Precancerous and malignant tumours of the oral cavity

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Leukoplakia and erythroplakia

Leukoplakia is an unbrushable white lesion, while the erythoplakias are fiery red. They are associated with increased risk of cancer and have normally no symptoms. The risk factors for leuko- and erythroplakias are smoking, chewing tobacco and excessive alcohol intake.

The risks of progression into invasive squamous cell carcinoma is 3-25% with leukoplakia, and more than 50% with erythroplakia. It's important to distinguish them from benign oral lesions like oral candidiasis.

Squamous cell carcinoma

90% of oral cancers are squamous cell carcinomas. It counts for 3-4% of all malignant tumors and affects mainly men. The risk factors for squamous cell carcinoma are smoking, alcohol and HPV16. The HPV-associated type affects younger patients that have no history with smoking or drinking alcohol, but they also have a better prognosis than the non-HPV-associated type.

The most frequent locations are lower lip, base of mouth or the both sides of the tongue. It spreads to the lymph nodes in the neck, mediastinum and retropharyngeal lymph nodes, and to the liver, lung and bones with hematogenic spread.

If detected early, the 5-year survival chances are 80%, but if the tumor is advanced, the chances are only 20%. So, it’s an aggressive tumor.

The complications from this are

  • Cachexia
  • Arrosion bleedings
  • Aspiration pneumonia