Oral cancer causes a significant impairment of the quality of life due to significant disfigurement of the face, difficulty in eating, and speaking. There are many predisposing factors, including smoking, alcohol abuse, tobacco chewing, syphilis, dietary deficiencies of riboflavin, and iron deficiency anemia. Chronic dental problems such as dental abscess, ill-fitting dentures, and sharp teeth can cause chronic ulcers in the mouth, and they can undergo neoplastic change.
Neoplasms of the oral cavity can be benign, premalignant, and malignant. Examples of benign tumors include fibroma, hemangioma, papilloma, minor salivary gland tumors, lymphangioma, and torus, all of which are considered solid tumors. Ranula and mucocele are benign cystic changes in the oral cavity. Premalignant conditions include leukoplakia, erythroplakia, and melanosis/mucosal hyperpigmentation. They are not malignant but can change into oral cancer. The risk of malignant change in erythroplakia of the oral cavity is 17 times higher than that of leukoplakia. Similarly, melanosis can lead to melanoma of the oral cavity.
Papilloma is common in the 20s and 30s, and hemangiomas are seen mostly in children. Leukoplakia is seen three times more common in males than females after the age of 30 years. On the other hand, the incidence of erythroplakia is the same in males and females. Carcinoma is more common after the age of 50, mostly in males. Cancer of the floor of the mouth is more common in females, and alveolar carcinoma is equally prevalent in males and females.
1Appearance, surface, and consistency of the lesion
Lesions will always look different depending on the type of oral cancer. For example, papilloma and fibromas are less than 1 cm in size. Both have a smooth surface, but papilloma has an irregular surface, and fibroma is covered with the mucosal surface. Torus (submucosal bony outgrowth) grows as a solid lobulated mass. Pyogenic granuloma, which is a benign tumor of the oral cavity, is smooth on its surface. Ranula has a translucent swelling in the mucosa of the oral cavity.
Premalignant tumors are also very different from each other. For instance, leukoplakia occurs as a patch or nodule on an erythematous base. Erythroplakia occurs as a red patch or plaque, which is velvety and brighter than the surrounding mucosa. Melanosis or hyperpigmentation of the mucosa looks darker than the surrounding mucosa.
In most cases, carcinoma causes an ulcer or a lump that fails to heal. Carcinoma of the lip may grows outward with everted edges, or it can cause ulcers. Patients with carcinoma of the tongue usually present as a lump or irregularity on the surface of the tongue. Still, it may have four forms which are, a lump with indistinct edges, an ulcer with an everted edge, papilliferous/warty lesions with a papillary or fissured surface.