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      Gingival squamous cell carcinoma masquerading as an aphthous ulcer

      case-report

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          Abstract

          Gingival squamous cell carcinoma (GSCC) is an uncommon condition of the oral cavity. It is seldom associated with classic risk factors of oral cancer and shows a predilection for females. It's close clinical resemblances to various lesions of the oral cavity may make it go unnoticed. This may lead to diagnosis at advanced stages and coupled with the proximity to underlying alveolar bone may result in subsequent morbidity and mortality. A case of GSCC camouflaged as an aphthous ulcer in a middle aged woman is presented. The article highlights the importance of early diagnosis resulting in conservative treatment approaches.

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          Most cited references31

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          The National Cancer Data Base report on cancer of the head and neck.

          The National Cancer Data Base (NCDB), a large sample of cancer cases accrued from hospital-based cancer registries, is sponsored by the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The NCDB permits a detailed analysis of case-mix, treatment, and outcome variables. To provide an overview of the contemporary status of the subset of patients with head and neck cancer in the United States. The NCDB, which obtains data from US as well as Canadian and Puerto Rican hospitals, accrued 4 583 455 cases of cancer between 1985 and 1994. Of these cases, 301350 (6.6%) originated in the head and neck. We address 295022 cases of head and neck cancer limited to the 50 United States and District of Columbia. Cases were segregated into an earlier group (1985-1989) to permit 5-year follow-up and into a later group (1990-1994) to analyze a more contemporary group. Comparison between both periods permits identification of trends. The largest proportion of cases arose in the larynx (20.9%) and oral cavity, including lip (17.6%) and thyroid gland (15.8%). Squamous cell carcinoma (55.8%) was the most common histological finding, followed by adenocarcinoma (19.4%) and lymphoma (15.1%). Income level (low), race (African American), and tumor grade (poorly differentiated) were most notably associated with advanced stage. Treatment was most commonly surgery alone (32.4%), combined surgery with irradiation (25.0%), and irradiation alone (18.9%). Overall 5-year, disease-specific survival was 64.0%. Cancer of the lip demonstrated the best survival (91.1%) and cancer of the hypopharynx the worst survival (31.4%). This NCDB analysis of cancer of the head and neck provides a contemporary overview of head and neck cancer in the United States. It also serves to introduce a series of NCDB articles that address specific anatomical sites and histological types through separate, detailed analysis.
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            A comprehensive review of oral cancer.

            Oral squamous cell carcinomas comprise 2-3% of all new malignancies diagnosed in the United States, making it the 10th most common malignancy. However, for the last few decades, the average five-year survival rate of 50% has not changed significantly. This article reviews the risk factors associated with the development of oral cancer and how premalignant (leukoplakia and erythroplakia) and actual cancerous lesions may appear. Diagnostic tools and aids to diagnosis are discussed, as are treatment modalities. It is imperative that all dental professionals perform a simple head and neck examination in addition to an oral examination during each new patient visit and each six-month recall appointment. Early detection saves lives.
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              Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis?

              Stage at diagnosis is the most important prognostic indictor for oral and oropharyngeal squamous cell cancers (SCCs). Unfortunately, approximately 50% of these cancers are identified late (stage III or IV). We set out to examinationine the detection patterns of oral and oropharyngeal SCCs and to determine whether detection of these cancers by various health care providers was associated with a lower stage. Data were gathered on 51 patients with newly diagnosed oral or oropharyngeal SCC through patient interview and chart audit. In addition to demographic data, specific inquiry was made regarding the circumstances surrounding the identification of the lesion. The main outcome measure was tumor stage grouping based on detection source. Health care providers detecting oral and oropharyngeal SCCs during non-symptom-driven (screening) examinations were dentists, hygienists, oral and maxillofacial surgeons, and, in 1 case, a denturist. All lesions detected by physicians occurred during a symptom-driven examination. Lesions detected during a non-symptom-driven examination were of a statistically significant lower average clinical and pathologic stage (1.7 and 1.6, respectively) than lesions detected during a symptom-directed examination (2.6 and 2.5, respectively). Additionally, a dental office is the most likely source of detection of a lesion during a screening examination (Fisher exact test, P =.0006). Overall, patients referred from a dental office were of significantly lower stage than those referred from a medical office. Finally, patients who initially saw a regional specialist (dentist, oral and maxillofacial surgeon, or otolaryngologist) with symptoms related to their lesion were more likely to have appropriate treatment initiated than those who initially sought care from their primary care provider. Overall, detection of oral and oropharyngeal SCCs during a non-symptom-driven examination is associated with a lower stage at diagnosis, and this is most likely to occur in a dental office. A regional specialist was more likely than a primary care provider to detect an oral or oropharyngeal SCC and initiate the appropriate treatment during the first visit for symptoms related to the lesion. Copyright 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:285-291, 2003
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                Author and article information

                Journal
                J Indian Soc Periodontol
                J Indian Soc Periodontol
                JISP
                Journal of Indian Society of Periodontology
                Medknow Publications & Media Pvt Ltd (India )
                0972-124X
                0975-1580
                Jul-Aug 2013
                : 17
                : 4
                : 523-526
                Affiliations
                [1] Department of Periodontics, Government Dental College and Hospital, Hyderabad, Andhra Pradesh, India
                Author notes
                Address for correspondence: Dr. Gudi Pavan Kumar, H. No. 207/3RT, Near Ramalayam, Saidabad Colony, Hyderabad - 500 059, Andhra Pradesh, India. E-mail: drpavan82@ 123456yahoo.co.in
                Article
                JISP-17-523
                10.4103/0972-124X.118329
                3800420
                24174737
                eec837c9-5cc9-4ea5-9bff-bbccd10be0d5
                Copyright: © Journal of Indian Society of Periodontology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 April 2012
                : 08 July 2013
                Categories
                Case Report

                Dentistry
                early diagnosis,gingiva,squamous cell carcinoma
                Dentistry
                early diagnosis, gingiva, squamous cell carcinoma

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