: Oral Squamous Cell Carcinoma, Squamous Cell Carcinoma of the Oral Cavity, Oral Cancer, Oral Malignancy, Oropharyngeal Carcinoma
  1. See Also
    1. Oral Tumor
  2. Epidemiology
    1. Squamous Cell represents 90% of oral cavity tumors
    2. Incidence increases with age
    3. Oral Cancer is 9th most common cancer
      1. Represents 3% of cancers in men
      2. Represents 2% of cancers in women
  3. Risk Factors (account for 75% of cases)
    1. Tobacco Abuse confers 6 fold risk
      1. Smokers represent 90% of Oral Cancer patients
    2. Alcohol Abuse or heavy use
    3. Combined risk of heavy Alcohol and Tobacco use
      1. Women: 100 fold risk of Oral Cancer
      2. Men: 38 fold risk of Oral Cancer
      3. Blot (1988) Cancer Res 48:3282-7 [PubMed]
    4. Other risks
      1. Viral Infection (HSV, HPV)
      2. Sunlight exposure
      3. Poor Dentition
  4. Locations
    1. Lateral Tongue
    2. Floor of mouth
    3. Lower vermilion lip border
    4. Alveolar ridge
  5. Symptoms
    1. Halitosis
    2. Painless Oral Ulcer
    3. Trismus may be present with deep invasion
  6. Signs
    1. Early changes
      1. Erythroplakia
      2. Leukoplakia
      3. Spotted Leukoplakia
    2. Later Changes
      1. Oral Ulcer with raised borders
    3. Spread to submandibular and cervical Lymph Nodes
      1. See Lymphadenopathy of the Head and Neck
      2. Perform complete Oral Examination
  7. Associated Conditions
    1. Adjacent cancer in laryn, esophagus, lungs in 15% cases
  8. Management
    1. Surgical excision
    2. Radiation Therapy
  9. Prognosis
    1. Oral Cancers are advanced by diagnosis in 60% of cases
    2. Five year survival: 50-55%
  10. Prevention
    1. Tobacco Cessation
    2. Alcohol cessation
  11. References
    1. Diaz in Noble (2001) Primary Care Medicine, p. 1757
    2. Alvi (1996) Postgrad Med 99(4):149-56 [PubMed]
    3. Weinberg (2002) Am Fam Physician 65(7):1379-86 [PubMed]

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