Canis ISSN: 2398-2942

Oral squamous cell carcinoma: labial and lingual

Contributor(s): Jane Dobson, Dick White

Introduction

  • Less common than the gingival form; mucosal surface of lip/cheek or tongue.
  • Signs: dysphagia, hypersalivation.
  • Lip/cheek may respond to wide local surgical resection; lingual more aggressive with very poor prognosis unless early recognition.
  • Treatment: for non-operable soft tissue masses, radiotherapy may offer a 50% survival at 1 year.
    The tongue has too narrow a therapeutic index for radiotherapy treatment.
  • Prognosis: soft tissue masses: 5-10% regional lymph node metastases; 3-36% distant metastases.
  • Lingual: overall metastatic rate of 37.5%.

Pathogenesis

Predisposing factors

General
  • Lingual - some relationship to white-coated animals.

Pathophysiology

  • Lingual and lip/cheek - route of spread via local lymph nodes → thoracic metastases.
  • Lingual - rostral site has improved prognosis over caudal location, where lymphatic drainage is denser and risk of metastatic spread higher.
  • Lingual - typically rapid extension and invasion into the tongue → full thickness involvement.
  • Lip/cheek commonly ulcerative rather than proliferative → less prompt to metastasize.
  • Primary tumor → local lymph node metastases → distant metastases, usually thoracic.
  • Lingual - recent attempt to grade histological features with clinical characteristics:
    • Grade 1 - relatively benign.
    • Grade 2 - aggressive surgery with or without chemotherapy.
    • Grade 3 - poor prognosis.

Timecourse

  • Lingual: owner median referral time - 1.5 months (10 cases).

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Withrow S J & MacEwen E G (1996)Small Animal Clinical Oncology. 2nd edition. Philadelphia: W B Saunders Co, ISBN 0 7216 5592 0 (Useful up-to-date reference; a starting point).
  • Slatter D (1993)Textbook of Small Animal Surgery.2nd edn. Philadelphia: W B Saunders Co, ISBN 0 7216 8329 0.
  • Volume II, section 16 - comprehensive section on all aspects of oncology, including radiotherapy.
  • White R A S (1990) In:The Manual of Small Animal Dentistry.Cheltenham: British Small Animal Veterinary Association. pp 101-112. (Affordable source, very readable).


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