ORAL CANCER

TUMOR BENIGN
(NEOPLASM)





MALIGNANT
EPI-CARCINOMA
C.T-SARCOMA


CARCINOMA-malignant neoplasm of
epithelial origin
- uncontrolled proliferation of cells
-non encapsulated
Metastasis
90% of oral cancers are squamous cell
carcinomas
DEF-a malignant epithelal neoplasn
exhibiting squamous differentiation and
characterised by formation of keratin



ETIOLOGY
CLINICAL FEATURES
symptoms
a sore in the mouth that does not heal (most common
symptom)
a lump or thickening in the cheek
a white or red patch
chewing or swallowing
difficulty moving the jaw or tongue
numbness of the tongue or other area of the mouth
Foul odour
Bleeding .loose tooth
loosening of the teeth or pain around the teeth or jaw
lump or mass in the neck
Clinical features

CLINICAL PRESENTATION
Exophytic mass-forming; fungating, papillary,
verruciform
Endophytic (invasive, burrowing, ulcerated)
depressed, irregularly shaped ulcer with "rolled" border
Leukoplakic (white patch)
Erythroplakic (red patch)
Erythroleukoplakic (combined red-and-white
EARLY CARCINOMA

stony hard, non tender, and enlarged
the malignant cells have perforated the
capsule of the node and invaded into
surrounding tissues, the node will feel
"fixed," or not easily movable.
radiograph
Radiolucency with irregular ragged margins
Floating teeth
Moth eaten appearance
Pathological fracture



STAGE TNM CLASSIFICATION

Stage I - T1 NO MO

Stage II - T2 NO MO

Stage III - T3 NO MO, or
T1, T2, or T3, N1 MO

Stage IV - Any T4 lesion, or
Any N2 or N3 lesion, or
Any Ml lesion


Investigations
Toulidine blue
BIOPSY-brush. punch, insicional

FNAC
Radiographs ,CT , MRI
Bone scan


INVESTIGATIONS

Toulidine Blue
DYSPLASTIC FEATURES

Histopath
HISTOPATHOLOGY

Broaders grading

Used to stage cancer histologically
Degree of differentiation of tumor cells is
found
1.Well diffferentiated
2.Moderately
3.poorly
Radiotherapy
Treatment using ionizing radiation
MOA-Radiation kills the cells by
interaction with water molecules in the cell
producing charged molecules. This disrupts
the biochemical process in the cell and
damages the DNA causing cell death
2 TYPES


1.TELETHERAPY-


A MACHINE IS USED TO
DIRECT BEAMS OF
RADIATION AT THE
TUMOR FROM OUTSIDE
PATIENT.
Electromagnetic radiation
high energy X rays or gamma rays
1MeV to 25MeV(super voltage radiation)
Source is from telecobalt machine or linear
accelerator
50 to 60 grays
Fractionised that is total dose is broken
down
2 gray per day for 5 weeks

2.BRACHYTHERAPY-
THE RN SOURCE
IS PLACED CLOSE
OR WITHIN
TUMOR-radio active
isotope
Interstitial implants
Surface moulds
Side effects

Radiation mucositis
Osteoradionecrosis
Xerostomia
Radiation caries
Candidiasis
Fibrosis

Surgery-
resection, radical neck dissection


ssssss
CHEMOTHERPAY

METHOTREXATE
CISPLASTIN
VINCRISTINE

Anemia
Ulceration
Alopecia