OSCC manifesting as an ulcer on the floor of the mouth and ventral surface of the tongue. Figure 2. OSCC manifesting as an exophytic lesion of the floor of the mouth and anterior mandibular buccal gingiva. However, one cannot exclude the possibility that some patients were not aware of having had pre-existing leukoplakia at the site of OSCC while others may have been treated by traditional healers for some kind of unidentified oral mucosal lesions which in fact was premalignant leukoplakias or early OSCCs which by the time of diagnosis had already progressed to frank OSCC manifesting clinically as an ulcer, or as an exophytic lesion [ 7 , 17 ].
The distribution of carcinomatous lesions by clinical type is shown in Table 2. It has been suggested that if the growth of the OSCC is very rapid so that the mass of malignant cells out-paces its blood supply, then the lesion will become necrotic and breakdown into an ulcer Figure 1 , but if the mass of malignant keratinocytes has grown more slowly and has sufficient blood supply, an exophytic Figure 2 OSCC will develop.
The greater the amount, the greater the frequency and the longer the duration of tobacco smoking and alcohol consumption, the greater is the risk of carcinoma, and the risk is increased by the concurrent use of these agents. However, OSCC can be idiopathic; and it is clear that subject-specific genetic factors and environmental factors also play important roles either predisposing to or affording protection against OSCC [ 13 ]. Two affected patients use snuff only. Therefore, it is that it is likely the incidence of OSCC could be substantially reduced by abstinence from tobacco smoking or exercising moderation in alcohol consumption.
It is probable that the thin non-keratinized epithelium of both the ventral surface of the tongue and the floor of the mouth allow penetration of carcinogens, particularly constituents of tobacco smoke, and alcohol to a greater extent than thicker and more keratinized parts of the oral epithelium so that these agents can reach the progenitor cell compartment in the basal cell layer of the epithelium, mediating malignant transformation. This may explain why the ventral surface of the tongue and the floor of the mouth are the sites most commonly affected by OSCC [ 13 ].
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It has been reported that OSCC affects males more frequently than females, probably because males more often indulge in high-risk habits such as tobacco smoking and drinking alcoholic beverages than do females [ 13 , 19 ]. The mean age of the patients at the time of diagnosis of OSCC was OSCC more frequently affects Blacks than Whites, and at the time of diagnosis is significantly more advanced in the former than in the latter [ 7 , 13 ].
Furthermore, in general, the average 5-year survival rate is lower for Blacks than for Whites most probably because Blacks have more limited access to health care services, and because, for educational and socioeconomic reasons Blacks delay seeking medical advice and treatment. Although these factors play no direct role in the development of OSCC, they indirectly influence morbidity and mortality [ 13 ].
Eighty-eight percent of the patients in this study had more than one site affected. This probably reflects extension of a single lesion to one or more contiguous oral sites; but one cannot rule out the possibility that some cases of widespread OSCCs developed by conjugation of lesions that arose from multiple subclones of cells in fields of precancerised oral epithelium in which the precancerised keratinocytes were already committed to the pathway of cancerization [ 20 ].
We certify that we have participated adequately in the intellectual content, conception and design of this work or the analysis and interpretation of the data as well as writing of the manuscript. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Read More. Special Issues Frequently Asked Questions. Links Advanced knowledge sharing through global community… Read More. Take a look at the Recent articles. Materials and methods This prospective study is based on random cases seen and diagnosed by a single clinician MB in the Department of Maxillofacial and Oral surgery at Medunsa Oral Health Centre, Ga-Rankuwa, South Africa, during the period July to June and not on the total number of OSCCs that were diagnosed in the centre during this period.
Thirteen percent were younger than 45 years, In this study of 32 patients, 70 oral sites were affected: eight patients had one site affected, 14 had two sites affected, six had three sites affected and four had four sites affected. Table 1. OSCC manifesting as an ulcer on the floor of the mouth and ventral surface of the tongue Figure 2. OSCC manifesting as an exophytic lesion of the floor of the mouth and anterior mandibular buccal gingiva Figure 3. OSCC manifesting as a leukoplakia on the ventral surface of the tongue Figure 4.
Table 2. Authorship and contributionship We certify that we have participated adequately in the intellectual content, conception and design of this work or the analysis and interpretation of the data as well as writing of the manuscript. Oral cancer. Part 1: human papillomavirus-mediated carcinogenesis. Head Face Med 6: J Cancer Res Ther SADJ J Natl Cancer Inst J Cancer Ther 3: Quickest way to get there Cheapest option Distance between.
There are currently travel restrictions within South Africa. Explore options for future travel. Do I have to wear a face mask on public transport in Ga-Rankuwa? Wearing a face mask on public transport in Ga-Rankuwa is mandatory. Is it compulsory to practice social distancing in Ga-Rankuwa?
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