Squamous Cell Carcinoma

This is a rather large squamous cell cancer located on the lateral border of the tongue. These lesions are generally painless until they become large enough to feel during normal tongue movement, which is probably the main reason that the patient did not seek treatment until this late stage. Note the combination of red and white areas which is the hallmark of this type of oral cancer.

The image above shows a squamous cell carcinoma located at the base of the lingual frenum. In lay terms, it is located under the tongue at the base of the thin strip of tissue that runs vertically from the floor of the mouth to the undersurface of the tongue. In this case, one can see serious calculus buildup around the teeth. The stain on the calculus is caused by tobacco smoke.

The above image is obviously a very advanced case of squamous cell carcinoma. It was found in an 86 year old woman, and it had been growing for many years before it got so large. Surprisingly, the patient had had a cataract operation two months prior to this photo. No one at that time had thought to examine her mouth. In a way, this is testimony to the fact that it can take many years for oral cancer to kill a person. Notice that in spite of its advanced condition, many parts of this lesion look like the earlier lesions in the images above.

The image above shows a squamous cell carcinoma developing in the mucosa overlying the hard palate. (There are no teeth present.) The keratinized tissue that looks like a callus is called nicotinic stomatitis and is caused by heavy tobacco smoke exposure. Nicotinic stomatitis is NOT considered to be a pre-cancerous lesion. This particular patient had, however, been smoking an average of 30 cigars a day for approximately 30 years. The squamous cell lesion sprang from several different focal points. The cancer probably arose within several separate areas of leukoplakia which were scattered throughout the nicotinic stomatitis lesion.

Cancer of the lip is another form of squamous cell carcinoma. The precipitating factor in lip cancer is prolonged, multiple exposures to the sun.

Verrucous carcinoma is also called "snuff dipper's cancer". It derives its name from its wart-like (cauliflower-like) appearance. It generally develops in the exact site of the chronic tobacco placement and is most often located on the gingiva and in the buccal/labial vestibule. In this case, it developed on the tongue due to chronic pipe smoking. It rarely metastasizes to other areas of the body, but tends to be locally invasive. This particular case started out much smaller, however it was misdiagnosed by medical pathologists for a number of years as simple leukoplakia (hyperkeratosis).

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