Rangaswamy Shruthi, Chikkalingaiah Rajkumar Garudanahally, Sanjeevarayappa Priya N, Govindraju Poornima
Department of Oral and Maxillofacial Surgery, Rajarajeshwari Dental College and Hospital, Bengaluru, Karnataka, India.
Department of Oral and Maxillofacial Surgery, V S Dental College and Hospital, Bengaluru, Karnataka, India.
Ann Maxillofac Surg. 2019 Jul-Dec;9(2):247-252. doi: 10.4103/ams.ams_280_18.
Oral submucous fibrosis is a chronic debilitating condition with potential for malignant transformation. Squamous cell carcinoma arising from a background of oral submucous fibrosis presents clinically as a distinct disease due to different etiopathogenesis.
This prospective case series describes thirty cases of oral squamous cell carcinoma (OSCC) alongside oral submucous fibrosis (OSF). Patient clinical data were recorded including type and duration of habits, site of tumor, size, histological grading and nodal status.
A total of 76% cases were reported in males and 24% in females. A total of 73.3% cases had a history of use of gutka of which 16% used only arecanut or gutka while the remaining used gutka along with smoking and quid habits and 26.7% cases smoked tobacco products or used smokeless tobacco. Primary site of presentation was buccal mucosa and seven cases of carcinoma at retromolar trigone (RMT) altogether accounting for 66% of the cases. 53.3% cases reported were advanced tumour T4 lesions, 10% T3 lesion, 30% reported as T2 lesions and 6.7% T1 lesion. 55% of cases showed nodal involvement of different level and 46.5% cases were N0. About 60% of cases were histologically well differentiated squamous cell carcinoma.
Carcinoma arising from a background of oral submucous fibrosis follows a distinct clinical presentation. Malignant transformation occurs in younger age group and with better histological grading.
口腔黏膜下纤维化是一种慢性致残性疾病，具有恶变潜能。由于发病机制不同，由口腔黏膜下纤维化背景引发的鳞状细胞癌在临床上表现为一种独特的疾病。
本前瞻性病例系列描述了30例口腔鳞状细胞癌（OSCC）合并口腔黏膜下纤维化（OSF）的病例。记录了患者的临床数据，包括习惯类型和持续时间、肿瘤部位、大小、组织学分级和淋巴结状态。
共报告男性病例占76%，女性病例占24%。共有73.3%的病例有嚼食古特卡的历史，其中16%仅食用槟榔或古特卡，其余则将古特卡与吸烟和咀嚼烟草习惯同时使用，26.7%的病例吸食烟草制品或使用无烟烟草。主要发病部位为颊黏膜，磨牙后三角区（RMT）有7例癌，共占病例的66%。报告的病例中53.3%为晚期肿瘤T4病变，10%为T3病变，30%报告为T2病变，6.7%为T1病变。55%的病例显示不同程度的淋巴结受累，46.5%的病例为N0。约60%的病例为组织学高分化鳞状细胞癌。
由口腔黏膜下纤维化背景引发的癌症具有独特的临床表现。恶变发生在较年轻的年龄组，且组织学分级较好。
