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