Oral cancer differential diagnosis: Difference between revisions
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|8550/3 | |8550/3 | ||
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* 2-6.5% of all intraoral salivary gland tumors | |||
* Age range was from 11-77 years, with a mean of 45 years | |||
* Male to female ratio of 1.5:1 | |||
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* Buccal mucosa | |||
* Upper lip and | |||
* Palate | |||
| | | | ||
| | |Biopsy shows: | ||
* Solid sheets of epithelium with secretory material | |||
* Ductal differentiation in tumors | |||
|- | |- | ||
|Mucoepidermoid carcinoma | |Mucoepidermoid carcinoma | ||
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|- | |- | ||
| rowspan=" | | rowspan="4" |Salivary gland adenomas | ||
|Pleomorphic adenoma | |Pleomorphic adenoma | ||
|8940/0 | |8940/0 | ||
|40-70% of minor gland tumors | |||
| | | | ||
| | | | ||
| | | | ||
| | * Palate | ||
* Lips and | |||
| | * Buccal mucosa | ||
|Painless, slow growing, submucosal masses, but when | |||
traumatized may bleed or ulcerate. | |||
|Biopsy shows cellular, and hyaline or plasmacytoid cell | |||
|- | |- | ||
|Myoepithelioma | |Myoepithelioma | ||
|8982/0 | |8982/0 | ||
|42% of minor gland tumors | |||
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* Palate of younger individuals | |||
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|Basal cell adenoma | |Basal cell adenoma | ||
|8147/0 | |8147/0 | ||
|20% of minor gland tumors | |||
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* Upper lip | |||
* Buccal mucosa | |||
| | | | ||
| | |They are histologically | ||
similar to those in major glands. | |||
|- | |- | ||
| | |Cystadenoma | ||
|8149/0 | |8149/0 | ||
|7% of benign minor gland tumors | |||
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* Lips | |||
* Cheek | |||
* Palate | |||
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* Classic (elderly men of Mediterranean/EastEuropean descent) | |||
* Endemic ( middle-aged adults and children in Equatorial Africa who are not HIV infected) | |||
* Iatrogenic (Immunosuppressed, post-transplant) | |||
* AIDS associated (HIV-1 infected individuals) | |||
| | | | ||
* HHV-8 | |||
* Immunologic, genetic, and environmental factors | |||
| | | | ||
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* Skin ( most common) | |||
* Mucosal mem- branes such as oral mucosa, lymph nodes and visceral organs | |||
| | | | ||
| | * Purplish, reddish blue or dark brown macules | ||
* Plaques and nodules that may ulcerate | |||
|Biopsy of all 4 types show: | |||
* Vascular slits and sparsely distributed lymphocytes. | |||
|- | |- | ||
|Lymphangioma | |Lymphangioma | ||
| | | | ||
|9170/0 | |||
| | | | ||
* Pediatric lesions | |||
* Present at birth or during the first years of life. | |||
* Appear mostly in the head and neck area but may be found in any other part of the body | |||
| | | | ||
* Developmental malformation | |||
* Genetic abnormalities | |||
* Turner's syndrome | |||
| | | | ||
|Tongue | |||
| | | | ||
* Circumscribed painless swelling | |||
| | * Soft and fluctuant on palpation | ||
* Irregular nodularity of the dorsum of the tongue | |||
|Biopsy shows: | |||
* Thin-walled, dilated lymphatic vessels of different size, which are lined by a flattened endothelium | |||
|- | |- | ||
|Ectomesenchymal chondromyxoid | |Ectomesenchymal chondromyxoid | ||
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* Age range varies from 9-78 years | |||
* No distinct sex predilection. | |||
| | | | ||
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| | |Asymptomatic, slow growing solitary nodule in the anterior dorsal tongue | ||
| | |Biopsy shows: | ||
* Round, cup-shaped, fusiform, or polygonal cells with uniform small nuclei and moderate amounts of faintly basophilic cytoplasm | |||
* Some tumors may show nuclear pleomorphism, hyperchromatism, and multinucleation | |||
|- | |- | ||
|Focal oral mucinosis | |Focal oral mucinosis (FOM) | ||
| | | | ||
| | | | ||
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* The lesion affects all ages | |||
* Rare in children | |||
* There is no distinct sex predilection. | |||
| | | | ||
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* Gingiva( most common site) | |||
* Palate | |||
* Cheek mucosa and | |||
* Tongue | |||
|Asymptomatic fibrous or cystic-like lesion | |||
|Histopathology is characterized by: | |||
* Well-circumscribed area of myxomatous | |||
tissue | |||
* Fusiform or stellate fibroblasts | |||
* Absent or sparse reticular fibres | |||
* Mucinous material shows alcianophilia at pH 2.5 | |||
|- | |- | ||
|Congenital granular cell | |Congenital granular cell epuli | ||
| | | | ||
| | | | ||
| | | | ||
* Affects newborns | |||
* Females are affected ten times more often than males | |||
|Etiology uncertain | |||
| | | | ||
| | | | ||
* Maxilla | |||
* Mandible | |||
|Solitary, somewhat pedunculated fibroma-like lesion attached to the alveolar | |||
ridge near the midline | |||
| | | | ||
* Ultrasound for prenatal diagnosis | |||
* Immuno histochemically, the tumor cells are positive for vimentin and neuron specific enolase | |||
* No reactivity with cytokeratin, CEA, desmin, hormone receptors or S-100 | |||
|- | |- | ||
| rowspan="6" |Haematolymphoid tumours | | rowspan="6" |Haematolymphoid tumours | ||
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|Second most com- | |Second most com- | ||
mon cancer of the oral cavity | mon cancer of the oral cavity | ||
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* Loose teeth | * Loose teeth | ||
| | | | ||
Biopsy shows: | Biopsy shows: | ||
* Large cells with predominantly round nuclei and membrane-bound nucleoli, consistent with centroblastic morphology. | * Large cells with predominantly round nuclei and membrane-bound nucleoli, consistent with centroblastic morphology. |
Revision as of 15:26, 6 February 2018
Oral cancer Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Oral cancer differential diagnosis On the Web |
American Roentgen Ray Society Images of Oral cancer differential diagnosis |
Risk calculators and risk factors for Oral cancer differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
There are different types of cancers of the oral cavity and oropharynx. It is important that they are differentiated from one another.
Oral cancer must be differentiated from actinic keratosis, dermatologic manifestations of oral leukoplakia, erythroplasia, lichen planus and mucosal candidiasis.
Oral cancer differential diagnosis
Type of cancer | Subtype | ICD-O Code | Epidemiology | Etiology | Second primary tumors | Localization | Clinical features | Diagnostic procedures |
---|---|---|---|---|---|---|---|---|
Squamous cell carcinoma | Verrucous carcinoma | 8051/3 | Older males |
|
||||
Basaloid squamous cell carcinoma | 8083/3 | |||||||
Papillary squamous cell carcinoma | 8052/3 | |||||||
Spindle cell carcinoma | 8074/3 | |||||||
Acantholytic squamous cell carcinoma | 8075/3 | |||||||
Adenosquamous carcinoma | 8560/3 | |||||||
Carcinoma cuniculatum
(epithelioma cuniculatum) |
8051/3 | |||||||
Lymphoepithelial carcinoma | ||||||||
Epithelial precursor lesions | ||||||||
Proliferative verrucous leukoplakia and precancerous conditions | ||||||||
Papillomas | Squamous cell papilloma and
verruca vulgaris |
|||||||
Condyloma acuminatum | ||||||||
Papillomas and papillomatosis
in immunodeficiency |
||||||||
Focal epithelial hyperplasia | ||||||||
Granular cell tumour | ||||||||
Keratoacanthoma | ||||||||
Papillary hyperplasia | ||||||||
Median rhomboid glossitis | ||||||||
Median rhomboid glossitis | ||||||||
Salivary gland tumours | Acinic cell carcinoma | 8550/3 |
|
|
Biopsy shows:
| |||
Mucoepidermoid carcinoma | 8430/3 | |||||||
Adenoid cystic carcinoma | 8200/3 | |||||||
Polymorphous low-grade
adenocarcinoma |
8525/3 | |||||||
Epithelial-myoepithelial
carcinoma |
8562/3 | |||||||
Clear cell carcinoma,
NOS |
8310/3 | |||||||
Basal cell
adenocarcinoma |
8147/3 | |||||||
Cystadenocarcinoma | 8450/3 | |||||||
Mucinous adenocarcinoma | 8480/3 | |||||||
Oncocytic carcinoma | 8290/3 | |||||||
Salivary duct carcinoma | 8500/3 | |||||||
Myoepithelial carcinoma | 8982/3 | |||||||
Carcinoma ex pleomorphic
adenoma |
8941/3 | |||||||
Salivary gland adenomas | Pleomorphic adenoma | 8940/0 | 40-70% of minor gland tumors |
|
Painless, slow growing, submucosal masses, but when
traumatized may bleed or ulcerate. |
Biopsy shows cellular, and hyaline or plasmacytoid cell | ||
Myoepithelioma | 8982/0 | 42% of minor gland tumors |
|
|||||
Basal cell adenoma | 8147/0 | 20% of minor gland tumors |
|
They are histologically
similar to those in major glands. | ||||
Cystadenoma | 8149/0 | 7% of benign minor gland tumors |
|
|||||
Kaposi sarcoma |
|
|
|
|
Biopsy of all 4 types show:
| |||
Lymphangioma | 9170/0 |
|
|
Tongue |
|
Biopsy shows:
| ||
Ectomesenchymal chondromyxoid
tumour of the anterior tongue |
|
Asymptomatic, slow growing solitary nodule in the anterior dorsal tongue | Biopsy shows:
| |||||
Focal oral mucinosis (FOM) |
|
|
Asymptomatic fibrous or cystic-like lesion | Histopathology is characterized by:
tissue
| ||||
Congenital granular cell epuli |
|
Etiology uncertain |
|
Solitary, somewhat pedunculated fibroma-like lesion attached to the alveolar
ridge near the midline |
| |||
Haematolymphoid tumours | Non-Hodgkin lymphoma | Second most com-
mon cancer of the oral cavity |
|
|
NHL of the lip presents with:
|
Biopsy shows:
| ||
Extramedullary plasmacytoma | 9734/3 | |||||||
Langerhans cell histiocytosis | 9751/1 | Associated with:
|
and
|
Common oral symptoms
include:
|
Biopsy shows ovoid Langerhans cells
with deeply grooved nuclei, thin nuclear membranes and abundant eosinophilic cytoplasm | |||
Hodgkin lymphoma | Strongly associated with Epstein- Barr Virus |
|
Most patients present with localized disease (stage I/II), with
|
|||||
Extramedullary myeloid
sarcoma |
9930/3 | History of acute myeloid leukaemia,
predominantly in the monocytic or myelomonocytic subtypes |
|
Isolated tumor-forming intraoral mass | Biopsy shows an Indian-file pattern of infiltration | |||
Follicular dendritic cell
sarcoma / tumour |
9758/3 |
|
History of underlying hya-line-vascular Castleman disease |
|
The patients usually
present with a painless mass |
Biopsy usually exhibits
borders and comprises:
| ||
Mucosal malignant melanoma | 8720/3 |
|
No known etiological factors associated with oral melanoma | 80% arise:
gingivae Others:
|
|
|