1. Peutz-Jeghers

2. Median Rhomboid Glossitis

3. Fissured Tongue

4. Benign Migratory Glossitis (BMG)

5. Tori

1. Pyogenic Granuloma (Pregnancy tumor)

2. Peripheral Giant Cell Reparative Granuloma

3. Chronic Inflammatory Fibrous Hyperplasia

1. White Sponge Nevus

2. Lichen Planus

3. Candidiasis

1. Squamous Cell Papilloma

2. Squamous Cell Carcinoma

3. Verrucous Carcinoma

1. hyperpigmentation on oral and labial mucosa (due to increased melanin)

2. intestinal polyposis

-oral mucous analogue of psoriasis

-painless, multiple foci of desquamation of filiform papillae that have circular pattern, with red color and yellow border

-1-2% in young adults

-20% of patients with fissured tongue --> BMG

-benign protrusion of bone, covered by thin mucosa

-25% - in palate

-6-8% - in mandible

Results from injury during mastication to squamous mucosa --> hyperkeratosis + parakeratosis + acanthosis

These changes induce acute and chronic inflammation of the subepithelium

-tumorfactive, non-neoplastic lesion of gingival/alveolar tissues secondary to trauma

-3-4cm vascular, red lesion

-increased number of multinucleated giant cells with chronic inflammation

-MOST COMMON abnormality

-exophytic nodules of well collagenized CT on traumatized areas of oral mucosa (i.e. lateral tongue, buccal mucosa)

-AKA - fibroma, fibrous polyp, fibroepithelial lesion

white patch of oral mucosa that CANNOT be rubbed off

-usually genetic, inflammatory, premalignant or invasive malignant

-fine lacework of white hyperkeratotic papules (Wickham's Striae)

-ulcerations and bullous lesion may be seen

What could cause Lichen Planus?

-hyperkeratinized

-acanthosis

-saw tooth rete peg

-liquefaction degeneration of basement membrane

-band-like chronic inflammatory infiltrate at junction of basal cells and superficial subepithelial tissues

-curd-like lesions which can be removed

-supprative exudates with hyphae

-Diabetes Mellitus

-Immunocompromised (i.e. AIDS)

-patients on antibiotics (disturbs balance of oral flora)

-cauliflower like exophytic lesions on pedicle (mm in diameter)

-MOST COMMON benign epithelial neoplasm

-finger-like projections of normally maturing stratified squamous epithelium surrounding a central core of vascular CT

What are some demographics for Squamous cell Carcinoma?

-90% of all oral cancers

-6% male; 2% female

-35% of all causes in India/Asia due to Betel Nut

-potentially have a 5 year survival

-occurs in males in 6th-8th decade of life

1. Tobacco

2. Alcohol

3. Trauma from broken dentition

4. HPV (if no h/o smoking/EtOH)

5. family history

6. Lichen Planus (malignant transformation)

-early signs are innocuous (mucosal thickening, leukoplakia)

-advanced disease - exophytic, ulcerated lesion that is indurated at margins/base

What does Squamous Cell Carcinoma look like under microscope?

-wide range in squamous cell that could be well-differentiated, showing keratin/intracellular bridging

-Grade I-IV

-neutrophils within keratinized pearl nests

1. primary disease 

2. metastatic disease --> blood vessels or base of brain

3. due to intercurrent disease (bronchopneumonia)

1. excise primary lesion via commando procedure (radical neck dissection)

2. RADIATION Therapy**

1. low grade papillary exophytic lesions

2. on alveolar, buccal, mucobuccal folds of elderly patients

3. M = F

papillary, acanthotic with deep penetration of enlarged rete pegs that show infiltration with minimal atypia

better than invasive squamous cell carcinoma with minimal metastasis

1. intussuception of bowel --> necrosis

2. association with malignancies - breast, pancreas, lung

1. keratinization

2. thickening of stratum spinosum (acanthosis)

3. inflammatory infiltrate at junction