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Oral Cavity Cancer

Carcinoma cavitatis oris

For medical students2 min readUpdated 2026-10-10

Understanding malignant neoplasms is based on the fundamental principle of the unity of structure and function. Analysis of structural changes allows for an accurate determination of the morphological basis of pathological processes and tracking the dynamics of disease development.

Basis of pathologyMorphological changes determine the nature of the disease

Clinical thinkingFormed through understanding the regularities of processes

DiagnosisRequires knowledge of formulation rules and causes of discrepancies

Principles of Studying Pathological Anatomy

Mastering clinical disciplines is impossible without establishing a reliable baseline. The main objective of studying pathological anatomy, including the pathology of the dentognathic system and oral organs, is to demonstrate a clear link between morphological changes and subsequent disturbances in body functions.

Each disease has its own dynamics of development. Studying this dynamics allows future specialists (including dental and medical students) to form correct clinical thinking. It should be based on a deep understanding of general patterns of pathological processes occurring in the patient's body at various stages of the disease.

Dentognathic System Pathology and Related Processes

As part of systemic pathology, various lesions and inflammatory processes are examined in detail. Although malignant epithelial tumors require separate attention, a broad spectrum of pathologies must be known for differential diagnosis. The tissues of the oral cavity and jaws can develop:

Tumor-like lesions and cysts (e.g., cherubism).
Fibrous and vascular gingival proliferations, such as epulis (angiomatous and fibromatous variants), as well as gingival fibromatosis.
Odontogenic neoplasms (various variants of odontogenic fibroma, cementoma, cementoblastoma).
Precancerous lip changes, which include Manganotti's cheilitis.

In addition, systemic infectious processes can manifest on the oral mucosa and tongue, such as the formation of a specific "typhoid" or "raspberry" tongue.

Tumor Processes of Various Genesis

For a complete understanding of oncological vigilance, one must navigate tumor classification as a whole, including neoplasms in children. Pathological anatomy classifies tumors according to their tissue origin.

Among mesenchymal tumors, benign (e.g., fibroma, chondroma, chondroblastoma, chondromyxoid fibroma) and malignant counterparts (such as bone or soft tissue fibrosarcoma, chondrosarcoma) are distinguished. A special place is occupied by specific neoplasms of other systems, such as pheochromocytoma or choriocarcinoma, the mechanisms of development of which help understand the general principles of oncogenesis and metastasis.

Clinical and Anatomical Analysis

A critical part of practical training is the analysis of general medical concepts and strict rules for formulating clinical and pathoanatomical diagnoses. Errors in tumor diagnosis can lead to serious consequences.

Students and physicians are required to analyze categories and identify causes of diagnostic discrepancies to minimize them in future practice. This promotes an analytical approach to each clinical case based on morphological confirmation.

Frequently asked questions

What are the most frequent localizations of oral cavity mucosal cancer?

The most frequent localizations of oral mucosal cancer indicated in sources include:

Tongue — accounts for about 55% of all malignant neoplasms of the oral cavity; the lateral surface of the middle third of the tongue and the root area are most frequently affected.
Floor of the mouth — the tumor is localized in the region of the sublingual folds, along the midline near the frenulum, or in the lateral parts of the floor of the mouth.
Buccal mucosa — characterized by rapid tumor spread into the thickness of the cheek and its muscles.
Hard palate.
Soft palate.

What macroscopic (clinical and anatomical) growth forms are characteristic of oral cavity cancer?

The following clinical and anatomical growth forms are described for oral cavity and lip tumors:

Exophytic cancer — for lip cancer, includes papillary and verrucous forms.
Endophytic cancer — contrasted with the exophytic growth type.
Infiltrative form of oral mucosal cancer — affects the mucous membrane diffusely, does not ulcerate, is characterized by high malignancy; tumor borders within the infiltrate are not defined.
Ulcerative-infiltrative form of lower lip cancer — an ulcer located on a very dense infiltrate, the dimensions of which significantly exceed the dimensions of the ulcer itself.

To which regional lymph nodes does squamous cell carcinoma of the tongue predominantly metastasize?

Regional metastasis of tongue cancer occurs via lymphatic pathways to the following groups of lymph nodes:

Submental lymph nodes (nodi lymphatici submentales) — affected when the tumor is localized on the tip and anterior parts of the tongue.
Submandibular lymph nodes (nodi lymphatici submandibulares) — lymph drains into them from the lateral parts of the tongue (in transit through the floor of the mouth).
Deep cervical lymph nodes — affected due to direct lymphatic connections with various parts of the tongue.

With which benign and tumor-like processes of the gingiva must oral cavity cancer be differentiated?

Among benign and tumor-like gingival processes that should be considered in the differential evaluation of lesions in this area, sources describe:

Periodontomas (epulides) — collective clinical terms for polypoid gingival formations, including tumor-like lesions and true tumors.
Peripheral giant cell (reparative) granuloma — traditionally referred to as giant cell epulis.
Angiomatous epulis.
Fibromatous epulis.
Gingival fibromatosis — in elderly patients, numerous papillary formations can develop on the gingival surface.

What are the main etiological factors contributing to the development of squamous cell carcinoma of the oral cavity?

Proven etiological factors contributing to the occurrence of oral carcinomas include:

Tobacco smoking — incidence increases 18-fold in active smokers.
Excessive consumption of strong alcohol.
Chronic trauma to the mucosa.
Poor oral hygiene.
Alimentary malnutrition and metabolic disorders (including those associated with alcohol abuse).
Occupational carcinogens and negative environmental impacts.

How does keratinizing squamous cell carcinoma differ from non-keratinizing carcinoma on microscopic examination?

Upon microscopic examination, these histological variants have the following differences:

Feature	Keratinizing Carcinoma	Non-keratinizing Carcinoma
Keratinization	Formation of keratin, keratohyalin granules, and "cancer pearls"	Absence or minimal signs of keratinization
Cells	Pronounced intercellular bridges	Oval/polygonal cells, intercellular bridges usually not defined
Mitoses	Relatively rare	High mitotic activity, frequent atypical mitoses
Polymorphism	Less pronounced (well-differentiated)	Pronounced cellular polymorphism (poorly differentiated)

What principle is the presentation of pathological material based on?

It is based on the fundamental principle of the unity of structure and function.

What is the main purpose of studying morphological changes?

The primary goal is to form clinical thinking based on an understanding of the patterns of disease development.

Why is it necessary to study categories of diagnostic discrepancies?

This is necessary to understand the causes of diagnostic errors and to correctly formulate clinical and pathoanatomical diagnoses.

Go deeper

Morphological characteristics of Manganotti's cheilitis
Differential diagnosis of epulis variants (angiomatous and fibromatous)
Odontogenic tumors: cementoma and cementoblastoma
Rules for formulating a pathoanatomical diagnosis
Causes of discrepancies between clinical and pathoanatomical diagnoses