Where does it arise and how does it develop?
Most often, the tumor appears on the mucous membrane of the cheek, on the floor of the mouth under the tongue, on the gum or alveolar process. Development is usually preceded by a long stage of precancerous changes, when the cells have already changed, but the tumor has not yet formed. Gradually, the area thickens, ulcerates and begins to grow deeper, affecting the muscles and jaw bone. Next, the tumor cells enter the lymph nodes of the neck. Early detection at the stain stage allows for minimal intervention.
- Buccal mucosa and retromolar region
- Floor of the mouth
- Gums and alveolar process
- Hard palate
- Red lip border
- Spread to the lymph nodes of the neck
Precancerous changes
Leukoplakia is a white spot or plaque that cannot be removed with a spatula; it is more often associated with smoking and nasvay and in some cases eventually develops into a tumor. Erythroplakia looks like a bright red velvety area and is more dangerous than leukoplakia, so it almost always requires a biopsy. Conditions that require monitoring also include lichen planus and submucosal fibrosis associated with chewing formulas. These changes are painless and can only be noticed upon examination.
- Leukoplakia - a white, indelible spot
- Erythroplakia - red velvety area
- Mixed white and red lesions
- Lichen planus
- Submucosal fibrosis
- Chronic ulcer from a denture or sharp tooth
Symptoms
Manifestations depend on the location of the tumor. Common symptoms include a non-healing ulcer, induration, discolored area, pain when chewing and swallowing, and foreign body sensation. When the gums are damaged, the teeth become loose and the socket heals poorly after removal; when there is a tumor in the bottom of the mouth, the mobility of the tongue is impaired and slurred speech appears; when it grows into the muscles, it becomes difficult to open the mouth. An alarming sign of the later stages is a dense, immobile lymph node in the neck and weight loss.
- Non-healing ulcer or erosion
- Consolidation and thickening of the mucous membrane
- Pain when chewing and swallowing
- Loose teeth and bleeding
- Numbness of the lip or chin
- Difficulty opening the mouth
- Enlarged lymph nodes in the neck
Diagnostics
Examination and palpation of the mucous membrane, floor of the mouth and neck can suggest a tumor, but only a biopsy with histological examination gives the final answer. For suspicious spots, it is performed even in the absence of complaints. The prevalence is assessed by ultrasound of the lymph nodes of the neck, CT or MRI with contrast, and the condition of the jaw is assessed by an orthopantomogram or CT. Be sure to exclude distant lesions and examine the larynx and pharynx, since with such risk factors several tumors are possible at the same time.
- Complete examination of the mouth and neck
- Biopsy with histological examination
- Ultrasound of the lymph nodes of the neck
- CT or MRI of soft tissues of the neck with contrast
- Assessing the condition of the jaw bones
- CT chest
- Examination by an ENT doctor with endoscopy of the pharynx and larynx
Treatment and prevention
The main method for tumors of the oral cavity is surgery with removal of the lesion within healthy tissue and intervention on the lymph nodes of the neck when indicated. Depending on the stage and histology results, radiation therapy is added, sometimes in combination with chemotherapy. Modern surgery involves immediate tissue restoration, which improves speech, chewing and appearance. Prevention is simple and effective: giving up tobacco and nasvay, limiting alcohol, treating sharp edges of teeth and regular dental checkups.
- Surgical removal of the tumor
- Lymph node dissection of the neck according to indications
- Radiation and chemotherapy
- Reconstructive surgeries and prosthetics
- Quitting tobacco, nasvay and alcohol
- Removal of traumatic teeth and dentures
- Preventive dental examination every six months
- HPV vaccination at recommended ages
