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The Head and Neck
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
The mucosa can be the site of two lesions that can be precancerous or early cancer. Such lesions require special attention for their diagnosis and management that differ from the well-established tumors that will be discussed under each anatomic site: Leukoplakia—While small lesions can be excised, extensive lesions can be observed and biopsied. 13-ds-Retinoic acid lozenges are being tried in the management of such patients.12Erythroplakia — This red velvety mucosal lesion must be considered carcinoma until proven otherwise. This lesion is usually in situ or early invasive squamous cell carcinoma. Therefore, it should not only be biopsied, but should be completely excised with few millimeters of margin and histologically examined for invasion and free margins.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Assess the size (T status) and site including fixity to tongue, mandible and floor of mouth (FOM), as well as the presence of any trismus and the patient’s dental status. Some patients may have had preceding erythroplakia/leukoplakia. Some countries, e.g. India, have trialled screening (visual inspection in high-risk populations) that may allow earlier detection (Subramanian S, Bull World Health Organ, 2009), but there is no standard routine screening test for oral cancer in most of the world.
Oral cavity malignancy
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Occurring less frequently than leucoplakia (0.02-0.5% in Asian population), erythroplakia is defined as a lesion of the oral mucosa that presents as a bright red velvety plaque that cannot be characterised clinically or pathologically as any other recognisable condition. The lesions may be irregular in outline and distinct from adjacent normal mucosa (Figure48.3). The surfaces may be nodular or broadly atrophic in nature and frequently display contact bleeding. These lesions can coexist with leucoplakia. The risk of malignancy (or in-situ change) within erythroplakia is high and therefore biopsy is essential, after which surgical ablation is frequently necessary.
Oral Potentially Malignant Disorders (OPMD): What is the clinical utility of dysplasia grade?
Published in Expert Review of Molecular Diagnostics, 2021
Kenneth P. H. Pritzker, Mark R. Darling, Jason T-K Hwang, David Mock
OSCC often, but not always, supervenes on a macroscopically visible, mucosal lesion of long duration. The lesions of concern can present as a white lesion, leukoplakia [18] or much less commonly, a red lesion, erythroplakia [19–21]. While some white mucosal lesions have a specificity sufficient to be excluded from leukoplakia, oral leukoplakia is quite common, with a global prevalence of 2–3% [22,23]. Leukoplakia continues to represent evolving definitions and diverse biology, making clinical management challenging [24]. OPMDs encompass a wide spectrum of lesions [25] which can be presented as white or red mucosal patches or a mixture [25–27]. Oral lesions classified by the World Health Organization (WHO) as OMPDs include leukoplakia, erythroleukoplakia, erythroplakia, oral submucous fibrosis, dyskeratosis congenita, smokeless tobacco keratosis, palatal lesions associated with reverse smoking, chronic hyperplastic candidiasis, oral lichen planus (OLP), discoid lupus erythematosus, syphilitic glossitis, and actinic keratosis [23,28]. Others referenced elsewhere include oral lichenoid lesions (OLL) [16,29,30], exophytic verrucous hyperplasia, and proliferative verrucous leukoplakia [23,30], oral lesions of graft vs host disease [16,31], oral epidermolysis bullosa [16] and hyperkeratosis of unknown significance [16,25,26,32,33].
Genotoxicity of yellow shammah (smokeless tobacco) in murine bone marrow cells in vivo
Published in Drug and Chemical Toxicology, 2021
Saeed Alshahrani, Pankaj Tripathi, Hassan A. Alhazmi, Syed Mamoon Hussain, Abdul Hakeem Siddiqui, Waquar Ahsan, Mohammad Al Bratty
Shammah is an addictive substance associated with a plethora of deleterious health issues, including cancer and cardiovascular diseases. These hazardous effects are attributed to the presence of harmful chemicals such as polyaromatic hydrocarbons, specifically nitrosamines and heavy metals, which have long been associated with risk of different types of cancers (Pappas et al. 2006). ST has already been reported to be linked with oral cancer, hypertension, heart diseases and various other life threatening ailments (WHO 2011, Anand and Illias 2017). Cancer caused by chewing ST usually begins as leukoplakia or erythroplakia. Erythroplakia is generally more severe than leukoplakia and over a period of time, it has greater chances of becoming cancerous (Priscillla and Joel 2000, Gupta et al. 2012). Bagchi et al. (1996) reported that the administration of aqueous extract of ST to rats not only induced hepatic mitochondrial and microsomal lipid peroxidation, but also increased the incidence of hepatic nuclear DNA single-strand breaks. Furthermore, impairment of the sperm head morphology, decreased total sperm count and various oxidative stress induced genotoxicity and germ cell toxicity were observed in animals treated with ST (Das et al. 2016). Adverse reproductive effects including stillbirth, premature birth and low birth weight were also reported to be caused by ST (Abdulsallam 2017).
Epidemiological Assessment of Oral Cancer Burden in Pakistan
Published in Cancer Investigation, 2021
Naila Malkani, Sara Kazmi, Muhammad Usman Rashid
Oral precancerous lesions are also major risk factors for oral cancer. The dental cysts and lesions in the mouth for a longer period can lead to the formation of cancer. Similarly, precancerous lesions like erythroplakia or leukoplakia can potentially develop into oral cancer. The causes for these lesions development include poor dental hygiene, chewing tobacco, and low-quality dental procedures (71). In Pakistan, the maintenance of proper oral health is a challenge because of the high cost, lack of awareness on the importance of oral hygiene, and unavailability of health insurance. The improper handling of oral or dental disease can lead to the development of cysts and lesions which if not treated properly can cause oral cancer.