NEOPLASMS
Skin Cancers
Nonmelanoma Cancers
Basal Cell Carcinoma (BCC)
Squamous Cell Carcinoma (SCC)
Etiology: risk factors include exposure to ultraviolet light, genetic factors, long-term immunosuppressive, and arsenic ingestion
Method of Transmission: genetic predisposition as seen in several syndromes, such as nervous basal cell carcinoma syndrome (may be transmitted to offspring)
Characteristics: 85% found in the head and neck with most on the face, presents as a popular growth with a sessile base early, borders of lesions are raised and exhibit a pearly appearance, may be pigmented and resemble a nevus or may have a flat scar-like appearance, lesions are painless
Dental Implications: Pt should be referred to an appropriate physician for evaluation
Treatment/Prognosis: surgical excision, laser surgery, cryosurgery (freezing w/ liquid nitrogen), electrodesiccation (burning), and radiation therapy; Pt’s who have had one skin cancer have a 50% chance of developing another BCC at a different site within 5 years
Citation: pg. 99-100 Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.
Etiology: risk factors include ultraviolet light, arsenic ingestion, radiation therapy, areas that were previously burned, genetics, and skin diseases or injuries that cause scarring; HPV has been associated with SCC in the head and neck region
Method of Transmission: NOT transmissible, unless associated with HPV after infection of the virus
Characteristics: develops in a preexisting actinic keratosis, painless, non healing, rough, erythema, scaly papule, may cause pruritus or itching, lesion enlarges as it becomes indurated, surface eventually becomes ulcerated and crusted and bleeds easily, any non healing lesion should be biopsies and identified
Dental Implications: painless lesions, nonnhealing ulcers should be suspected as being SCC and should be biopsied
Treatment/Prognosis: surgical excision, laser surgery, cryosurgery (freezing w/ liquid nitrogen), electrodesiccation (burning), radiation therapy, and PDT, Pt should be monitored for new lesions on an annual basis
Citation: pg. 100-01 Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.
Melanoma
Etiology: risk factors include artificial tanning, Neville/moles, immunosuppressive, personal history of skin cancer, familial history of melanoma, ultraviolet radiation, sun exposure and previous sunburns, and individual characteristics
Method of Transmission: slight genetic predisposition
Characteristics: mimic characteristics of benign pigmented lesions such as the nevus, variably colored with a slightly raised irregular border (radial phase), exhibits modular appearance and forms raised; variably colored; with dome-shaped areas within the original lesion (vertical phase), lentil maligna melanoma develops within sun-exposed skin; grows slowly; large; flat; multicolored macula
Dental Implications: clinician should observe all visible pigmented areas using the ABCDE method and refer any suspicious areas for evaluation
Treatment/Prognosis: prognosis depends on the thickness of the original/primary lesion and whether there has been metastasis to regional lymph nodes or distant metastasis, the thinner and more localized the tumor then the higher chances of a complete cure
Citation: pg. 101-05 Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer
Cancer Metastasis to the Oral Cavity
Etiology: cancer cells from any type of primary tumor may metastasize to the oral cavity (breast, lung, prostate, renal cell, liver, and colorectal cancers reported more frequent)
Method of Transmission: N/A
Characteristics: lesions of the jaw bones can presents as poorly defined radiolucent, pain, loosening of teeth, bone expansion, growth of a soft tissue tumor, numbness of the lip or other soft tissue
Dental Implications: Pt’s who present with a history of cancer should always be examined for any suspicious areas in the oral cavity or on any periodic radiographic surveys
Treatment/Prognosis: determined by the type of primary tumor and the extent of metastasis, prognosis is very poor
Citation: pg. 106 Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.