Premalignant Conditions Of The Oral Cavity

Premalignant Conditions Of The Oral Cavity

Enlist premalignant lesions of oral cavity. Discuss clinical features, investigations and management of carcinoma of anterior two­third of tongue.

Answer. Premalignant Lesions of Oral Cavity

• Leukoplakia
• Erythroplakia
• Mucosal changes associated with smoking habits
• Carcinoma in situ
• Bowen disease
• Actinic keratosis, actinic chelitis and actinic elastosis.

“Causes Of Premalignant Lesions In The Mouth”

Anterior two­third of tongue Clinical Features

• Painless ulcer or swelling on the tongue which later on may become painful. Pain is present in the tongue due to infection or ulceration or due to involvement of lingual nerve.
• Salivation is excessive and is often blood-stained.
• Visible ulcer can be seen on anterior two-third of tongue.
  Ulcer can bleed on touch; edge, base and surrounding areas are indurated.
  Often indurated area is more extensive than primary tumor.
  Edges are everted.
  Ulcer may cross the midline and extend to the floor or mouth/alveolus/mandible.

“Risk Factors For Developing Oral Premalignant Conditions”

• Fetor oris is due to infected necrotic growth.
• Ankyloglossia restricted mobility of the tongue. It is due to infitration of the mouth or mandible.
• Disarticulation—difficulty in talking is due to disability of the tongue to move freely.
• Presence of palpable lymph nodes in the neck which are hard, nodular and get fied to underlying tissues in advanced stages.

“Symptoms Of Oral Premalignant Conditions”

Anterior two­third of tongue Investigations

• Wedge biopsy
• FNAC of lymph nodes
• CT scan to see the status of lymph node secondaries.
• MRI to assess extent of primary tumor
• Chest X-ray to see bronchopneumonia
• Orthopantomogram