Malignant tumors of the oral cavity

Malignant tumors of the oral cavity

Operative MALIGNANT T TUMORS Oral OF THE Surgery ORAL CAVITY IIE early detection of nialigllancies is of utltlost inlportance. To this Cll(l, th...

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Operative MALIGNANT

T

TUMORS

Oral OF THE

Surgery ORAL

CAVITY

IIE early detection of nialigllancies is of utltlost inlportance. To this Cll(l, the much closer relationship that exists totlay hrtween the lnetli(~ill alrtl (Clinics for the detection of tumors hily(b dental professions should he utilized. been established in almost every city in the l:~i~tl, ill the hosldtals illld in the metlical and dental schools. If these clinic’s ilt’f? to I)C c,rg:rnixetl j)l.Ol’C’t’l~, il clentist should be it~cluded OJI tllc staff of each one. The New York TJTniversity College 01’ Del1iistry has Iwet1 one OC 111~ such a clinic in u~(Io~earlier dental schools to recognize the import:ltice 1111 graduate teachings. The Tun~or Uiuic. here is colnposrtl of tlentists who i\rt’ qualified ns oral tli;lglm&iiltJs :iu(l tletital ~~a~liologists. ciltlcel’ S171’ge011S, il pathologist. and ii ~,adiotherRI)ist,. The tleutal stntleilt is t:tnght diagnosis :lncl F[e has an opportunity to see tlic‘ he ilk0 learns 1101~to j)erform l)iol)sies. follow-up of cases iLlIt the fitlal surgieill prosthwis, when inclicated. While the treatment of malignallcp is primarily the I)roblern of the mwli~a1 profession, malignancies of the oral cavity ilre sew more frequently 1))~thta dentist. The recognit,ion and prevention of ln:llig~mllcies ant1 the hospitalization of patients at the earliest possihlr moment for ptx)lwr treatment iIj*e tlrcl responsibilities of the dentist. The dental profession must he highly con~met~cletl for its pradiw ot periodic esa.nriilation of patients. We mast not forgd the tremendons opportunity we hare for the study of e;lI~l~ itntl al)l)nrentlp minor distnrbunccs. \\‘(a have the ild\~illltage of working ill a field where there is tlirevt \%ion 01’ lesions that JllRy I)e precursors Of I~lilligllntl~ic~S. This perulits tlirwt c~linic;ll esanlination, inspection in the early stages. illlil ~)ill~)i~tiOf~ Of il tly iIl~llOl~lJlillit~ arisitlg in the oral cavit,y. Vailurc l)y thr tlcntal an<1nletli(*;11 I)rof’essions 11)twognize malignancies of the oral c;rdy is unfortunate. To single out the dental profession HS the most Frequent offrntler irntl to cl;linl that its nleullwm ;I w not qualified to recognize these lesions. is unfair illIt nJltJ4ne. ‘l’hta dent.ist is hetier qnalifietl than his medical confrere to rwogrlixe Iesiolls ol’ thp OJXI c;lvity, IIv iweires mow training as au lilitl~l,yi’itcla:~t~ stntlcilt. I’OSt~~~ttlllilt(~ w~nrscs 0Ii

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A tmponsil)lc n~rtttlter of the I’amily, v.ho will the IJest, ntethocl of treattntrtt. not di~nlgr the tme mature of the tlisease to thp I)atient, should 1~ notifirtl. The patient, shonltl not I)e toltl tlitwtly ihilt he ?I;IS il c*att(ber.alt~hough it might he ttecessitt’>. to ittl’ortrt hittl ;rl~out the set?c,usness 01 his c*olttlition it’ he t10~ I II spite of the eswllenl cvlu1101I)t*ese~~thitttself itttntetli;ttely t’ot. tl.eittttt(bllt. wheii twogc*ittiOll;ll pul)licity intlicatitig tlial (‘iltl(‘t?l’ is ~ut~altlr. wlwcially IllPttrim1 illltl tlY!ilt~il f?;l’ly, the jmtirtit ~VllO l
the i’CI?t that

it (‘iltl(‘(‘t’.

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h(a hirs IlOt Ibeen tOItI,

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to the tw~tntrnt given. cittt keel) hitrr I’uncdiotting mow or less There ;tt’e SOIIIP indivitln;tls who will itrsist they want to kttow the

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Leukoplakia This

Icsion

(‘iltl

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i’Olltlt1

iti

:ltly

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01’ IhP Ot’ill

(*;I\-ity-lips.

tollgtlc,

(b’igs. 2. :I, ;llltl 4). It ])l.C’SclttS itsel1 ilS whitish ])iltCll~S ililtl consists 01’ it sitril)lc thickming or’ the ~t~utotw ~ltetttt)~;t~l~, which n:ny 1~: Ioc;tlizd 01’ tlifYnsc1. This lesion tn;ty 1~ Colnltl where ~ll~‘~‘liS,

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ansl ,silv(,rs \vhite in allFig. G.-Lichen planus of cheek. The lesion is shiny, Iawlikv. ~arance. No skin manifestation of the ~lisease is present. Numerous tiny raisell lesions with n w11 pinhr:ulFig. ‘I.-Nicotinic stomatitis of pal&r. The patirnt is an invrtclrate pip? smoker. sized center resembling a crater.

,I lesion 011 the palate (c~tr~tno~rly tlesct4jecI 1)~ riiatry as nicaotinic stoltlai itis) I\-ltich is SWII itt ittvetetxtc l)il)r stttokers (I.‘ig. ‘i). JI’C~Iwlieve, is ;I (‘orttt 01 It al)peat’s as tiny. txisetl lesiotts which may c’ovet’ the etttirc lettkol)litkiit. ;I tiny cratcat-. This twl [)>lliltC’ with ;t ret1 l~ittheatl-sizetl cetttet., t*esettrl)iittg

Rttd tna? hleecl readily on being trauttiatimd. at’tet* stttokitrg h;ts lwett tlisc~outitntctl. \\‘c II;I\~v SWII, itt the tttouth of it I)hysici;rtt, where this lesiott I)t.;tcti(.:tlly tlisal)pratwl wht~t~ strtokittg. n-a tliwotttittuetl ittttl ~wutwtl (III ~~rs~tt~~~tiott of pilw slttokittr.. Jl;t~t>- itt thca firltl OU (*ittt(‘t’t’ lwlievr tltitt (att’t;titl intlivicln;tIs have \vltitt tcIt(leney ;ltltl tllilt cltrottiv itv4t;ttiott tllil~ tOtlc*ll triight ltr tPl*ttt~tl ;I tllilligflatlt

cTrttct* is il tltfl This

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01'

usually-

ofY c~nt.cittotttatons

capillaries

jwrsists

changes

clett

itt these sttsceptil)lc

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LVhy lellkt)l~l;tki;t tie\-elol)s itt the 1t1out11~ of sotttt’ stttc1ket.s ittttl ttttt itt tJtht?t’s ttray 1)~’csl)lainetl otl the ltithis 01 lo~itl epithelial snswl)til,iliiy to the initatiott of

tolMec~0.

or c;tt*(*ittottt;t.

lKc~\z;t~\-ct*.o~tl?; ;I stttitll Iwrcetttagc Iutt ;I vrr>. high

Iwwetttage

of tltcw

of sttt(iket*s tlere101) leukoplakiw lesions

:IIY’ fotuttl

itt strtokers.

Treatment \\‘I~PII lenkt)l)litki:t is ~ttt~otttI)li(~;tt~tl, it shottltl lte ol)set*vetl pet*iotlic~aliy to 0F it~ritiltiott titltst hr t~elitc~vetl 01’ rorr*ected. ttotc any ehanxes. All fOt*illS \!%en the lesion is \-erruwsed, lctpilla i*y, or fisswwl, it; should be biopsiecl to

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Fig. mandible report). Fig. nmna

14 on 15

(biops:

C’at-cir Pain is se1 noma of t

jaw. RI’CI1mt

Fig.

Ifi.

I o-I:<

Differential

Fig.

19.

Diagnosis

Fig.

Y!n

Fig.

a:{.-Lateral Scopic report

:

plates of right an41 malignant tunwr

left mandibles of un~letcrminetl

shcrwing type,

cxtcnsivr; yrc)bnbIy

radiolucY+nt malignant

area. melanoma.

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