Tongue cancer pathophysiology: Difference between revisions
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*The rates of malignant transformation of leukoplakic lesions range from less than 1% to as high as 17.5%, averaging 4.5-6%. Erythroleukoplakia (leukoplakia erosiva) and nodular leukoplakia exhibit the highest rate of malignant transformation. | *The rates of malignant transformation of leukoplakic lesions range from less than 1% to as high as 17.5%, averaging 4.5-6%. Erythroleukoplakia (leukoplakia erosiva) and nodular leukoplakia exhibit the highest rate of malignant transformation. | ||
*Erythroplakia is defined as a red, velvety plaque found on the oral mucosa that cannot be ascribed to any other predetermined condition. No sex predilection is recognized in erythroplakia and it is rarely found on the tongue compared with other sites in the oral cavity. Erothroplakia is considered as the earliest sign of asymptomatic cancer by Mashberg.<ref>{{Cite journal | author = [[A. Mashberg]] | title = Erythroplasia: the earliest sign of asymptomatic oral cancer | journal = [[Journal of the American Dental Association (1939)]] | volume = 96 | issue = 4 | pages = 615–620 | year = 1978 | month = April | pmid = 0273632}}</ref> | *Erythroplakia is defined as a red, velvety plaque found on the oral mucosa that cannot be ascribed to any other predetermined condition. No sex predilection is recognized in erythroplakia and it is rarely found on the tongue compared with other sites in the oral cavity. Erothroplakia is considered as the earliest sign of asymptomatic cancer by Mashberg.<ref>{{Cite journal | author = [[A. Mashberg]] | title = Erythroplasia: the earliest sign of asymptomatic oral cancer | journal = [[Journal of the American Dental Association (1939)]] | volume = 96 | issue = 4 | pages = 615–620 | year = 1978 | month = April | pmid = 0273632}}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 05:44, 17 December 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Genes involved in the pathogenesis of tongue cancer include TP53, c-myc, and erb-b1. On gross pathology, exophytic, ulcerative, and infiltarative growth patterns are characteristic findings of tongue cancer.[1]
Pathophysiology
Genetics
The mutations in tumor suppressor genes has been reported in patients with tongue cancer. Genes involved in the pathogenesis of tongue cancer include TP53, which is located on chromosome 17. Other oncogenes associated with squamous cell cancers of the tongue include c-myc and erb -b1.
Gross pathology
Squamous cell carcinoma is the most common malignancy of the tongue. It typically has three gross morphologic growth patterns: exophytic, ulcerative, and infiltrative. The infiltrative and ulcerative are the types most commonly observed on the tongue.The macroscopic appearance of tongue cancer depends on the following:
- Duration of the lesion
- The amount of keratinization
- The changes in the adjoining mucosa
A fully developed tongue lesion appears as an exophytic bulky lesion that is gray to grayish-red and has a rough, shaggy, or papillomatous surface.
Microscopic Pathology
- Microscopically, tongue cancers are broadly based and invasive through papillary fronds.
- Tongue cancer constitutes of highly differentiated squamous cells lacking frank cytologic criteria of malignancy with rare mitoses. The surface of the lesion is covered with compressed invaginating folds of keratin layers. An astromalike inflammatory reaction and a blunt pushing margin may be seen.
Pathogenesis
- Leukoplakia and erythroplakia have the greatest potential for malignant transformation in tongue cancer. Leukoplakia is defined as a white patch of the mucosa that cannot be characterized clinically or pathologically as any other disease.
- Leukoplakia is considered a premalignant condition from the chronic irritation of the mucous membranes, resulting in increased rates of epithelial and connective tissue proliferation. Leukoplakia usually occurs after the age of 40 years, with the peak incidence before age 50 years. Leukoplakia is 2-3 times more common in men than in women.
- The rates of malignant transformation of leukoplakic lesions range from less than 1% to as high as 17.5%, averaging 4.5-6%. Erythroleukoplakia (leukoplakia erosiva) and nodular leukoplakia exhibit the highest rate of malignant transformation.
- Erythroplakia is defined as a red, velvety plaque found on the oral mucosa that cannot be ascribed to any other predetermined condition. No sex predilection is recognized in erythroplakia and it is rarely found on the tongue compared with other sites in the oral cavity. Erothroplakia is considered as the earliest sign of asymptomatic cancer by Mashberg.[2]
References
- ↑ A. Mashberg (1978). "Erythroplasia: the earliest sign of asymptomatic oral cancer". Journal of the American Dental Association (1939). 96 (4): 615–620. PMID 0273632. Unknown parameter
|month=ignored (help) - ↑ A. Mashberg (1978). "Erythroplasia: the earliest sign of asymptomatic oral cancer". Journal of the American Dental Association (1939). 96 (4): 615–620. PMID 0273632. Unknown parameter
|month=ignored (help)