TUMOR OF ORAL CAVITY

ONCOLOGY SURGERY LECTURE

 CAVUM ORIS’S TUMOR
B E N I G N T U M O R

LEUCOPLAKIA : - Hyperkeratosis
- Premaligna
MUCOCELE / KISTA RETENSI
RANULA : - Marsupialisation

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Cavum oris cancer:
Origin from epitel/come from mucosa or salivary gland in cavum
oris’s wall and organ in mouth, SCC 90%
Lip (13%)
Tongue 2/3 anterior (37%)
Mucosa bukal (10%)
Base mouth
Gingiva upper and lower
Palatum durum, Molle's Palatum
Base mouth (15%)
Retromolar's Trigonum (Cancer-UICC's Against's Union's
International's 2002
Cavum Oris border:
Anterior : Side vermilion upper lip and lower lip
Superior : Palatum durum and molle
Lateral : Right Bukal and left
Inferior : Base mouth and tongue
Posterior : Arkus faringeus anterior left right and
uvula, Arkus glossoplatinus right left, Side
lateral tongue base, Papilla sirkumvalata
tongue.
not include to oris cavity cancer:
Sarkoma and savage tumor odontogen in maksila or
mandibula
Soft network Sarkoma and nerve perifer in lip or
cheek
Lip skin Karsinoma or cheek skin
Epidemiology
Insidens and relative frequency
In indonesia 1, 5 - 5% from entire cancers.
Most often involve tongue (37%)
Man: Woman = 3/2 – 2/1
Age on 40 thn (70%)
Widespre at world, Insidens at french and indians,
Low at japanese
Etiology
Tobacco (cigarette smoke)
Alcohol
Tooth Karies
Mouth Higiene
Virus infection (HPV's, EBV, HIV)
Siflis, Syndrome's Vinson's Plummer
Imunodefisiency
Susur (tobacco)
Leukplakia/eritroplakia
 HISTOPATOLOGI CLASSIFICATION

a. Histopatology types
NO TYPE of HISTOLOGY ICD.M
1 Squamous cell carc. 5070 / 3
2 Adenocarcinoma 8140 / 3
3 Adenoid cyst. carc 8200 / 3
4 Ameloblastic carc 9270 / 2
5 Adenolymphoma 8561 / 3
6 Mal. Mixed tumor 8940 / 3
7 Pleomorphic carc 8941 / 3
8 Melanoma maligna 8720 / 3
9 Lymphoma maligna 9590 / 3 - 9711/3
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b. Differensiation Degrees

DIFFERENSIA
TION
DEGREES
GRADE KETERANGAN
G1 Well Differensiation
G2 Moderate Differensiation
G3 Bad Differensiation
G4 Undifferensiated =
anaplastik

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 Supporting investigation

C. Standards pathology report

Necessary reported in investigation result patologis
from spesimen operation has been coverred:
Type of hystology tumor
Diffrensiation Degree (grade)
TNM's investigation determine to stage of a disease
patologis (pTNM)
 DIAGNOSIS

History taking:
Long Ulcus
Pain time
Haemorrage
Smoke/alcohol story
Social-ekonomy
Physical  Inspection / palpasi bimanual
 Initially : White/red pockmarked
 Leukoplakia/eritroplakia, Without ulcerasi
 Advanced : Ulcus, Indurasi, Infiltratif, Fungating, Eksofitik
 SUPPORTING INVESTIGATION

1. Radiography investigation
a. Artless X-foto
 X-foto mandibula AP/lateral, Eisler, Panoramik, Oklusal
(Gingiva mandibula cling in mandibula Tumor)
 Head X-foto lateral, Waters, Oklusal (Cling in maksila Tumor)
 Hap's X-foto: Palatum durum
X-foto thorax: Metastase pulmonum
b. Imaging
 USG hepar
 CT scan / MRI: Lokoregional
 Bone Scan
2. Laboratory investigation
DL, Etc for operation preparation
3. Pathology investigation
FNA (primary and metastase KGB)
Eksisi's biopsy: When does tumor <1cm (limit safety
margin 1cm from tumor side) general anesthesy
Incisional biopsy
Histopatology:
- type
- differentiation
- vast invasion of tumor
STAGING
T: Tx – Tis – T4 (0 – 2 – 4 cm)
N: Nx – N0 – N3 (0 – 2 – 4 – 6 cm)
M: Mx – M0 – M1
Staging of a disease 0 – IVc (every T, Every N, M1)
Therapy
Multidisiplin: Onkologi's operation, Neck head, Plastic,
Prostodonsi, Etc.
The aim of :
Primary tumor Eradikasi and metastase regional KGB
Returning function
Kosmetic