Apr 28, 2020 premalignant and malignant lesions of oral cavity notes edurev is made by best teachers of. Oral cavity anatomical and physiological specificities. Management of premalignant disease of the oral mucosa. Pindborg department of oral and maxillofaeial surgery and oral medicine, university hospital and departments of oral pathology and. Its defined as a clinical term for a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Early evaluation of oral precancerous lesions can have dramatic effect on oral cancer mortality rate. Premalignant or precancerous also referred to as potentially malignant oral lesions involve the skin lining of the mouth known as the epithelium and may be at risk for becoming transforming into an oral cancer, although it is difficult to predict which lesions will transform and how long it will take see below. The efficacy of oral brush biopsy with computerassisted analysis in identifying precancerous and cancerous lesions ravi mehrotra1, sanjay mishra1, mamta singh1 and mangal singh2 abstract background. Oral white and red lesions leukoplakia, erythroplakia and erythroleukoplakia is considered a premalignant lesion, even though risk of malignant change is small. Oral leukoplakia, a precancerous lesion of squamous cell.
Oral lesions appear as areas of opacification with loss of elasticity. A morphologically altered tissue in which cancer is more likely to occur than in its apparently normal counterpart who 1978. They have a potential for malignant transformation. The detection of oral pre malignant lesions with an. Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Precancerous lesions of oral mucosa pubmed central pmc. Oral lesions that have been identified clinically as having potential for malignant conversion include leukoplakia a predominantly white lesion. Oral leukoplakia occurs as a white patch or plaque of questionable risk that cannot be characterized clinically or pathologically as any other known disease. Dentists look for abnormal changes that are loosely called lesions.
Betel nut chewing, oral premalignant lesions, and the oral. Metformin hydrochloride in preventing oral cancer in. Precancerous conditions and lesions affect a variety of organ systems, including the skin, oral cavity, stomach, colon, and hematological system. Download precancerous lesions of the gynecologic tract pdf. The efficacy of oral brush biopsy with computerassisted. Premalignant lesions clinical medicine diseases and. Precancerous lesions of oral mucosa are the diseases that have. They reported that the overall sensitivity of methylene blue uptake in cases with suspected lesions was 90%, specificity 69%, and accuracy 79%. Pathologists are required to recognize precursor lesions based on morphology or genetic analysis and to speculate on the premalignant potential of such lesions.
Leukoplakia and erythroplakia premalignant squamous. The health professional can usually identify them by patient history and clinical xamination. Ppt premalignant oral lesions powerpoint presentation. The incidence of oral cancer worldwide varies 218% and in india 0. White lesions such as linea alba, leukoedema, and frictional keratosis are common in the oral cavity but have no propensity for malignant transformation. An oral premalignant lesion opl is an area of morphologically or genetically altered tissue that is more likely than normal tissue to develop cancer. Terms commonly used to describe oral lesions fixed a lesion that is nonmobile and firmly attached to the underlying structures mobile a movable lesion that does not appear to be connected to underlying structures indurated hard and firm tissue palpation that would normally be soft exophytic a lesion that appears to be growing outward from the mucosa. An early diagnosis of oral cavity is very important both the timely and effective treatment, which can eventually affect the progress. In the united states, cancers of the oral cavity and oropharynx represent. Oral carcinogenesis proceeds through a stepwise accumulation of genetic damage over time. Premalignant conditions of oral cavity candidiasis.
Lesion of mucosa similar to lichen planus due to drugs lichenoid dermatitis. Premalignant conditions of oral cavity free download as powerpoint presentation. Premalignant oral lesions ontario dental association. Oral leukoplakia should be confirmed by mucosal biopsy. Metformin hydrochloride may help prevent oral cancer from forming in patients with an oral premalignant lesion. It is the most common premalignant lesion and the most studied pmd.
Oral leukoplakia has been defined in various ways, usually by the characteristics. Use of the carbon dioxide laser in the management of premalignant lesions of the oral mucosa volume 98 issue 12 j. However they must be able to recognize lesions at particular risk and several features which help to assess the likelihood of malignant transformation. Clinically, typical lesion of oral erythroplakia is less than 1. This document is highly rated by students and has been viewed 625 times. Evaluation of serum beta 2microglobulin in premalignant and malignant lesions of the oral cavity. Oral premalignant lesions of the oral cavity such as leukoplakia and erythroplakia remain a diagnostic and treatment challenge. Histopathologically, moderate or severe dysplasia was usually seen in lesion with erythroplakia. Oral cancers are attributed to a number of causal agents including tobacco, alcohol, human papillomavirus hpv, and areca betel nut. Premalignant conditions of the oral cavity head and neck cancer clinics series by peter a. The detection of premalignant and early malignant lesions of the oral cavity allows for treatment that may be. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 796. A routine part of an oral examination should be inspection not only of the teeth and gums but also of the soft tissues in and around the mouth. The most common of these lesions is squamous dysplasia in association with leukoplakia and erythroplakia, which is the primary focus of this article.
The most common oral precancerous lesions are oral leukoplakia, oral submucous fibrosis osmf, and oral erythroplakia. Many oral sccs develop from premalignant conditions of the oral cavity. Oral cancer and precancerous lesions the oral cancer foundation. Premalignant conditions of the oral cavity springerlink. Advances in the diagnosis of oral premalignant and. Pdf diagnostic techniques of oral premalignant lesions. Premalignant squamous lesions of the oral cavity are areas of altered epithelium that are at an increased risk for progression to squamous cell carcinoma scc. Preliminary results of screening for pathological lesions in oral mucosa and. Despite many advances in diagnosis and treatment, the survival statistics have only marginally improved. Modified from ajcc manual for staging of cancer, 1997, ed. Introduction cancers of the oral cavity and oropharynx represent approximately three percent of all malignancies in men and two percent of all malignancies in women.
Oral premalignant lesions were present in around 52% of the study population that was exposed to tobacco, amongst which tobacco quid lesion was the most common 10. However, remember that a biopsy of the lesion is required to establish a definitive diagnosis. But before biopsy, some staining methods may be used as a diagnostic aid. Cancer of the oral cavity is the sixth most common malignancy reported worldwide and one with the highest mortality rate among all malignancies. High prevalence of p53 mutations in premalignant oral erythroplakia was reported in a study designed by qin et al. Premalignant lesions of oral cavity a clinicopathological study introduction a precancerous lesion is a morphologically altered tissue in which oral cancer is more likely to occur than in its apparently normal counterpart.
Various premalignant lesions, particularly red lesions and some white lesions have a potential for malignant change. An improved molecular classification of opl may help refining prevention strategies. Oral white and red lesions leukoplakia, erythroplakia and erythroleukoplakia is considered a premalignant lesion. Finally, leukoplakia size is also correlated with cancer risk, although the cutoff size for risk level remains speculative. The disease specific fiveyear survival rate especially for patients with advanced oral cancer has not improved significantly over the period of time. We identified two main opl geneexpression subtypes, named immunological and classical, in 86 opl discovery. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. This lesion may be a result of a hypersensitivity reaction to dietary constituents such as betel nut, capsaicin, etc. Immunological and classical subtypes of oral premalignant.
It is not related to the presence or absence of dysplasia, but is considered a premalignant condition arising from chronic irritation of the oral mucosa. A number of lesions and conditions are included under the umbrella of opmd including 1 leukoplakia, 2 erythroplakia, 3 oral submucous fibrosis, 4 palatal lesions in reverse smokers, 5 oral lichen planus, 6 discoid lupus erythematosus and 7 actinic cheilitis 3. An investigation was undertaken to evaluate the influence of betel nut chewing on the oral microbiome and oral. Abstract in the united states, cancers of the oral cavity and oropharynx represent. Oral leukoplakia is a premalignant lesion that has. Lasers in the management of oral premalignant lesions. Premalignant lesions are morphologically atypical tissue which appear abnormal when viewed under the microscope, and which are more likely to progress to cancer than normal tissue. Surgical treatment of premalignant lesions of the oral. Recognition of such change is vital in preventing carcinoma changes.
It poses a threat to convert to frank malignancy if not treated. Those early lesions can be biopsied and submitted for interpretation to pathologists. Oral squamous cell carcinoma oscc is a major cause of cancerassociated morbidity and mortality and may develop from oral premalignant lesions opl. Though oral cancer is one of the major killers of modern times, there seem to be no widely accepted criteria for decision making in clinical. Oral cancer and precancerous lesions neville 2002 ca. Premalignant lesions and conditions linkedin slideshare.
Although betel nut chewing has been established as an independent cause of oral cancer, the mechanisms of carcinogenesis are poorly understood. The recognition and timely treatment of potentially premalignant conditions of the oral cavity can minimize the change to an overt malignancy in many patients through patient education, appropriate treatment and surveillance. Oral premalignant lesions and early oral cancers are quite varied in appearance fig. Premalignant changes arising in other oral lesions are uncommon. However, using clinical features to classify lesions is difficult. Approximately 4%of all malignant tumors in people appear in the neck and oral cavity. Oral squamous cell carcinoma scc is the th commonest cancer worldwide, and the most common cancer in the asian subcontinent due to the widespread habit of tobacco and betel nut chewing. Management of such lesions includes observation, excision, ablation, or.
Although the white color in leukoplakia is a result of hyperkeratosis or acanthosis, similarly appearing white lesions that are caused by reactive keratosis smokers keratosis or frictional keratoses e. Premalignant oral lesions include oral leucoplakia, oral erythroplakia, oral proliferative verrucous leukoplakia, oral submucous fibrosis, oral lichen planus olp and actinic cheilitis 8,9. Many lesions are innocuous and can be easily diagnosed and named based upon their appearance alone. Leukoplakia could be classified as mucosal disease, and also as a premalignant condition. Chen et al used methylene blue in fiftyeight patients with suspicious oral cavity lesions. White lesions oral leukoplakia, a premalignant lesion. The most effective way of combating this dilemma is an early detection, diagnosis and eradication of earlystage lesions and their precursors. Practitioners will see many oral white lesions but few carcinomas. Premalignant and malignant lesions of oral cavity notes. Because the oral cavity is easy to examine and risk factors for oral cancer are known, there is great opportunity to improve patient outcomes through diagnosis and treatment of premalignant lesions before the development of invasive oral carcinoma. In our study we evaluated olp because it is the most common premalignant condition, as well as dysplasia, because it is considered a previous stage of. Oral premalignant lesions look like red or whitish plaques or lesions in the mouth that do not rub off and can be associated with a higher risk of cancer.
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