oral pathology , squamous cell carcinoma SCC take it simple

1. SIMPLIFIED DENTISTRY
Squamous Cell Carcinoma
🙂 Clinical picture
 W.M 3/90  whites , males > , 3% of all cancers , 90% of oral cancers (most common oral cancer)
 Site  skin , bone , vermillion border (90% lower lip) , Intra-Oral (post.lateral of tongue is the most common site)
Central Cause destruction of bone , Moth eaten radiolucent
Peripheral White patch (leukoplakia) , Red patch (erythroplakia) , Mixed (speckled leukoplakia)
Exophytic growth , Endophytic growth (malignant ulcer)
Criteria of Malignant ulcer Differential diagnosis of Malignant ulcer
1. Persistent (> 2 weeks)
2. Induration (hard) , Fixation to the underlying
3. Raised Everted Rolled borders
4. Painless , easily bleeding , may be oozing or crusted
1. Chronic traumatic ulcer
2. Deep fungal ulcer
3. TB. Ulcer
4. Tertiary stage of syphilis
 Metastasis  lymphatic spread (locally to reginol lymph nodes) , blood spread (distant metastasis)
 Clinical evaluation , Clinical estimation , TNM staging system 
T  tumor size M  distant metastasis (blood)
N  regional lymph node metastasis
No lymph metastasis homolateral bilateral contralateral
N 0 < 2-4 < N 3b N 3c
single single multiple N 3a
N 1 N 2a N 2b
TNM stages 
Stage T N M 5 years survival
I 1 0 0 85%
II 2 0 0 66%
III 1 , 2 , 3 0 , 1 0 41%
IV 1, 2 , 3 , 4 0 , 2 , 3 0 , 1 9%
😮 Histopathology
Histopathological evaluation , histopathological estimation , WHO classification
WHO classification Well differentiated Moderate differentiated Poorly differentiated
Surface Epithelium Show signs of dysplasia
Basement Membrane Non intact (invaded)
Shape of
neoplastic cells
Still have the shape of original
prickle cells
Still have the shape of original
prickle cells
(Collected in cell nests
invading C.T)
Undifferentiated , arranged
singly
(loss of cellular adhesion)
Function of
neoplastic cells
Still have the function of original
prickle cells to form keratin :
 Keratin pearl
 Epithelial pearl (central area
of keratin surrounded by
prickle cells)
No Keratin pearl
No Epithelial pearl
No Keratin pearl
No Epithelial pearl
Signs of malignancy Low Moderate High
😍 Treatment  surgical removal , radiotherapy , chemotherapy Prognosis  aac to : - site , TNM stage , Pathology
< 2-4 < < + invades adjacent
T 1 T 2 T 3 T 4
No distant Metastasis M 0
Clinical or Radigraphic evidence M 1