Oral Cancer: what does it look like?
The following pictures are most of the cancer cases that I have diagnosed over the past several years.
The above photo was in interesting case. This patient presented for a denture consultation to get her teeth removed, I noticed the lesion and requested permission to biopsy during her surgery procedure. Due to finances, she wanted to go to her dermatologist since they were in her network. At a surgery follow up, I still saw the lesion and asked about the biopsy. Patient reported the biopsy was done and that the pathology report came back as negative. This did not seem right, so I requested for the patient to give me a copy of the biopsy. When I read the biopsy report the biopsy was not taken in the lesion, it was taken in the lip. We then proceded to have the lesion biopsied and came back as Squamous Cell Carcinoma. This patient needs multi-level speciality care, referral to a head and neck cancer dr, medical oncologist, and radiation oncologist. In consultation we can provide high level care. This patient ultamately was treated by Dr. Fayette Williams with surgery only! The lesion was removed and a fore arm flap placed to preserve as much oral opening as possible.
The above case was rather atypical. Upon a regular dental check up, this patient presented with a large white lesion that had been there for a month or so. The white plaque was non-removable, adherent, and was quite large. The patient at the time was in his late twenties. I performed 2 biopsies and each came back as Moderate Epithelial Dysplasia. This is a dicey diagnosis since it is not technically Squamous Cell Carcinoma, but it is heading that way. For younger patients with Moderate Epithelial Dysplasia with in 24-38 months about 40% will proceed to Squamous Cell Carcinoma. Treatment is definately necessary; we referred this patient to a local head and neck surgeon and had the lesion removed.
For the above picture, sometimes oral cancer lesions can be difficult to see. It appears that there is some mucosal sluffing, however that is not the case. A biopsy taken shows that this is Squamous cell carcinoma. Again, patient was referred to a local head and neck surgeon, medical oncologist, and radiation oncologist. This lesion was removed along with all of the bone and teeth associated with it.
The above photo is a picture of Squamous Cell Carcinoma. Our patient initially presented with a severe erosive form of lichen planus that was diagnosed with a biopsy. The dental literature states that there is about a 1% risk of malignancy with lichen planus, and we typically see this with the erosive or basilar form. Over several years the lesion changed appearance and denied us the ability to biopsy for several months. Once the lesion got to be big enough that it was being bitten during eating; we were allowed to biopsy; with pathology showed invasive Squamous Cell Carcinoma. Patient revived a CT of the neck to look for involved neck nodes, resection, and radiation.
If you think you may have oral cancer here are a few questions to ask your self.
- Has it been there for 2 weeks
- Is it white and does not rub off
- Is it bleeding
A answer yes to any of the above should prompt you to seek care of a qualified dental professional. If you want to contact our office for an evaluation please contact us at 817 336 2121.