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Tumours of the OralCavity

Agung Dinasti P. dr.,Sp.THT-KL.,M.Kes

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Introduction

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Introduction

Oral Cancer is the sixth leadingcause o cancer !orld!ide

 The sur"i"al rate !as #$%. To&acco and alcohol are s'nergistice(ect

 Treat)ent o earl' oral cancer is

surger'. Locall' ad"anced T*+ are&est treated !ith co)&ined surger'and adiotherap'.

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EPIDEMIOLOGY 

 The incidence o oral cancer "aries throughoutthe !orld.High incidence in ndia, /rance, S0 Asia..

ndonesia 1 2% o H3 cancer Age onset #2 'rs. Sex ratio *45

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EPIDEMIOLOGY 

tongue *$ %

6oor o )outh *2 %

&uccal )ucosa 5# %

gingi"a 5$ %

hard palate 7 %

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Anatomy of Oral Cavity

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Anatomy of Oral CavityLymphatic drainae

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Anatomy of Oral CavityLymphatic drainae

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!is" factors

Hea"' to&accoAlcohol.

S'philis8iruses 90:, HS8, HP8, H8;3eglect o oral dental h'giene9chronic

inection, un

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P!ECA#CE!O$%LE%IO#%

Leu"opla"ia >hite pla?ue 0+ 4 to&acco use, repeated trau)a Micros  H'per@eratosis d'splasiaErytroplasia ed pla?ue =reater ris@ o )alignanc'

 All !hite red )ucosal lesions  &iopsy or)icroscope e"aluation

 Treat)ent 4  To&acco cessation topical &leo)'cin in di)eth'l suloxide 9DMSO; etinoids 4 Cis-retinoic acids 0xcision+a&lation

52

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Leu"opla"ia

De'nition( a !hitish patch orpla?ue that cannot &e characteriBed

clinicall' or pathologicall' as an'other disease.

&et!een #% and $#% o theselesions are pre)alignant

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)omoeneousLeu"opla"ia

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*errucous or #odularLeu"opla"ia

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Carcinoma+leu"opla"iaappearin,

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Erythropla"ia+Erythroplasia,

a red and oten "el"et' lesion, !hich,unli@e leu@opla@ias, does not or) apla?ue &ut is le"el !ith or depressed

&elo! the surrounding )ucosa. ed oral lesions usuall' are )ore

dangerous than !hite oral lesions. Carcino)as are seen 5 ti)es )ore

re?uentl' in er'thropla@ias than inleu@opla@ias, &ut leu@opla@ias are ar)ore co))on

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Erythropla"ia

#-72% carcino)a or carcino)a insitu or sho! se"ere d'splasia.

0r'throplasia a(ects patients oeither sex in their sixth and se"enthdecades and t'picall' in"ol"es the6oor o the )outh, the "entru) othe tongue, or the sot palate.

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Erythropla"ia

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Erythropla"ia

Reference: Kumar: Robbins and Cotran: Pathologic Basis of Disease, 7th ed.,

Copyright © 2005 Saunders

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Erythroleu"opla"ia

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Oral )airy Leu"opla"ia

>hittish corrugated thic@ening o)ucosa on lateral tongue &order

Occurs al)ost exclusi"el' in H8-inected patients Pro&a&ilit' o de"eloping ADS is #2% at

5 )onths and E2% at *2 )onths in

patients !ith hair' leu@opla@ia0:8 present in tissue

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Oral )airy Leu"opla"ia

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Oral Cancer-Progression

Reference: Kumar: Robbins and Cotran: Pathologic Basis of Disease, 7th ed.,

Copyright © 2005 Saunders, An Imprint of Elsevier 

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%.uamous cell carcinoma oflip

Gross(  Flcerated nodule !ith

raised e"erted edges  Oten on lo!er lip

)istoloically(  >ell di(erentiated

s?ua)ouscarcino)as

%pread(  =ro!th is relati"el'

slo!  Su&)andi&ular nodes  Deeper cer"ical

l')ph nodes

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%.uamous cell carcinoma ofTonue / 0loor of the mouth

More aressive than tu)ors o the lipsGrossly starts as a nodule G )alignant

ulcer

%pread(1-LocalLocal in

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%.uamous Cell carcinoma ofthe Tonue

Peror) incisional :x in an' oral lesion persist or )ore than$!@s

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$ncommon Malinant Tumorsof The Oral Cavity

Malinant

melanomaLymphomasLeu"emic

in'ltration

Adenocarcinomaof minorsalivary lands

%arcomas

Acute Leu@e)ia4 gu) in"ol"e)ent

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E4amination

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$E

%tain

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%tain

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Manage)ent

PO=3OSTC /ACTO Stage o lesion SiBe o lesion 0xtent o nodal disease Tu)or thic@ness Depth o penetration Perinural in"asion intral')phatic in"asio

8ascular in"asion H'stopthologic

*2

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 Surger' nec@ dissectionadiation therap'Che)oherap'Co)&ination

*5

Manage)ent

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!adiation Treatment

Ad"antage a &etter unctional result!ith superior speech and s!allo!ing

disad"antages di)inution o taste,

xerosto)ia and protracted nature o thetreat)ent course. Curati"e dosage o radiotherap'  at

least !ee@s o treat)ent  a(ect thetreat)ent choice.

Co)plications

 associated !ith thosetreated !ith interstitial and external &ea)irradiation.

*$

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Stage and stage 8 disease a co)&ination o radiation therap' and

surger' pro"ides a &etter chance orcure or than does either )odalit' alone.

addition o che)otherap' 4▪ Contro"ersies

▪ the onl' Iusti

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%ummary

0arl' diagnosis o oral cancer cana(ect prognosis

Precancerous lesion should &enoticed and treated opti)all'Pre"ention is the @e' to a"oid oral

cancer 

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T)A#5 YO$