Description: In excess of 90% of all oral cancers are of the squamous cell type. As stated in other sections in this monograph, early carcinoma may clinically appear as leukoplakia or erythroplasia. It may also appear as a mixture of erythroplasia and leukoplakia as is illustrated in fig. 58.Another common clinical appearance is an area of chronic ulceration as shown in fig. 59.
Squamous carcinoma is about four times as common in men as in women. Risk of acquiring the disease increases with each passing decade but is seldom seen in those under forty. According to the American Cancer Society there are about 17,000 new cases in the United States each year. Although no area of oral mucosa is immune, certain areas are more vulnerable. Soft palate, lateral and ventral tongue mucosa, and floor of the mouth are especially prone to develop squamous carcinoma.
Etiology: The etiology is unknown. Naturally, suspicion has fallen on smoking and alcohol.
Treatment: Usual treatment consists of surgical excision, irradiation, and chemotherapy or combinations of these.
Prognosis: The five year survival rate is about 50%. Early diagnosis increases the chance of survival.
Differential diagnosis: Hyperkeratosis, erythroplasia, lichen planus, and traumatic ulceration. A definitive diagnosis can be established only by biopsy