Glossary of Oral Path CUdental squamous cell carcinoma

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T/F An ulcer is defined as the full thickness loss of epithelial covering; elevated margins often appear with acute ulcers.
T, F elevated margins=chronic
SCCA comprise _____% of all oral cancers.
SCCA is caused by loss of cell cycle control due to the activation of _____ and inactivation of ________ genes resulting in increased proliferation and decreased apoptosis. Increased angiogenesis and degredation of basement membrane lead to ________ and
oncogenes, tumor suppressor, metastesis
SCCA incidence is_____ cases/year. ___% die from their disease.
31,000, 25-30
List from most to least risk for SCCA: alcohol, reverse smoking, smokeless tobacco, cigar/pipe, cigarette
reverse smoking > cigar/pipe > cigarette > smokeless tobacco > alcohol (additive effect)
Smokers increase their risk of SCCA __X while heavey smoking and alcohol consumption increased the risk __X.
10, 40
Other SCCA risk factors include UV light (SCCA lower lip), _________ syndromes (Plummer-Vinson), DNA repair deficiency syndromes, HPV, candidiasis, chronic irritation and male : female ratio is _:_.
iron deficiency, 3:1 (high in African Americans)
EBV and HIV are risk factors for SCCA? T/F
False, for lymphomas
The ____________ is the most common intraoral site for SCCA which can manifest themselves as red, white, mixed or ulcerated aggressive lesions capable of metastasis to regioinal ______ ______.
lateral tongue, lymph nodes
The ____________ is the 2nd most common intraoral site for SCCA causing painless non-healing ulcers.
floor of the mouth (especially w/ smoking/drinking Hx)
Which is not an area where SCCA is normally found: buccal mucosa, gingiva, hard palate, lower lip, soft palate.
hard palate (usually adenocarcinoma)
SCCA of the gingiva can resemble localized ___________.
periodontal disease
SCCA of the lower lip is more common in males than females and is caused mainly by ______ and ______.
sun exposure, pipe smoking
T/F Usually there is an epithelial change evident due to SCCA?
Considering all the following possibilities, which clinical presentation of SCCA is most uncommon: non-healing ulcer, exophytic mass, red, white, mixed red/white, verrucopapillary mass, submucosal/intraosseous mass.
submucosal/intraosseous mass
Which is not a warning sign for SCCA: persistant lesions with no obvious cause, isolated perio defects, tingling / numbness, unexplained cervical lymphadenopathy, dysphonia, dysphagia, dyspnea.
dyspnea in not a warning sign. Tingling/numb, lesions w/o cause are most important
T/F Histologic grading is the most important parameter for the prognosis and treatment planning of SCCA.
False, Clinical staging is most important
Staging is used to identify the extent of the disease before treatment and is based on the TNM system which stands for _____________.
Tumor size, Nodal involvement, Metastesis.
Tumors can be spread by all the following except: local extension, lymphatic spread, hematogenous spread.
all are true
T/F Posterior tumors are more prone to early metastesis.
If a lymph node is ______ to tissue, it implies that the cancer has perforated the capsule of the lymph node resulting in a bad prognostic indicator.
fixed (along with enlarged, hard and non-tender)
T/F Improvement in early stage detection of SCCA has improved in the last 25 years.
Treatment for SCCA includes ______, the primary modality, radiation and chemo.
External beam radiation treatment typically last ___ weeks 5 days/week using 5000 cGy to the tumor. Other forms of radiation include hyperfractional therapy (2 times/day), IMRT (intensity-modulated radiotherapy - spares normal tissue) and __________ (rad
5 to 6, brachytherapy
Pretreatment planes for SCCA include all the following except: indicated extractions (esp. mandibular), alveoloplasty, 14-21 day healing time prior to radiation, complete restorations, impressions for fluoride carriers, daily fluoride for 6 weeks, jaw ex
daily fluoride should be administered for life to avoid radiation caries
Which is not a short term side effect of head and neck radiation therapy: mucositis, loss of taste, pain, radiation dermatitis, xerostomia, redness, hypersensitivity.
xerostomia is a long term side effect
Time frame for head and neck radiation: 1-2 weeks ____________, 3 weeks ___________, 4-5 weeks __________.
loss of taste + thick saliva, mucositis of pharynx, mucositis of buccal mucosa and tongue
All are long term effects fo head and neck radiation except: xerostomia, radiation caries, dysphagia, bone changes, trismus, hyperpigmentation of skin, altered development of jaw/teeth in young patients, carotid atheromas.
all are true
______________ occurs more frequently in the mandible when radiation exceeds 6500 cGy causing avascular necrosis.
Radiation osteonecrosis
Treatment for osteoradionecrosis includes surgical removal of bone and ________.
hyperbaric O2
The five year survival rate for SCCA on the lower lip is __% while the tongue is __%.
94, 48
Reasons for poor prognosis of oral SCCA are: late diagnosis, difficult anatomy and _____________, which describes the concept of the remaining tissue surrounding the SCCA had already undergone some genetic change and is more prone to developing additiona
field cancerization
Clinical signs of maxillary sinus SCCA include: dull ache, referred pain to teeth, failure of an extraction site to heal, palatal ulcer and most importantly ________.

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