Facultative Precancerous Diseases

LOOKING but not SEEING

TYPES OF TUMORS Benign Tumors Precancerous lesions Maligant Tumors ***DIAGNOSIS: Secondary Prevention  Early Lesion

A precancerous condition or premalignant condition, sometimes called a potentially precancerous condition or potentially premalignant condition, is a state of disordered morphology of cells that is associated with an increased risk of cancer. If left untreated, these conditions may lead to cancer precancerous condition is also called speckled leukoplakia or speckled erythroplakia. The risk of oral cavity cancer developing from erythroleukoplakia falls between the risk for leukoplakia and erythroplakia.

Facultative vs. Obligatory Obligate Facultative

Facultative: 1. In general, not obligatory but rather capable of adapting to different conditions. These facultative precancerous : The most typical setting that of chronic irritation and inflammation.

What you may see CLINICALLY Leukoplakia Speckled leukoplakia Leukoerythroplakia Erythrokoplakia Erytholeukoplakia Speckled erythroplakia Granular erythroplakia Erythroplakia Ulceration proliferative verrucous leukoplakia (PVL) oral submucous fibrosis.

Signs & Sypmtoms A lump or thickening in the oral soft tissues Soreness or a feeling that something is caught in the throat Difficulty chewing or swallowing Ear pain Difficulty moving the jaw or tongue Hoarseness Numbness of the tongue or other structures

LEUKOPLAKIA Leukoplakia is a condition in which thick, white patches form on the tongue and the lining of the cheeks of the mouth. Smoking is the most common cause, but other irritants can cause this condition as well. Mild leukoplakia is usually harmless and generally goes away on its own.

Leukoplakia Atrophy of epithelium on the tongue & lips as a sequel to recurrent acute or chronic inflammation of the mucosa has been shown to promote the development of leukoplakia. The mechanism underlying such changes is not infrequently endogenous. Szodoray (1963) & Maskillejson (1969) regarded photosensitive cheilitis as a precancerous state and Venkei and J. Sugar (1965) classified the chronic forms of cheilitis as facultative precancerous changes that pre-dispose to the development of frank precancerosis, leukoplakia

PROLIFERATIVE VERRUCOUS LEUKOPLAKIA

ERYTHROPLAKIA Erythroplakia is a red patch on the oral mucosa that cannot be accounted for by any specific disease entity. A lesion that is both white and red.

ORAL SUBMUCOUS FIBROSIS

ADJUNCTIVE TECHNIQUES Diagnostic Adjuncts?? Loupes White light Vital stains Light-based adjuncts Cytopathologic adjuncts

Light-based Adjuncts

Vital Stains

VELSCOPE

PREVENTION Drink alcohol in moderation The risk of developing oral cancer increases with the amount and length of time alcohol and tobacco products are used. Limit your exposure to the sun.  It's important to see your dentist regularly for screenings. Good diet

TREATMENT Surgery Hairy leukoplakia requires treatment with an antiviral medication. Avoiding pre-disposing factors Cryotherapy

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