OPT Epithelial
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| oral squamous papilloma | benign HPV 6&11 induced proliferation of stratified squamous epithelium
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| recurrent respiratory papillomatosis (RRP) | papillomas in respiratory tract; juvenile and adult onset
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| juvenile-onset RRP | passed to fetus from mother with genital warts; laryngeal papillomas
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| adult-onset RRP | laryngeal papillomas that cause hoarseness
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| verruca vulgaris | common wart; benign proliferation of squamous epithelium induced by HPV-2 that is contagious
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| condyloma accuminatum (venereal wart) | HPV-induced proliferation of squamous epithelium transmitted sexually
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| multifocal epithelial hyperplasia (Heck disease) | proliferation from HPV 13&32; papules on lips and tongue
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| sinonasal papilloma | benign proliferations of sinonasal mucosa, not always induced by HPV
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| molluscum contagiosum | epithelial proliferation induced by this member of the DNA poxvirus; pink umbilicated papules on head and genitals
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| verruciform xanthoma | squamous proliferation mainly in mouth of unknown cause; fine papillary surface with white/yellow/red color
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| seborrheic keratosis | on sun-exposed skin but not in mouth; benign tan-brown macules that have 'stuck-on' appearance
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| sign of Leser-Trelat | sudden appearance of many seborrheic keratoses
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| sebaceous hyperplasia | localized proliferation of sebaceous glands in nose, cheeks and forehead; resembles basal cell carcinoma
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| Muir-Torre syndrome | autosomal dominant disorder of sebaceous hyperplasia, malignancies and keratoacanthomas
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| ephelis (freckle) | hyperpigmented macule, more often in fair-skinned, blue-eyed people
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| actinic lentigo (solar lentigo) | well-demarcated pigmented brown macule on sun-exposed skin in old people
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| lentigo simplex | benign cutaneous melanocytic hyperplasia not caused by sun-exposure; LEOPARD syndrome
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| melasma | 'mask of pregnancy'; hyperpigmentation of face and neck, can also be due to oral contraceptives
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| oral melanotic macule (focal melanosis) | increase of melanin in basal layer of oral mucosa; usually solitary and benign but resembles melanoma
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| acquired melanocytic nevus (mole) | proliferation of neural crest nevus cells that migrate to epidermis; associated with BRAF mutation
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| junctional nevus | increased nevus cells along basal layer, forming 'theques'; flat and demarcated
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| compound nevus | nevus cells in junctional area and superficial CT; slightly elevated
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| intradermal nevus | all nevus cells in CT; raised with papillomatous surface
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| intramucosal nevus | intradermal nevus in the mouth; most common melanocytic spot in mouth
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| congenital malanocytic nevus | present at birth and more malignant than acquired forms
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| halo nevus | zone of depgimentation surrounding nevus due to immunologic attack
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| spitz nevus | nevus that mimics melanoma seen in children
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| blue nevus | 'Tyndall effect' gives nevus a blue color since deep in CT; common type in oral cavity
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| leukoplakia | white patch or plaque that cannot be rubbed off and isn't anything else; no histopathologic change
-premalignant, especially in smokers and become SCC on lateral tongue, floor and lower lip in particular
-biopsy and microscopic evaluation is mandatory
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| verruciform leukoplakia | leukoplakia with surface irregularities with projections
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| erythroplakia | leukoplakia with areas of redness
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| speckled leukoplakia/erythroleukoplakia | leukoplakia with combined color change
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| proliferative verrucous leukoplakia (PVL) | high risk, multiple plaques that progress to verrucous to SCCA
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| epithelial dysplasia | alteration of squamous epithelium that can progress to SCCA without invasion of CT
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| erythroplakia | red patch or plaque not diagnosed as anything else; almost all have epithelial dysplasia, carcinoma in situ, or invasive SCCA so should be biopsied ASAP
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| smokeless tobacco keratosis | thickened and white mucosa where tobacco is placed; should be biopsied if remains 6 weeks after cessation
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| oral submucous fibrosis | chronic, progressive scarring at high risk for SCCA, from chewing betel quid
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| nicotine stomatitis | seen on palate in pipe and cigar smokers, due to heat rather than chemicals
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| actinic keratosis (solar keratosis) | from UV exposure, precancerous scaly plaque with sandpaper surface
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| actinic cheilosis | lesion on lower lip vermillion in males; scaly with possible ulcerations
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| keratoacanthoma | self-limiting, mimics SCCA in sun-exposed areas; dome-shaped nodule with keratin plug
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| squamous cell carcinoma | malignancy of stratified squamous epithelium, 90% of oral malignancies
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| HIV-positive oropharyngeal carcinoma | SSCA that is on the rise, related to HPV transmission via oral sex
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| tobacco smoke | has over 70 carcinogens and produces free radicals to increase risk of SCCA
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| smokeless tobacco | increases risk for SCCA but depends on type; dry snuff is worse than wet snuff
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| alcohol | not initiating factor for SCCA but potentiates other effects
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| Plummer-Vinson syndrome | severe iron-deficiency anemia with increased risk for SCCA on pharynx
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| oncogenic viruses | high risk HPV can increase risk of SCCA especially HPV-16
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| immunosuppression | diminished immune system can affect development of SCCA
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| ocogenes and tumor suppressor genes | can be acted on by viruses, radiation and carcinogens to allow cancer to develop
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| SCCA of lip vermillion | 90% on the lower lip; crusted, ulcerated mass that grows slowly
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| tongue | most common site of intraoral SCCA, usually on lateral and ventral surfaces
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| SCCA of floor of mouth | arises from preexisting leukoplakia/erythroplakia; most likely to metastasize
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| gingival and alveolar SCCA | irregular lesion that spreads laterally along the gingiva
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| SCCA of buccal mucosa | worse prognosis with tendency to metastasize
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| oropharyngeal SCCA | in posterior region of oral cavity, usually larger and higher chance to metastasize
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| metastatic spread | largely spread through lymphatics to cervical lymph nodes
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| TNM (tumor-node-metastasis) | staging of cancer based on size of primary tumor, metastasis to regional nodes and distant metastases
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| treatment of oral SCCA | guided by clinical stage, location; includes excision, chemo, radiation or combination
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| tumor stage | best prognostic indicator for lip and intraoral carcinomas
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| HPV-status | best prognostic indicator for oropharyngeal carcinomas
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| verrucous carcinoma | low-grade SCCA usually at site of cewing tobacco; large, white thick plaque
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| spindle cell carcinoma | rare variant of SCCA with invasive portion of tumor formed by spindle-shaped epithelial cells that mimic sarcomas; fast-growing and metastasizes early
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| adenosquamous carcinoma | rare, high grade variant of SCCA with combination of surface SCCA and underlying adenocarcinoma; sometimes produces mucin, almost universal cervical lymph node metastasis at time of discovery
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| basaloid squamous carcinoma | high-grade SCCA variant with high association with alcohol and smoking; usually late stage at diagnosis
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| carcinoma of maxillary sinus | uncommon and usually SCCA; chronic sinusitis at first then fast progressing to pain and paresthesia
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| sinonasal undifferentiated carcinoma (SNUC) | high-grade malignancy of nasal cavity; rapid growth and tumor necrosis
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| nasopharyngeal carcinoma | cancer of lymphoid-rich nasopharynx, endemic in China; associated with smoking, EBV, enlarged cervical nodes
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| basal cell carcinoma | most common skin cancer in the US; locally invasive slow-spreading tumor from UV exposure
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| nodular | most common BCCA, with telangiectatic blood vessels
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| pigmented | BCCA that mimics melanoma
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| sclerosing | BCCA that looks like a scar; perform Mohs surgery on this type
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| superficial | BCCA that looks like psoriasis
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| nevoid | BCCA that looks like nevus and there are usually multiple; part of nevoid basal cell carcinoma syndrome
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| Merkel cell carcinoma (neuroendocrine carcinoma of skin) | rare aggressive malignancy from UV exposure and weak immune status; tumor cells contain granules that look like these in Merkel touch receptors
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| melanoma | extremely fatal malignant melanocytic tumor; can occur wherever melanocytes are present
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| radial growth phase | lateral spread of melanoma along basal cell layer
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| vertical growth phase | melanoma tumor cells that invade the underlying connective tissue
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| ABC's of melanoma | Asymmetry, Border irregularity, Color variegation, Diameter larger than pencil eraser, Evolving size, shape, color etc.
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| superficial spreading melanoma | 70% of cutaneous melanomas; in interscapular area in men and back of legs in women
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| lentigo maligna melanoma | melanoma that develops in pre-existing pigmentation on face of elderly; has long radial growth phase
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| nodular melanoma | melanoma when vertical invasion begins immediately and sometimes shows no pigment
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| acral lentiginous melanoma | melanoma most common in blacks and oral cavity
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| oral melanomas | rare but usually on palate and maxillary gingiva/mucosa
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| depth of invasion | important prognostic indicator for melanoma
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| Clark system | classifies melanomas on 5 levels of tissue
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| Breslow system | classifies melanoma by actual measurement of tumor thickness
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| treatment of cutaneous melanoma | surgical excision with wide margins
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| sentinal node biopsy | surgery used to see if first node on drainage path contains tumor to decide if more surgery should be done
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| mucosal melanomas of head and neck | all aggressive and stage III melanomas; usually have distant metastases
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Created by:
aharnold
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