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Histology of oral cancer

The most common malignant lesion in the mouth is squamous cell carcinoma (90%). This is often preceded by precursor lesions such as oral leukoplakia. When squamous cell cancer infiltrates deeper in the tissue it has a tendency to spread through lymph- and blood vessels.

There are other less common types of oral cancer such as: adenocarcinoma from minor salivary glands, lymphoma from tonsillar region and melanoma from melanin-producing cells of the oral mucosa.

In oral biopsies the pathologist must evaluate the squamous epithelium:

  • atypia and degree of atypia
  • carcinoma in situ
  • invasive carcinoma
  • depth of invasion

When resection of tumor is performed the pathologist should evaluate tumor type, size, depth of invasion, pattern of invasion, vessel invasion, perineural invasion and resection borders.

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