Neoplasms

Basal Cell Carcinoma

Squamous Cell Carcinoma

Melanoma

Cancer metastasis to oral cavity

Etiology

Epidemiology

Pathogenesis

Characteristics

Dental implications

Treatment and prognosis

breast, lung, prostate, renal cell, liver, and colorectal cancers have been know to metastasize to the oral cavity

Primary tumor metastasis to the oral cavity is rare, 1-2% of oral cancers

metastasis usually occurs 2-3 years after diagnosis and completion of treatment,metastasis to the mandible is more common, the gingiva followed by the tongue.

poorly defined radiolucent, painful, loosening of the teeth, bone expansion, growth of a soft tisue tumor.

All patients with a history of cancer should be examined for any suspicious lesions

treatment is determined by primary tumor, prognosis is 10% reaching 5 years

Etiology

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Mode of transmission

May be associated with genetic predisposition

Epideemiology

less than 1% of all skin cancers, white men over 40, leading cause of cancer death in women 35-30, 20 times higher in whites than blacks

Pathogenesis

developes in the melanocytes when sun damage occurs

Characteristics

irregular borders, variable colored, dome shaped areas, large flat multicolored macule. mucosal melanomas make up 1% of oral cavity cancers

Dental implications

The clinician should observe all visible pigmented areas using the ABCDE method

Differential diagnosis

Benign nevus, Kaposi sarcoma, Solar lentigo, tattoo, pigmented basal cell carcinoma

Treatment and prognosis

Responsible for the majority of deaths associated with skin cancer. Prognosis depends on characteristics and metastasis. 5 year survival survival rate is 92%

Etiology

UV light, arsenic ingestion, radiation therapy, past burns, genetics, skin disease, injuries. HPV

Mode of transmission

associated with HPV virus

Epidemiology

fair skinned, older, history of sun damage, 2-3 times more frequent in men than women.

Pathogenesis

begins as keratinocytes, can occur in areas effected by actinic keratosis and scar tissue, slow growing,metastasizes in about 2%

Characteristics

painless, non helaling rough, red scaly papule. may itch, becomes crusted and bleeds easily, more dangerous than BCC, metastasizes more rapidly

Dental implications

painless, non healing ulcers should be suspected as ASS and biopsied

Etiology

Mode of transmission

Epidemiology

Pathogenesis

Characteristics

Dental implications

Differential Diagnosis

Actnic keratosis, Keratoacanthoma, Seborrheic keratosis, Squamous cell carcinoma, Malignant melonoma

patient should be referred to the appropriate physician

85% found on the head and neck, papular growth with sessile base then becomes more nodular, center becomes depressed, ulcerated and crusted. painless, can cause deformities if left untreated.

BCC starts in the deep layer of the epidermis in sun exposed areas, enlarges slowly, in rare cases BCC can metastasize.

BCC most common skin cancer, occurs between ages of 50-80

Genetic predisposition in certain syndromes

exposure to UV light, genetic factor, long-term immunosuppression, arsenic ingestion. latency of 20-50 years

Treatment & Prognosis

Surgical excision, laser surgery, cryosurgery, electrodesiccation, radiation therapy

Differential diagnosis

actinic keratosis, Psoriasis, eczema,BCC

Treatment and prognosis

surgical excision, laser surgery, cryosurgery, electrodesiccation, radiation therapy, PDT. 5 year survival rate for localized SCC is 90% or higher