The Head and Neck
E. George Elias in 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.
The gastrointestinal system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Oral potentially malignant disorders are mucosal lesions that have a potential risk of developing into oral cancer. Examples include lichen planus, oral submucous fibrosis, chronic hyperplastic candidosis, leukoplakia, and erythroplakia. Leukoplakia (Figure 10.10) is a clinically descriptive term for a white patch that cannot be scraped off or attributed to any specific disease clinically or histologically. Erythroplakia is the analogous term for a red patch and speckled leukoplakia refers to similar lesions with white and red areas. These are not pathological entities and cover a variety of histological changes. On biopsy, a small proportion of leukoplakias, and many erythroplakias and speckled leukoplakias, show dysplastic premalignant changes. Generally the more severe the dysplasia, the greater is the likelihood of progression to carcinoma. Erythroplakias and speckled leukoplakias have a much greater incidence of severe dysplasia and are frequently early invasive malignancies at first biopsy.
Oral Cavity Cancer
Dongyou Liu in Tumors and Cancers, 2017
Clinical signs of oral cavity cancer range from (i) a sore (or a granular ulcer with fissuring or raised exophytic margins) on the lips or in the mouth that persists for 3 weeks or longer; (ii) a lump or thickening with abnormal supplying blood vessels on the lips, gums, mouth, or neck; (iii) a white or red patch (erythroplakia, leukoplakia, speckled leukoplakia, or verrucous leukoplakia) on the gums, tongue, or lining of the mouth; (iv) bleeding, pain, or numbness in the lips, mouth, chin, or cheek; (v) change in voice; (vi) loose teeth or dentures; (vii) trouble chewing or swallowing or moving the tongue or jaw; (viii) swelling of jaw; (ix) sore throat or a feeling that something is caught in the throat; to (x) weight loss.
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.
Related Knowledge Centers
- Carcinoma In Situ
- Dysplasia
- Glans Penis
- Leukoplakia
- Mouth
- Mucous Membrane
- Pathology
- Larynx
- Erythema
- Squamous-Cell Carcinoma