Oral Mouth Cancer in Detail
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Cancers are caused by a series of mutations.
Each mutation alters the behavior of the cell somewhat.

The following explains oral cancer in more detail for my Charlotte NC area patients.

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In anatomy, squamous epithelium (from Latin squama, "scale") is an epithelium characterised by its most superficial layer consisting of flat, scale-like cells called squamous epithelial cells. Epithelium may be composed of one layer of these cells, in which case it is referred to as simple squamous epithelium, or it may possess multiple layers, referred to as stratified squamous epithelium. Both types perform differing functions, ranging from nutrient exchange to protection.

Cancers of the squamous epithelium include squamous cell carcinoma, basal cell carcinoma, and other adnexal tumors. Squamous epithelial cells have a polygonal appearance when viewed from above.

Squamous epithelial cells have a polygonal appearance when viewed from above.

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The mucous membranes (or mucosae; singular mucosa) are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They line cavities that are exposed to the external environment and internal organs. They are at several places contiguous with skin: at the nostrils, the mouth, the lips, the eyelids, the ears, the genital area, and the anus. The sticky, thick fluid secreted by the mucous membranes and glands is termed mucus.

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Note: The term "basal lamina" is usually used with electron microscopy, while the term "basement membrane" is usually used with light microscopy. The structure known as the basement membrane in light microscopy refers to the stained structure anchoring an epithelial layer. This encompasses the basal lamina secreted by epithelial cells and typically a reticular lamina secreted by other cells. The basal lamina cannot be distinguished under the light microscope, but under the higher magnification of an electron microscope, the basal lamina and lamina reticularis are visibly distinct structures.


Dysplasia is a term used in pathology to refer to an abnormality of development. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells. Dysplasia is often indicative of an early neoplastic process.

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Keratin refers to a family of fibrous structural proteins. Keratin is the key structural material making up the outer layer of human skin. It is also the key structural component of hair and nails. Keratin monomers assemble into bundles to form intermediate filaments, which are tough and insoluble and form strong unmineralized tissues found in reptiles, birds, amphibians, and mammals. The only other biological matter known to approximate the toughness of keratinized tissue is chitin.          "dentist"

Keratosis: A localized horny overgrowth of the upper layer of skin such as a callus or wart. Among the common forms of keratosis are actinic keratosis and senile keratosis.

Keratinocytes are the predominant cell type in the epidermis, the outermost layer of the human skin, constituting 95% of the cells found there. Those keratinocytes found in the basal layer (Stratum germinativum) of the skin are sometimes referred to as "basal cells" or "basal keratinocytes". The primary function of keratinocytes is the formation of a barrier against environmental damage such as pathogens (bacteria, fungi, parasites, viruses), heat, UV radiation and water loss. A number of structural proteins (filaggrin, keratin), enzymes (proteases), lipids and antimicrobial peptides (defensins) contribute to maintain the important barrier function of the skin. Once pathogens start to invade the upper layers of the epidermis, keratinocytes can react with the production of proinflammatory mediators and in particular chemokines such as CXCL10, CCL2 which attract leukocytes to the site of pathogen invasion. Keratinization is part of the physical barrier formation cornification, in which the keratinocytes produce more and more keratin and eventually undergo programmed cell death. The fully cornified keratinocytes that form the outermost layer are constantly shed off and replaced by new cells. The average renewal / turnover time for the epidermis is 21 days.

Leukoplakia is a clinical term used to describe patches of keratosis. It is visible as adherent white patches on the mucous membranes of the oral cavity, including the tongue, but also other areas of the gastro-intestinal tract, urinary tract and the genitals. The clinical appearance is highly variable. The lesion cannot be rubbed off. Leukoplakia is not a specific disease entity, but is diagnosis of exclusion. It must be distinguished from diseases that may cause similar white lesions, such as candidiasis or lichen planus. The lesions of leukoplakia cannot be scraped off easily. Leukoplakia is a premalignant lesion. At the time of histological diagnosis:

    - 12-15% show dysplasia
    - 3-10% show carcinoma

2-6% have malignant transformation in 7 years.

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Erythroplakia (also known as "Erythroplasia") is a flat red patch or lesion in the mouth that cannot be attributed to any other pathology. There are many other conditions that are similar in appearance and must be ruled out before a diagnosis of erythroplakia is made. Sometimes, a diagnosis is delayed for up to two weeks in order to see if the lesion spontaneously regresses on its own or if another cause can be found. Erythroplakia frequently is associated with dysplasia, and is thus a precancerous lesion. Occasionally associated with leukoplakia (speckled). 4-7 times the risk of malignant transformation compared to leukoplakia. There is an absence of keratin production and a reduced number of epithelial cells. Since the underlying vascular structures are less hidden by tissue, erythroplakia appears red when viewed in a clinical setting. {dentist}        

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Squamos Cell Carcinoma: Can arise at site of preexisting leukoplakia or erythroplakia or may arise de novo.

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Squamous Cell Carcinoma

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