Journal Article on Gingival Squamous Cell Carcinoma Mimicking Periodontal Disease
Gingival Squamous Cell Carcinoma (GSCC) is an oral cancer of the gingiva. Although it is more rare (10%) than general Squamous Cell Carcinoma's (90%), it is much more aggressive and has usually affected nearby areas by the time it is diagnosed. Since the neoplasms invade the bone directly, they represent one of the most serious oral cavity malignancies. Diagnosis is often delayed because it's symptoms can frequently mimick other common, and often benign, oral lesions.
I believe the AAP classification would be a IV C, Periodontitis as a Manifestation of Systemic Diseases, Not otherwise specified. The etiology of GSCC is still unkown. GSCC is more common in women over the age of 50 with the average age being in the 70's. . Clinically, GSCC appears as an exophytic mass with a granular, papillary, or verrucous surface, or it presents as an ulcerative lesion. This article stated the the most predominant symptom is gingival pain except in the early stages when it can be asymptomatic. Other articles have stated that it is often asymptomatic. Unlike general SCC, Gingival Squamous Cell Carcinoma does not seem to have predisposing factors of smoking and alchohol. Most gingival tumors arise from nonkeratinized mucosa of the tongue and floor of the mouth. GSCC are well-differentiated and arise from keratinized mucosa of the mandibular posterior gingiva and the tumor may destroy the underlying bone structure causing tooth mobility. This article however, was describing a patient with a tumor located in the anterior gingiva of the maxillary teeth, and no mobility was observed. An important feature that could help arouse clinical suspicion of malignancy is the fact that periodontitis is normally generalized and GSCCs are localized. In this article, the patient presented with a painless hyperplastic and erythematous gingiva with white and ulcerated areas that could resemble an inflammatory lesion affecting the periodontium.
Treatment can't be started until it has been diagnosed. the article stated it is important to biopsy any lesion that remains longer than 2 weeks after removal of the suspected etiologic agents. Further research of information outside of this article stated that treatment most often surgery involving flap reconstructions, or modified neck dissecctions with marginal bone resection, and post operative radiotherapy. the patient in this article had treatment consisting of a maxilectomy bia block resection. The surgical defect was reconstructed with the use of an antebrachial skin flap. The survival and rate of recurrance were comparable to those of other SCC's of the oral cavity and oropharynx.
Maintenance consisits of frequent dental check ups to see if the patient remains symptom free. Patients should also always have a health professional check any suspected lesions or abnormality.
APA Citation and full article
Molina, A., Cirano, F., Magrin, J., & Alves, F. (2011). Gingival squamous cell carcinoma mimicking periodontal disease. The International Journal Of Periodontics & Restorative Dentistry, 31(1), 97-100
J Periodontol. 2006 Jul;77(7):1229-33.
Gingival squamous cell carcinoma: diagnostic delay or rapid invasion? Seoane J, Varela-Centelles PI, Walsh TF, Lopez-Cedrun JL, Vazquez I.
Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, and Primary Care Clinics, Galician Health Service, Burela, Lugo, Spain. [email protected]
Journal of Cranio-Maxillofacial Surgery
Volume 28, Issue 6, December 2000, Pages 331–335
·Institut Bergonié, Regional Cancer Center, Bordeaux Cedex, France
Department of Maxillofacial and Plastic Surgery, Centre Hospitalier Universitaire, Bordeaux Cedex, France
I believe the AAP classification would be a IV C, Periodontitis as a Manifestation of Systemic Diseases, Not otherwise specified. The etiology of GSCC is still unkown. GSCC is more common in women over the age of 50 with the average age being in the 70's. . Clinically, GSCC appears as an exophytic mass with a granular, papillary, or verrucous surface, or it presents as an ulcerative lesion. This article stated the the most predominant symptom is gingival pain except in the early stages when it can be asymptomatic. Other articles have stated that it is often asymptomatic. Unlike general SCC, Gingival Squamous Cell Carcinoma does not seem to have predisposing factors of smoking and alchohol. Most gingival tumors arise from nonkeratinized mucosa of the tongue and floor of the mouth. GSCC are well-differentiated and arise from keratinized mucosa of the mandibular posterior gingiva and the tumor may destroy the underlying bone structure causing tooth mobility. This article however, was describing a patient with a tumor located in the anterior gingiva of the maxillary teeth, and no mobility was observed. An important feature that could help arouse clinical suspicion of malignancy is the fact that periodontitis is normally generalized and GSCCs are localized. In this article, the patient presented with a painless hyperplastic and erythematous gingiva with white and ulcerated areas that could resemble an inflammatory lesion affecting the periodontium.
Treatment can't be started until it has been diagnosed. the article stated it is important to biopsy any lesion that remains longer than 2 weeks after removal of the suspected etiologic agents. Further research of information outside of this article stated that treatment most often surgery involving flap reconstructions, or modified neck dissecctions with marginal bone resection, and post operative radiotherapy. the patient in this article had treatment consisting of a maxilectomy bia block resection. The surgical defect was reconstructed with the use of an antebrachial skin flap. The survival and rate of recurrance were comparable to those of other SCC's of the oral cavity and oropharynx.
Maintenance consisits of frequent dental check ups to see if the patient remains symptom free. Patients should also always have a health professional check any suspected lesions or abnormality.
APA Citation and full article
Molina, A., Cirano, F., Magrin, J., & Alves, F. (2011). Gingival squamous cell carcinoma mimicking periodontal disease. The International Journal Of Periodontics & Restorative Dentistry, 31(1), 97-100
J Periodontol. 2006 Jul;77(7):1229-33.
Gingival squamous cell carcinoma: diagnostic delay or rapid invasion? Seoane J, Varela-Centelles PI, Walsh TF, Lopez-Cedrun JL, Vazquez I.
Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, and Primary Care Clinics, Galician Health Service, Burela, Lugo, Spain. [email protected]
Journal of Cranio-Maxillofacial Surgery
Volume 28, Issue 6, December 2000, Pages 331–335
·Institut Bergonié, Regional Cancer Center, Bordeaux Cedex, France
Department of Maxillofacial and Plastic Surgery, Centre Hospitalier Universitaire, Bordeaux Cedex, France