The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.for more details please visit  www.indiandentalacademy.com

1. MALIGNANT EPITHELIAL
TUMOURS-1
INDIAN DENTAL ACADEMY
Leader in continuing Dental
Education
www.indiandentalacademy.com

2. LEARNING OBJECTIVES
At the end of the lecture student should be able
to
• Describe etiology, clinical features, treatment
& prognosis of squamous cell carcinoma of lip,
buccal mucosa, floor of mouth, tongue, gingiva,
palate, maxillary sinus.
• Describe histopathology-well &moderately
differentiated sqamous cell carcinoma
www.indiandentalacademy.com

3. Carcinoma of Lip
Etiology
1. Tobacco (Pipe
Smoking)
Heat, Trauma from pipe
stem
2. Sunlight
3. Poor oral hygiene
4. Sharp cusps of teeth
5. Leukoplakia
www.indiandentalacademy.com

4. Clinical features
• Elderly males
• Lower lip > Upper lip
• Begins on vermillion border on one side of the
midline
• Commences as either
– Small area of thickening
– Induration & ulceration
– Irregularity of the surface
• Becomes crater like/ proliferative growth
• Slow to metastatize. Submental & Submaxillary
nodes www.indiandentalacademy.com

5. Treatment & Prognosis
• Surgical excision
• X-Ray radiation
• Success of treatment depends on
- Size of the lesion
- Duration
- Presence of metastatic lymph nodes
- Histologic grade of the tumor
www.indiandentalacademy.com

6. Carcinoma Of Tongue
Etiology
• Syphilis
• Plummer Vinson
syndrome
• Chronic irritation/
Trauma
• Leukoplakia
• Poor oral hygiene
• Use of alcohol/
tobacco www.indiandentalacademy.com

7. Clinical features
• Males more than females
• Painless mass/ ulcer
• Begins as indurated ulcer/ exophytic mass
• Proceed to fungating mass
• Infiltrate deeper layers
• Lateral border/ ventral surface of tongue
www.indiandentalacademy.com

8. •Lesions near base are insidious
•May present as dysphagia, sore throat
•High grade, metastatize early
•Metastasis ipsilateral, contralateral.
www.indiandentalacademy.com

9. Treatment & Prognosis
• Surgery
• Chemotherapy
• Radiation
• Factor affecting prognosis
1. Metastasis
2. Location
3. Duration
www.indiandentalacademy.com

10. Carcinoma Floor of Mouth
Etiology
• Smoking (pipe, cigar)
• Poor hygiene
• Dental irritation
• Leukoplakia
www.indiandentalacademy.com

11. Clinical features
• Indurated painful
ulcer on one side of
the midline
• Anterior area
• Early extension into
lingual mucosa of
mandible, tongue
www.indiandentalacademy.com

12. •Extends into submandibular & sublingual
glands
•Limitation of tongue movements
•Metastasis to submaxillary group of
lymph nodes
www.indiandentalacademy.com

13. Treatment & Prognosis
• Difficult & Unscessful
• Surgery & Radiations
• Recurrence common
• Fair prognosis
www.indiandentalacademy.com

14. Carcinoma Of Buccal mucosa
Etiology
• Commonest carcinoma
• Chewing tobacco/betel nut
• Leukoplakia
• Cheek biting
• Jagged teeth
www.indiandentalacademy.com

15. Clinical features
• Elderly
• Lesions along/inferior
line of occlusion
• Painful ulcer
• Infiltration common
• High metastasis to
submaxillary lymph
nodes.
www.indiandentalacademy.com

16. Treatment & Prognosis
• Surgery
• Radiation
• 50% survival rate over a period of 5 years
www.indiandentalacademy.com

17. Carcinoma Of Gingiva
Etiology
• Chronic irritation
• Inflammation
• Extraction of Tooth
www.indiandentalacademy.com

18. Clinical features
• Mandibular gingiva > Maxillary gingiva
• Ulceration, Erosion or Exophytic growth
• Fixed gingiva > Free gingiva
• Edentulous areas
• Early invasion
www.indiandentalacademy.com

19. • Maxillary carcinomas extend into palate, sinus
• Mandibular carcinomas extend into cheek bone,
floor of the mouth
• Pathologic fractures
• Metastasis common
www.indiandentalacademy.com

20. Treatment & Prognosis
• Surgical
• Radiation
• Poor prognosis
www.indiandentalacademy.com

21. Carcinoma Of Palate
Etiology
• No specific etiology
www.indiandentalacademy.com

22. Clinical features
• Poorly defined, ulcerated, painful lesions
• Crosses midline
• Involves lingual gingiva, tonsillar pillar, uvula
• Metastasis common
www.indiandentalacademy.com

23. Treatment & Prognosis
• Surgery
• Radiation
• Prognosis similar to gingival carcinoma
www.indiandentalacademy.com

24. Carcinoma Of Maxillary Sinus
Etiology
• Extremely dangerous
• Chronic sinusitis not related
• Exact etiology unknown
www.indiandentalacademy.com

25. Clinical features
• Elderly males
• Bulging of alveolar ridge
• Loosening of molars
• Swelling of the face
• Unilateral stuffiness
• Invasion of floor of sinus results in oral features
www.indiandentalacademy.com

26. • Medial wall invasion leads to nasal symptoms
• Superior wall invasion leads to ocular lesions
• Ulceration is delayed feature
• Metastasis to submaxillary & cervical nodes
Treatment & Prognosis
• Surgery
• Radiation
• Poor prognosis
www.indiandentalacademy.com

27. Well diff.SCC
Epithelial
pearl
islands
www.indiandentalacademy.com

28. Small malignant epithelial
islands in connective tissue
Individual cell keratinisation
Moderately
diff. SCC
www.indiandentalacademy.com

29. Summary
• Etiology, clinical features, treatment & prognosis
of squamous cell carcinoma of lip, buccal
mucosa, floor of mouth, tongue, gingiva, palate,
maxillary sinus.
• Histopathology-well &moderately differentiated
sqamous cell carcinoma
www.indiandentalacademy.com

30. BIBLIOGRAPHY
• Shafer’s Text Book of Oral Pathology 5 & 6th
edition
• Oral and maxillofacial pathology Neville, brad w
2nd
edition
• Oral cancer & Precancer J Pindborg 1st
edition
• Lucas’s pathology of tumor’s of the oral tissues
Cawson, R. 5th
edition
• Robbins basic pathology Kumar vinay, 8th
edition
www.indiandentalacademy.com

31. THANK YOU
www.indiandentalacademy.com