📝 “What are 3 Common Types of Oral Squamous Cell Carcinoma?”

- 9.22.24

Quick Review #232 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #squamouscellcarcinoma #cancer #oralcancer

1. Conventional Squamous Cell Carcinoma (SCC)

• Clinical: Often presents as a persistent ulcer, a non-healing sore, a red or white patch (erythroplakia or leukoplakia), or an exophytic growth. Most commonly affects the lateral border of the tongue, floor of the mouth, and gingiva.

• Radiographic: Often not detectable radiographically unless there is bone invasion, in which radiolucency with poorly defined margins can be seen.

• Histopathology: Characterized by invasive nests and cords of malignant squamous epithelial cells with features such as nuclear pleomorphism, hyperchromatism, and increased mitotic activity. Keratin pearl formation and intercellular bridges may be seen.

• Behavior: Locally invasive, with a significant risk of metastasis to cervical lymph nodes. Distant metastasis, though less common, can occur in advanced stages.

• Associations: Strongly associated with tobacco use, alcohol consumption, and high-risk strains of human papillomavirus (HPV, particularly for oropharyngeal SCC).

2. Verrucous Carcinoma (VC)

• Clinical: Appears as a slow-growing, warty exophytic mass. It most commonly affects the buccal mucosa, gingiva, and alveolar ridge.

• Radiographic: Rarely shows bone invasion unless in advanced stages.

• Histopathological: Characterized by broad, pushing rete ridges that invade but do not penetrate deeply. Cellular atypia is minimal, and the cells retain a well-differentiated appearance. Inflammatory response is often.

• Behavior: VC is locally invasive but rarely metastasizes.

• Associations: Linked to chronic irritation from smokeless tobacco & poor oral hygiene.

3. Basaloid Squamous Cell Carcinoma (BSCC)

• Clinical: Presents as an ulcerative or exophytic mass, often more aggressive in nature than conventional SCC. It commonly affects the base of the tongue and the oropharynx.

• Radiographic: In cases of bone involvement, presents with aggressive radiolucency and poorly defined margins.

• Histopathological: Shows basaloid cells arranged in solid nests, often with comedo-necrosis, surrounded by peripheral palisading of tumor cells.

• Behavior: More aggressive than conventional SCC, with a higher likelihood of nodal and distant metastasis.

• Associations: Also associated with smoking and alcohol use, and possibly with HPV, particularly in oropharyngeal cases.

References:

1. Naitoh, I., Nomura, H., Hata, Y., & Takahashi, K. (2023). Clinical presentations of gingival squamous cell carcinoma: A 53-year-old male patient with swelling and a mass.

2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2022). Oral and Maxillofacial Pathology (5th ed.)

3. Speight, P. M., & Farthing, P. M. (2023). The pathology of oral squamous cell carcinoma. Journal of Oral Pathology & Medicine, 52(1), 1-12.

4. ChatGPT.2024

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