The use of cytopathology to identify disturbances in oral squamous cell carcinoma at early stage: A case report.

Early detection of oral squamous cell carcinoma (OSCC) is a challenge for oral surgeons, as clinical features are not always classical. Cytopathological assays can help identify alterations at the cellular level. This article reports a case of OSCC in a young male adult without exposure to classical risk factors. The histopathological examination showed a micro invasive carcinoma invading the connective tissue. Cytopathological results showed a higher percentage of cells in deeper epithelial layers; the cytomorphometric examination revealed a nuclear/cytoplasmic ratio of 0.14; the mean number of Nucleolar Organiser Regions which have a high affinity for silver (AgNOR) per nucleus was 2.86, and the mean percentage of nuclei with >2 AgNOR was 58%. The micronucleus test found 3 micronucleated cells and several metanuclear aberrations. These findings support the hypothesis that cytological examination is an important tool to identify early changes in oral smears and thus help in the early clinical detection of suspicious malignant oral lesions that should be more rigorously followed.