The decay of the cancer tumor of the mucous membrane. Rak Mouth - Treatment

Located in the cavity of the neoplasm mouth, characterized by the deliberate slow growth And not prone to metastasis. A benign oral tumors of the oral cavity include papillomas, mixes, retention cysts, serra glands, fibromes, led fibromatosis, moma, hemangioma, lymphangioma. The diagnosis of oral tumors is carried out on the basis of data inspection, palpation, radiographic research, angiography and histological research. The removal of oral tumors is possible by surgical excision, electrocoagulation, laser valorization, cryodestruction, vascular sclerosation, or applying a radio wave method.

General

Oral tumors arising in childhoodoften associated with disorders of tissue differentiation during the period of intrauterine development. These include dermoid and retention cysts, serra glands, congenital neules. As a rule, these neoplasms are detected during the first year of life.

Epithelial Oral Tumors

Papillomas. Oral tumors consisting of multilayer flat epithelium cells. Localize most often on lips, tongue, soft and solid sky. Papillomas of the oral cavity are a rounded ledge over the surface of the mucous membrane. May have a smooth surface, but more often covered with papillary sprouts by type of cauliflower. Usually there are single papillomas, less often - multiple. Over time, these tumors of the oral cavity are covered with a corneuing epithelium, due to which they acquire a whorescript and rough surface.

Netures. In the oral cavity, the nevi is observed in rare cases. They are more often convex and have a different degree of pigmentation from pale pink color to brown. Among tumors oral cavity There are blue nonsense, papillomatous Nestrow, Nestrow Ot and others. Some of them may be ill-based with the development of melanoma.

Serra glare. Usually, this type of oral tumors is located in the field of alveolar process or solid sky. Serra glands are semi-odd formations of yellowish color up to 0.1 cm and dense consistency. May have multiple. Usually by the end of the first year of the child's life, the spontaneous disappearance of these formations is observed.

Connectant oral tumors

Fibroms. Most often fibromes of the oral cavity are found in the field of the lower lip, language and in heaven. They have a kind of smooth oval or rounded formation, in some cases located on the leg. The color of these oral tumors does not differ from the color of the surrounding mucosa.

Duma fibromatosis. Not all authors include gum fibromatosis to oral tumors, some believe that it is based on changes in an inflammatory nature. Fibromatous growths are painless dense education. They can wear a local nature within a few teeth and diffuse, capturing the entire alveolar process of both lower and upper jaw. Tumor growths in fibromatosis are localized in gum papillars and can be so pronounced that the crowns of the teeth are completely closed. This type of oral tumor requires differentiation from hyperplastic gingivitis.

Moma.. Develop from muscle tissue. Rabdomiomes are formed from the fibers of the cross-striped muscles. Most often are observed in the form of single nodal formations in the thickening of the language. Leiomiomes are developing from smooth muscle fibers and usually localized in the sky. Myoblastoma (Abrikosov Tumor) are the result of disisembogenesis and are diagnosed in children up to a year. They are a rounded tumor of the oral cavity of up to 1 cm, covered with epithelium and having a brilliant surface.

Mixoma. These tumors of the oral cavity may have a rounded, nipple or a barride surface. Located in the area of \u200b\u200bthe solid sky or alveolar process.

Pyiogenic granuloma. Develops from mucosa or connective tissue elements of the oral cavity. It is often observed after injury to the mucous membrane of the cheeks, lips or language. Piogenic granuloma has similarities with a richly blood-cutting granulation tissue. It has a rapid increase in dimensions up to 2 cm in diameter, dark red color and bleeding when touched.

Epulisa. Benign oral tumors, located on the gum. May grow from deep layers of gums, periosteum, periodontal tissues. Most often, epulis occurs in the field of the front teeth. Classified on fibrous, giantheal and angiomatous education.

Nevnomane. Are formed as a result of the growth of the cells of the Schvanna shell nerve fibers. Reach in diameter 1 cm. Have a capsule. Nevnomers are almost the only oral tumors, when the palpation of which may be occurring soreness.

Vascular mouth tumors

Hemangioma. The most common tumors of the oral cavity. In 90% of cases, hemangiomas are diagnosed immediately or in the near future after the birth of the child. There are simple (capillary), cavernous, capillary-cavernous and mixed. A distinctive feature These oral tumors are their pale or decrease in size when pressing. The injury to hemangiom often leads to bleeding.

Lymphangioma. Arise as a result of imbigenesis disorders lymphatic system And usually detected in newborns. Characterized by the formation of limited or diffuse swelling in the oral cavity. Among the oral tumors, cavernous, cystic, capillary-cavernous and cystic and cavernous lymphangiomas distinguish. These oral tumors are prone to inflammation, which is often associated with injury of the mucous membrane or exacerbation of any chronic inflammatory disease Nasopharynx: pulpitis, tumor biopsy or after removing it.

To determine the depth of germination of the oral cavity tumor, an ultrasound of education is used to estimate the state of bone structures - x-ray study. When the gum fibromatosis, an orthopantomogram is carried out, which often detects the sections of the destruction of the alveolar process. In diagnosis vascular tumors Often use angiography.

Treatment of oral tumors

The difficulty of speech and chewing food in the presence of the oral tumor, constant traumatization of the neoplasms of this localization, as well as the likelihood of their malignation - all this is a reason for active surgical tactics. Depending on the type of oral tumor, the use of electrocoagulation, removal of laser, cryodestruction, radio wave method, surgical excision, sclerotherapy is possible.

The removal of the oral tumors of the diffuse character is carried out in several stages. Exciration of fibromatous growths produced with periosteum. Plots destroyed bone tissue Subjected to cutting and coagulation. The vascular tumors of the oral cavity can be sclerized by introducing sclerosing substances directly into the tumor vessels.

Modern medicine Oncological diseases of the oral cavity in appearance divides on three types:

1. Knocked.
   • In the mouth appears a clear form. The surface of the mucous membrane in this place is either no change or has whitewashed spots. A new education usually quickly increases its sizes.
2. Jazznaya.
   • It is manifested in the form of ulcers on the mucous membrane. She is worried about the patient and does not heal for a long time. Pathology in the form of ulcers quickly progresses. This shape of the cancer of the oral cavity is striking the mucousse more often than other varieties.
3. Papillary.
   • It looks like a tumor of a dense structure, which hangs into the oral cavity. The cover of the mucous appearance does not change.

The photo shows cancer of the oral mucous membrane in initial stage

Separate varieties of tumors

Depending on the deployment of education distinguish:

1. Cancer shy.
   • Dislocation of education often on the mouth line, at the level of its corner. First, can resemble an ulcer. Over time, restrictions arise in the opening of the mouth, discomfort during chewing and conversation.
2. • The tumor is on the muscles of the bottom and can capture the nearby zones: the lower part of the tongue and in salivary glands. The patient complains of pain and amplification of salivation.
3. Tumor of the tongue.
   • The difficulties arising from chewing and discomfort during the use of the speech apparatus are sometimes a consequence. The tumor is deployed on its side surfaces - cases of such pathology are often found. Less often cancer occurs on the lower surface of the language or on its top, affects its root or tip.
4. Tumor in the zone of alveolar processes.
   • The problem can be deployed on top and on lower jaw. Cancer can affect and teeth, which causes bleeding and pain in these places.
5. Cancer in the nose zone.
   • Depending on which tissue is subject to a disease, a different form appears. If covered soft fabrics, It develops cancer, which is called flat octoque. A solid panel may have a disease: cylindrome, adenocarcinoma, and a flat-belling appearance occurs. The problem reveals itself to the appearance of pain and discomfort during the food reception.
6. Metastase
   • Cancer Education is able to actively grow into a number of lying layers. The spread of the tumor depends on its type and localization. The development of the disease occurs in the promotion of cancer cells.
   • The cancer of the mucous membrane of the brush and alveolar trails of the lower jaw starts metastases into the zone of the subbands. Education arising in the distal departments give metastasis into nodes near yarem Vienna.
   • Language cancer, stationed in the area of \u200b\u200bits tip and side surfaces, progresses in the lymph nodes of the neck, and can also capture submandibular nodes.
   • In pathology - the cancer of the oral cavity is found, but infrequently remote metastases. They apply to internal organs:, g, heart, and also in.

The photo shows the bottom of the oral cavity

Causes and risk factors

• They put themselves with this harmful habit in a risk group for cancer in the field of oral cavity. This also includes chewing and sniffing tobacco.
• Use alcoholic beverages also contributes to the occurrence of the disease. If you combine these two bad habits, The probability of lesion of the oral cavity increases.
• Men are sick of collapse cancer more often than women.
• Sharp edges of a seal, an uncomfortable prosthesis or other factors that have a traumatic effect on the mucous membrane can lead to the development of cancer.
• which refers to the sixteenth type may be the cause of cancer.
• Among the problems of the mucous membrane, the flat deprived carries the threat of cancers.
• Weakening of immunity with systemic reception of chemicals is a risk factor for the appearance of oncology.
• Incompute meals with insufficient use of fruits and vegetables and deficiency of antioxidants - vitamins A, C and E creates conditions for the growth of cancer cells.
• Frequent contact with asbestos contributes to the occurrence of cancer in the oral cavity. Polycyclic organic compounds have the same adverse effect.

Symptoms and signs

To consult a specialist, if such changes appeared in the mouth:

• thickening language, which leads to discomfort during food and conversation,
• numbness language
• dinen numbness, some teeth,
• dental loss without a visible reason
• outlet of jaws
• pain in the oral cavity that takes a chronic character
• chronic increase in lymph nodes located in the neck area,
• voice change
• weight loss,
• appearance on lips or in the oral cavity of the formation that does not pass for a long time And tends to increase in size, it can be:
  • red stain
  • whitish stain
  • yazvka,
  • seal
  • thief.

These phenomena may not be cancer, but be reborn in them over time.

The formation of three phases of development pass:

1. the initial stage - The patient notices unusual phenomena in the health state of the oral cavity. There are obscure pains, seals, ulcers in the oral cavity.
2. Developed stage of the disease - ulcers become in the form of cracks. They can be deployed over the tumor. Holy feelings arise, which can be given to different areas of the head. Cancer tumor can develop without pronounced pain.
3. Launched step - The disease actively destroys the surrounding tissues.

Stages

The degree of development of the tumor, its size, specialists determine the stage of the disease.

• Stage zero - Cancer Education did not spread the deeper mucous membrane of the oral cavity. The tumor is very small.
• Stage first - The size of education does not exceed two centimeters. The spread of the disease does not occur.
• Stage second - Education has reached in the diameter of four centimeters. The progression of the tumor has not yet struck lymphatic nodes.
• Stage third - Education exceeded four centimeters and it can already be observed in the lymph nodes.
• Stage fourth - Education let metastases in the internal organs. Often the progression of the tumor happens in the lungs. However, the development of the disease can be directed to the nearest areas - the bones of the face, the zone of the nose sinus.

Diagnostics

The tumor specialist determines visually. The degree of expanding the disease in soft tissues is diagnosed with palpation. In bone structures, cancer education is detected by applying radiography.

The tumor is recognized by malignant or not after differential diagnosis. To confirm the diagnosis, the biopsy of the diseased tissues is carried out.

Treatment

There are various methods for the treatment of cancer tumor. The choice of method depends on the stage of development of the neoplasm and its form.

Surgical

If you can not do without cut-off tumor, surgical intervention involves. After the removal of education can be carried out to restore the disturbed external view patient.

Radiation therapy

This method is used most often when dealing with a robust cavity tumor. It can be used as an independent way or after surgical intervention.

Medicines are selected depending on the tolerability and stage of the disease.

Preparations of chemotherapy kill cancer cells. The method is used comprehensively with irradiation or with surgical intervention.

Prediction and prevention

Full cure is possible in the early stages of the disease. The shape of cancer also affects the forecast of the treatment result.

The papillary form is often cured completely. Cancer having a peptic shape, it is more difficult to treat.

If you compare the neoplasms of the rear and front parts of the cavity, the latter are better to be treated, are not so malignant.

Preventive actions:

• It is necessary to part with tobacco and alcohol abuse.
• It is reasonable to avoid ultraviolet rays of the Sun, when it is in the zenith.
• Select a ration rich in fiber and antioxidants. Eliminate the reception of very sharp and hot food.
• Monitor the oral cavity so that there is no injury factor (dentions of teeth with sharp edges) that destroys the mucous membrane.

Video about the symptoms and causes of cavity cancer:

The tumors of the oral cavity, like other organs and systems, is customary to divide on benign and malignant neoplasms. They are sufficiently common, and are detected not only with the direct appeal to the doctor, but also by chance, in the treatment of the dentist. Most often, dentists face tumors of epithelial origin, originating from a ferruginous, flat or chubous epithelium. It is possible to develop a tumor of the oral cavity from adipose tissue, muscle fibers, connective tissue structures, nerve trunks and vessels. Depending on the location allocate benign tumors Language, inner surface of the cheeks, soft and solid sky, sub-surround region, gums and lips. Morbidity malignant neoplasms The oral cavity is determined by household habits, nutrition, exposure to the external environment. The main share (65%) is occupied by tumors of the language, followed by tumors of the mucous membrane of the lump (12.9%), the bottom of the oral cavity (10.9%), the mucous membrane of the alveolar process of the upper jaw and solid sky (8.9%), soft Neuba (6.2%), alveolar mucous membrane of the lower jaw (5.9%), soft nose tongue (1.5%), front chickens (1.3%). These diseases of men suffer 5-7 times more often than women. The peak of morbidity falls at the age of 60-70 years, but the risk of ill increases from 40 years. Nevertheless, this type of disease is sometimes found in children. A special risk of getting sick arises when abuse of alcohol, smoking, chewing betel and falling. A certain danger represents constant injury to the mucous membrane with a tooth crown, a seal or denture. The risk group includes people working in harmful production (impact of harmful substances, increased temperatures and etc.). The influence of the nature of nutrition on the incidence is the lack of vitamin A, the use of too hot and acute food.

Views and symptoms

Among the neoplasms of the oral cavity in children are dominated by tumor-like (62.6%). More specification is found in girls (57.3%). Children with benign neoplasms of the oral cavity make up 4.9% of the total number of surgical patients. The average time from the emergence of the first symptoms of the disease to appeal to the doctor, according to our department, is 8.9 weeks (2.1 months). The greatest morbidity is observed between the ages of 1 and 1 year. High incidence in the neonatal period and breeding Related to identifying neoplasms of disthogenetic origin. The frequency of them to age for 3 years falls sharply, and by 12-16 it increases. The increase in morbidity in subsequent age groups is associated with an increase in injuries and enhancement of the hormonal function of an adhent body. The tumors are more often found on the mucous membrane of the lower lip, the alveolar process and the language, less often in the attachment area, on the upper lip, in the area of \u200b\u200bsolid and soft heaven. Tumor-like formations are often localized in the field of the lower lip, the sub-surround region, on the mucous membrane of the alveolar processes.
The greatest number of oral tumors occurs from epithelial tissue (flat, ferrous, chubum epithelium): tumors are 18.6%, tumor-like formations - 81.4%. Some of them are developing as a result of diembraformas (dermoid and epidermoid cysts, serra glands, the retention cysts of the sub-speaking salivary gland, associated with congenital atresia under-mandibular duct), in the origin of others (papillomas, papillomatozes) is assumed to be the role of viruses. Tumors of neoplastic nature - papillomas, some types of papillomatosis, nurses, neoplasms of large and small salivary glands. Injury (retention cysts and small salivary glands) are of great importance. Epithelial tumors occur in the postnatal period. In girls they are observed 2.25 times more often. These tumors are usually localized in the field of language, less often in the field of the upper and lower lips, solid and soft sky, extremely rare in the angles of the mouth, on the mucous membrane of the cheeks and in the sub-surround region. All of them are characterized by slow, asymptomatic growth. The greatest difficulties in the diagnosis are rarely occurring tumors: nevys, tumors of salivary glands. Papillomas and tumors of the salivary glands are prone to relapse. Treatment epithelial tumors Surgical. Papilloma . Among the epithelial tumors from the multi-layer flat epithelium, papillomas occupy second place after vascular tumors. Papillomas, as a rule, are found at the age of 7-12, girls are 1.9 times more often. These tumors are localized in the language, lips, in the area of \u200b\u200bsolid and soft sky. The tumor is the sprouting of a papillary nature in the form of a rounded or oval form, coastal (view of cauliflower), more often, sometimes multiple. Papillomas may have a brilliant smooth surface and in this case they are difficult to differentiate from fibromics. They are on a wide base or on the leg, have a pale pink color corresponding to the color of the surrounding mucous membrane. Long-termly existing papillomas due to the eclipse of the surface layer of the epithelium acquire a blessed color, become more dense, rough. In chronic injury, papillomas are dark red, shiny-red with ulceration phenomena. Grow slowly. Differentiate papillas from fibromes, Serra glands. Treatment. The removal of a tumor with the subject to the base is shown, since papilloma has increased mitotic activity at the base. Neuble or pigment tumors on the mucous membrane of the oral cavity in children are extremely rare (1.2% of the true tumors). They are distinguished in appearance, sizes, density, haired cover or vascular structures. Networks can be ill countered. Signs of Ozlochetics: rapid growth, ulceration, color change, seal, itching, pain. Patients with Nevus need to consult an oncologist. Differentiates of non-vascular neoplasms, papilloma (having a shorter character).
Surgical treatment - excision within healthy tissues. Tumor-like formation of flat epithelium relevant to the group rarely found. Papillomatosis - multiple papillary growths on the mucous membrane of the oral cavity (2.2% of tumor-like). We are found more often aged 7-12 years, which speaks in favor of their postnatal origin. There are reactive and neoplastic papillomatosis. The reactive papillomatozam includes multiple papillary growths on the oral mucosa, which ceases to grow in the elimination of chronic exposure to various stimuli (mechanical, thermal, chemical, microbial). Papillomatous growths are localized more often on the upper and lower lip, mucous membrane of the cheek, language, less often in the area of \u200b\u200bthe angles of the mouth of an alveolar process. Clinically papillomatozes are formation in the form of plaques of a rounded or oval shape on a wide base, more often than a papilla. Plaques can be located separately or sprinkled among themselves. The color corresponds to the surrounding mucous membrane or somewhat pale, soft or slightly dense consistency, painless with palpation, with a diameter of 0.2 to 2 cm. These formations are found equally often in boys and girls. Differential diagnosis is complex. Papillomatomatosis of neoplastic nature should be distinguished from the hyperplasia of the oral sheath membrane, which occurred when exposed to endogenous factors (avitaminosis, metabolic disorders transferred infectious diseases). L.neck It depends on the etiology of papillomatosis: during papillomatosis of neoplastic nature - surgical (laser scalpel can be used), with extensive lesions - cryodestruction (phased), in other cases - the elimination of the cause of the occurrence. Tumors made of chub formation epithelium.The chub emergency epithelium is the source of the occurrence of tumor-like formations - the serrated glands (9.3% of the tumor-like) (Fig. 12.3). Serra glands - the result of disonatogenesis and are detected under the age of 1 year. They are localized on the mucous membrane of the alveolar process of the upper and lower jaw, solid sky. There are single and multiple education. Clinically serrated glands are formation of a hemisphere, located on an unchanged mucous membrane of a guming roller, blessed-yellowish color, dense consistency, painless with palpation, with a diameter of 1 to 4-5 mm. They must be differentiated from papilloma, fibrom, prematurely cutting teeth.
Treatment It is not required because Serra glands by the year, as a rule, disappear. ABOUT pooholi out connective tissue. Tumors of connective tissue origin are built by the type of ripe connective tissue. Most often occur fibroms. They occupy the third place after vascular and epithelial tumors (23.6% of tumors) can be solid and multiple. There are solid fibromes when morphologically determined the dense arrangement of collagen fibers, sometimes with squeezing of lime, and soft, when the fruitful location of the fibers and single mature elements in them are defined. In soft fibromes, the mucous component can be formed, which is indicated as a fibromixoma, but they are not clinically different from soft fibrom. In etiology, the innate predisposition of tissues play a large role, as well as additional injury to the mucous membrane during chewing. Fibroms may have a disthogenetic origin and reveal immediately after the birth of a child. In the postnatal period, fibromes in children appear more often aged 12-16 years, equally often in boys and girls. They are localized more often in the area of \u200b\u200bthe tongue, the bottom lip, solid and soft sky, less often in the area of \u200b\u200bthe alveolar process, the upper lip, cheeks. Clinically represent a rounded or oval form formation on a wide base, sometimes on the leg, the color is the same as the surrounding mucous membrane. Consistency fibrom - from soft to very dense. Treatment Surgical - removal within healthy fabrics. Duma fibromatosis - a rare disease manifested by diffuse fibromatous heights of dense consistency, exciting all or partially alveolar extension of the upper or lower jaw, and sometimes both jaws. Duma fibromatosis Some authors relate to chronic inflammatory processes, others consider it a true neoplary, indicate its family-hereditary character. The reasons for gumper hyperplasia may be receiving medicines, endocrine disorders. Children fibromatosis dons occurs at the age of 7-12 and 12-16 years, as a rule, in girls.
We clinically distinguish between two forms: local, when the defeat is noted at the level of several teeth, and diffuse, when the growing is captured by the whole part of the alveolar process of the upper and lower jaws. The process is localized in guens papillars and applies to the alveolar process. Crowns of teeth can be hidden by growing up to their cutting edge. With palpation, fibromatous expansions are dense, fixed, painless. X-ray can be destructive changes in the alveolar process. Collagen fibers with single cellular structures are histologically determined. Diagnosis of fibromatosis does not represent difficulties, but sometimes it needs to be differentiated from hyperplastic gingivitis. Treatment Surgical - excision of growth together with the periosteum (in order to avoid relapse). Bone is closed with iodoform tampon. During the local form of growth, it is excised simultaneously, with diffuse - in several stages. When destruction of bone tissue requires the processing of foci of flashes and coagulation. Myoma - Muscle tissue tumor and more often localized in the area of \u200b\u200bthe language, the bottom of the oral cavity. There are several types of muscle tumors. Rabdomioma it consists of transverse muscle fibers and looks like a node thicker than the language. Leiomiomoma it consists of smooth muscle fibers and is located more often in the sky. Myoblastomioma (Abrikosov Tumor, Grain-Cell Moblatoma) refers to a group of disyogenetic tumors and is detected in children in the first year of life. Localizes more often in the area of \u200b\u200bthe tongue, the bottom lip, soft sky, the bottom of the oral cavity. The boys and girls are equally found in the same way. Clinically is the formation of a rounded or oval shape with a shiny smooth surface, whitish-yellowish color, with palpation dense, painless, more often with clear contours, a diameter of 0.3 to 1 cm. Locked directly under the epithelium. There are myoblastomiomes and without clear contours. Education may be single and multiple. Height slow, asymptomatic. Differential is necessary from the fiber, papillom. Often the diagnosis is established only after histological examination. Treatment Surgical. Mixoma - Tumor of unclear origin. Localizes in the area of \u200b\u200bthe alveolar part and solid sky. Arises at the age of 7-12, 12-16 years, which speaks of postnatal origin. It happens rounded shape, a buggy, nipple character. It may be observed both with benign and malignant tumors and have a double name - mixomioma, mixochondrome, mixofibrome, mixosarcoma, etc. It is found equally often in boys and girls. The tumor must be differentiated from the fibrome, neurine, papillom, more often the diagnosis is made after histological examination. Mixomes and myoblastomioma relevant to rarely occurring oral tumors in children (0.7-2.9% of tumors). P iogenic granuloma - Education arising from the injury of the lip mucosa, cheeks, language. It is formed from connective tissue, leather or mucous membrane. Often the pyrogen granule is difficult to differentiate from true hemangioma, so some authors propose to consider them as a variety of vascular tumors. In the classification of WHO, it refers to tumor-like formations. Piogenic granuloma enters a group of rare neoplasms (2.7% of tumor-like). Observed at the age of 7-12 years and in 12-16 years, more often in boys. The occurrence of pyrogen granuloma, as a rule, is preceded by injury. Clinically pyrogen granuloma is rapidly increasing (sometimes for several days) formation with a diameter of up to 1-2 cm, round or irregular shape, on a wide base, dark red, sometimes with surface necrosis phenomena, easily bleeding with the slightest touch, painless at a palpation. In appearance, pyiogenic granuloma resembles granulation tissue with rich blood supply. Differentiate the pyrogen granule from hemangiom, the retention cyst, most often formed after injury, angioepithelomes, melanoblastoma. Treatment Surgical. Some authors believe that when eliminating the traumatic start, the pyrogen granuloma can decrease in size or regress. Epulisa.The term "epulis" is descriptive and has only topographic importance - education on the gum. According to the histological classification of WHO, epulisses relate to tumor-like formations. The source of the growth of epulis can be a periodontal tooth, periosteum, deep layers of gums. In terms of tumor-like formations, they ranked second after the retention cyst (10.3% of tumor-like). Sometimes the appearance of epulis is preceded by injury (household, traumatic dental removal, injury orthodontic apparatus and etc.). In children, they meet more often at the age of 12-16, less often - 7-12 years old, girls are slightly more often. They are localized epulisers usually in the field of frontal teeth, less often in the area of \u200b\u200bpremolars and extremely rare in the molars area, on the lower jaw more often than on the top. By histological structure There are fibrous, angiomatous igigantomy. In the first place in terms of frequency there are epuls of fibrous.
Fibrous epulis it is a round or incorrect form formation on a wide base, color corresponds to the surrounding mucous membrane or a slightly pale of it, dense consistency, painless with palpation. The surface of the fibroangiomatous epulis of bright red color, it is a softer consistency, can be bleed when touched. Sometimes there are erosion on the surface. Angiomatous epulis - the growing bright red color with a cyanotic tint, the surface of which places erosioned, bleed when touched. Soft consistency, painless. The surface is more often buggy, less frequently smooth. It grows quickly, with a diameter of 0.5 to 1.5 cm. Radiographs may be changes characteristic of hemangiom. Giant meal epulis it is the formation of a rounded, oval or irregular shape, a soft or elastic elegustic consistency, a blue-bugs, sometimes with a pronounced brown shade, with a smooth or slightly buggy surface, with a painless palpation, during injury, it is moderately bleeding, it has a rapid growth, with a diameter of 0, 5 to 3 cm. Epuls are located only in the area of \u200b\u200bpermanent teeth, more often occur in girls 12-16 years. On the radiograph, the foci of osteoporosis, propagating from the surface in depth. The borders of the lesion are fuzzy, lubricated, no periosal reaction. Differentiate epulisses from tumors located on an alveolar process; Fibrous epulis - from a fibrome, angiomatous and giantheet - from hemangiom, as well as from hypertrophic gingivitis when it is localized in the field of individual groups of teeth and resulting from chronic irritation in response to overload, injury, chronic inflammation, as well as blood diseases, hormonal rearrangement of functions organism. Treatment Surgical - excision within healthy tissues to bone. With destructive changes in the subject to the dice - careful excision to the visible healthy bone tissue. The wound surface is closed with iodoform tampon. With an insufficiently careful operation, relapse is possible. Tumors of nervous tissue belong to the group rarely found in the oral cavity (1.2% of the true tumors). Nevnoma - Slowly growing tumor, histogenetically emanating from the Schwanno shell of the nerve. Located in the course of the nerve, from which it comes. Clinically is the formation of a rounded, oval, irregular form, dense consistency, sometimes painful when palpation, whitish or slightly yellowish color, with a diameter of 0.3-1 cm and more. Has a capsule. Differentiate from fibromes. Locardarous oral tumors are developing in men 5-7 times more often than women. People aged 60-70 are most often sick. Among the neoplasms of the oral cavity, 65% falls on malignant tumors of the language, 12.9% fall on the mucous cheeks, 10.9% - at the bottom of the oral cavity, 8.9 - on the mucous membrane of the alveolar process of the upper jaw and solid sky, 6.2% - On the mild sky, 5.9% - on the mucous membrane of the alveolar outflow of the lower jaw, 1.5% - on the tongue of the soft sky, 1.3% - on the front palas. Preiodine States: 1. Bondnate prediction: Bowen's disease and erytoplasia Caera. 2. Optional preference: the verpetary and erosive form of leukoplakia, papilloma and papillomatomatosis of the gum. 3. Background diseases: leukoplakia smokers, leukoplakia flat, chronic ozels of oral cavity. Factors contributing to malignancy: Harmful household habits (smoking, alcohol abuse, use of "NASA", Betel's chewing); Harmful production factors (chemical production, hot workshops, work in dusting premises, permanent stay in the open air, in a humid medium at low temperatures, excessive insolation); nutrition nature (insufficient content in food vitamin A or impaired its digestibility, systematic use of too hot food, sharp dishes); Chronic mechanical injury to a crown of a destroyed tooth, a sharp edge of a seal or a poorly made prosthetic; Single mechanical injury (biting language or cheeks during food or conversation, damage to the mucous membrane tool during the treatment or removal of the tooth. International Histological Classification of Malignant Oral Tumors: 1. INTRAEPITELIAL CARCINOMA (CARCINOMA IN CITU). 2. PlateLocking Cancer - germinates the connective tissue to be subject. Varieties of flat-stacked cancer: Iirnory plane carcinoma cancer (drover carcinoma); non-propelled flat-belling cancer; The low-differentiated cancer consists of the cells of the spin-like shape resembling the sarcoma. This species Cancer is significantly malignant compared to previous. The sarcoma arising in the oral cavity is quite diverse, but it is more rarely found than malignant tumors of epithelial origin. They distinguish between the Fibrospar, Liposarcoma, Leiomiosarcoma, Rabdomiosarcoma, Chondrosarcom, Hemangioendothelioma (Angiosarcoma), hemangioperation. There are four stages of cancer of the oral mucous membrane. Stage I - tumor (papillary), infiltration or ulcer in diameter up to 2 cm, not beyond any oral cavity department (cheek, gum, heaven, bottom of the oral cavity), is limited to the mucous membrane. In regional lymph nodes, metastases are not defined. The stage II is the defeat of the same or larger diameter, which is not beyond what one of the oral cavity department, although propagating in the submucoscent layer. In regional lymph nodes - single moving metastases. III Stage - the tumor was introduced into the toed soft fabrics (but not deeper the periposity of the jaw), spread to the neighboring departments of the oral cavity (for example, from the cheek per gum). In regional lymph nodes - multiple movable or limited moving metastases with dimensions up to 2 cm in diameter. A smaller tumor can be determined, but in regional lymph nodes, limited mobile or bilateral metastases are determined. The stage of the stage - the lesion is spreading into several departments of the oral cavity and deeply infiltrates the fabrics, the bones of the face, ulcerate its skin. In regional lymph nodes - fixed or disintegrating metastases. A tumor of smaller sizes can be determined, but with the presence of remote metastases. Language cancer is more common in the middle third of the lateral surface of the organ (62-70%) and in the root. The bottom surface, the back (7%) and the tip of the tongue (3%) are greatly affected. Language root cancer occurs in 20-40% of patients. Flake carcury cancer of the front of the language is more often 1-2 degrees of malignancy and comes from small salivary glands. Classification. According to the degree of propagation distinguish between four stages of language cancer: Stage I - a limited tumor or ulcer with dimensions from 0.5 to 1 cm in diameter, located in the thickness of the mucous membrane and the submucosal base. Metastasis in regional nodes is not yet. Stage II - a tumor or a ulcer of large sizes - up to 2 cm in diameter, turbulent in the thickness of the muscular tissue, but not beyond half of the language. In submandibular and chin areas, single moving metastases are noted. III Stage - a tumor or ulcer takes half of the language and proceeds for its average line or at the bottom of the oral cavity. Long mobility is limited. Movable multiple regional metastases or single, but limitedly movable. IV Stage - a large tumor or ulcer affecting most Language, applies not only to neighboring soft tissues, but also on the bones of the facial skeleton. There are multiple regional, limited movable, or single, but fixed, metastases. Malignant tumors Language Patients are often detected independently and pretty early (exception - hard-to-reach distal departments). This occurs as a result of the appearance of painful sensations, early emerging functional disorders (chewing, swallowing, speech). With the help of the mirror, patients often inspect the patient part of the tongue, detecting pathological formations. At palpation, the presence of dense tumor infiltrate at the base of ulcers is determined. Sometimes it strikes the inconsistency of the size of small ulcers and a large, deep infiltrate around it. The size of the tumor tumor increases in the direction from the tip to the root. It is necessary to take into account the possibility of spreading the tumor for the average language line. Pains for cancer of the tongue at first have a localized character, a small intensity. As the tumor grows, they acquire constant character, are becoming more and more intense, irradiated by the branches trigeny nerve. In terminal stages, patients are hardly talking, they often can't take ordinary food and even drink. It is possible to break the breathing in distal localizations due to the obturation of the tumor of the oral chub. A characteristic feature of the malignant tumors of the language is frequent and early metastasis in regional lymph nodes. The presence of a thick lymph network, a large number of lymphovenous anastomoses between the vessels of both half of the language explains the frequency of contralateral and bilateral metastases. The direct lining of the lymphatic vessels of the distal language in the deep lymph nodes of the upper third of the neck leads to early detection of metastases in this group of lymph nodes. Often patients discover the tumor node on the neck, not in the language of the language, and turn to a general surgeon or therapist. If the doctor estimates these manifestations like lymphadenitis, then incorrect medical tactic leads to the running of the tumor process. Cancer of the mouth of the mouth.Pretty men aged 50-70 years are sick. The topographic and anatomical features are associated with the proximity and, consequently, the possibility of spreading to the lower surface of the language, the alveolar outflow of the lower jaw, the opposite side of the oral bottom of the oral cavity, which is a bad prognostic sign.
In the terminal stage, the muscles of the mouth of the oral cavity will geruple the muscles of the oral gland, making it difficult to determine the initial point of growth. Often the proliferation of the tumor occurs paravazally on the system of the gear artery. Initially, patients note a tumor that is sensible. In the ulceration, pain appear, hypersion; When talking and receiving food, pain is enhanced. Repeated bleeding are possible. Sometimes, as with a cancer language, the first sign is a metastatic node on the neck. When localizations in the rear sections of the oral mouth often has the appearance of the gap. According to the histological type of the tumor of this localization, the planellic racks are most often. Cancer of the mucous membrane of the cheek. In the initial stage, malignant tumor is difficult to distinguish from banal ulcers. Typichnaya Localization of cancer sensations of cheeks: Corners of the mouth, the line of closure of the teeth, the retromolar region. Symptoms:pain with conversation, meals, when swallowing. The damage to the distal departments of the region leads to the restriction of the opening of the mouth due to germination of chewing or inner wing like muscles. The loss of the mucous membrane of the cheek is more common in men of more elderly than malignant tumors of other localities of the oral cavity. Sky mucosa cancer.On the solid sky, malignant tumors made of small salivary glands (cylinders, adenokystous carcinomas) occur more often. Flat-cell cancer of this localization is rare. The secondary tumors often occur as a result of the spread of cancer of the upper jaw, the nasal cavity.
On the soft sky, on the contrary, there are more commonly plane bakery cancers. The morphological features of tumors of this localization are reflected on their clinical flow. The solid sky cancer is quickly ulcerated, causing an unpleasant feeling first, and later pain, increasing during food and conversation. New-forming from small salivary glands for a long time may have small dimensions, increasing slowly, painlessly. In such patients, the first and main complaint - for the presence of a tumor on the solid sky. As the tumor grows and increase the pressure on the mucous membrane, it is ulcerated, the secondary infection is joined. Pain appear. Early engaged in the tumor process to be palaced. Cancer Front Sky Dress- more differentiated and less prone to metastasis. It is usually found in men aged 60-70 years. Complaints on unpleasant feelings in the throat, later - pain, increasing when swallowing. The restriction of the opening of the mouth and repetitive bleeding belongs to the late and prognostically bad symptoms. Cancer mucosaalveolar's top and lower jaw processes. Almost always has the structure of flat-belling cancer. It manifests itself pretty early, because In the process involved teeth and arises toothache. It may pass the doctor to the wrong way. In the initial period, the tumor is local and bleed with a slight touch. Infiltration of the bone tissue occurs in a few months and is considered as a late manifestation of the disease. The degree of propagation on the bone is determined by radiographically. Regional metastasis is observed in third of the patients. Features of regional metastasis of malignant oral tumors. The oral cancer cancer usually metastasizes in surface and deep neck lymph nodes. The frequency of metastasis is high and, according to various sources, is 40-70%. With the damage to the mucous membrane of the cheek, the bottom of the oral cavity and the alveolar trails of the lower jaw metastases are found in the subband lymph nodes. The chin lymph nodes are affected by metastases rarely when localizing tumors in the front sections of the listed organs. Cancer tumors The dust departments of the oral cavity are more often metastasized in the middle and upper jugular lymph nodes. With the damage to the mucous membrane of the oral surface of the alveolar processions of the upper jaw, the metastasis occurs in the surviving lymph nodes, inaccessible to palpation and surgical removal. Remote metastases when cancer of the oral cavity are rare. According to the US oncologists, they are diagnosed in 1-5% of patients. Remote metastases can affect light, heart, liver, brain, skeleton bones. Their diagnosis is very complex and in some patients are detected only on autopsy.

Treatment

There are various methods for the treatment of cancer tumor. The choice of method depends on the stage of development of the neoplasm and its form.

Surgical

If you can not do without cut-off tumor, surgical intervention involves. After removal of education, manipulations can be carried out to restore the disturbed appearance of the patient.

Radiation therapy

This method is used most often when dealing with a robust cavity tumor. It can be used as an independent way or after surgical intervention. With small tumors, radiation therapy may be the main method. After the operation, the method helps to alleviate pain, neutralize the residue of cancer cells, improves the possibility of swallowing. If necessary, it is used brachytherapy (internal irradiation). Rods containing material for irradiation are introduced into a tumor at a certain time.

Chemotherapy

Reception of drugs that can reduce the tumor called chemotherapy. Medicines are selected depending on the tolerability and stage of the disease. Preparations of chemotherapy kill cancer cells. The method is used comprehensively with irradiation or with surgical intervention.

Parfenov Ivan Anatolyevich

The asymptomatic flow of a malignant tumor of the mucous membrane at an early stage deprives the ability to start therapy in a timely manner.

But there are signs that can not be ignored, because it is possible to fully cure the disease at the initial stage of its development. On the reasons, symptoms and methods of treatment of cavity cancer will be discussed in the article.

Mucosa cancer forms

Oncological diseases of the oral cavity are conditionally divided into three types, characterized by etiology and external signs:

Mystery Cancer Shape
Name	Description
Knocked	On the tissues there are seals with china edges. The mucous either has white spots, or remains unchanged. The neoplasms with a noded form of cancer are rapidly increased in size.
Yazvnaya	The neoplasms have a kind of ulcers, they do not heal for a long time than deliver strong discomfort patient. Pathology peptic form Figrogressive. In comparison with other species, the mucous membrane is much more likely.
Papillary	The neoplasm has a dense structure. It is impossible not to notice, since the tumor literally saves in the mouth. The color and structure of the mucous remains almost unchanged.

Localization

Depending on the zone and the nature of the localization of the neoplasms, the following types of tumors are distinguished.

Cancer Schek

Foci is often detected more often on the mouth line at the level of the corners. At the initial stage of development resembles an ulcer.

Later, the patient feels some restrictions on closure and opening the jaw. Discomfort is also noted when firing food and conversation.

The bottom of the oral mouth

The location of the focal zone is observed on the muscles of the oral cavity with a possible capture of nearby sections of the mucous membrane ( bottom part Language with transition to salivary glands). The patient is experiencing strong pain and abundant saliva selection.

Language

The tumor is localized on the side surfaces of the language. Tangible discomfort is noted when conversing and fastening food.

There is such a species more often than the location of the foci on the upper and lower tissues of the tongue with the grip of the tip and root.

Foci can be formed on the upper and lower part of the oral cavity with the lesion of the teeth. This causes bleeding gums and pain when lung pressure on the dental row.

The palate consists of soft and hard tissues. Depending on which of them were amazed, a variety of cancer is diagnosed.

The flat-cell cancer is formed on soft tissues, and when the location of the foci on a solid nose is identified: a cylinder, adenocarcine, a flat-mellular view. Arriving pain and discomfort during chewing activities and conversation should alert.

Metastase

Cancer disease is characterized by the ability to spread in nearby layers. The direction of metastases is determined by lymph nodes, the tentacles crawl into them.

Each variety of cancer has its own vector motion:

• under the oncology, the cheeks and alveolar trails of the lower jaw metastases are progressing to the sub-adeptive nodes;
• education in distal departments are sent to nodes near the jugular veins;
• when the tongue cancer with the zone of damage to the tip or side of the metastases are set in the neck lymph nodes, sometimes grabbed the submandibular nodes;
• in the pathology of the tentacle crawling to internal organs, also affect bone tissue.

The reasons

Specific reasons provoking the development of cancer of the oral mucosa are unknown.

But the opinion of scientists different countries The following factors become the starting button:

Risk factors include:

• harmful habits (alcohol abuse, smoking, chewing and sniffing tobacco);
• the presence in the oral cavity of the prosthetic structures, which are periodically injured by the mucosa by sharp edges;
• work in enterprises where elevated concentration is marked toxic substances, asbestos and other chemical compounds;
• complications after complex injuries of a jaw system or operations to remove teeth.

Preiodine Diseases

There are pathological processes preceding malignant formations. According to medical Classification potential danger represent the following diseases.

Modern scientists consider the disease as intraepithelical oncology

Pathology was described in 1912 by Bowen and classified as a precancerous state.

Modern scientists consider the disease as intraepithelical oncology, but in the international histology directory, it is identified as a risk factor.

Symptoms:

• spindlers of a nodule-spotted nature;
• the location of the focus is predominantly in the rear parts of the oral cavity;
• the surface of the affected area of \u200b\u200bthe mucous membrane is velvety;
• over time, atrophy of the mucous membrane appears;
• education of erosions on the surface of the hearth.

Diagnosis is differentiated with red depriving and leukoplakia. The disease proceeds accompanied with unpleasant symptoms.

As a treatment method is chosen surgical method. The affected areas of mucous and tissue are removed completely. If there is an extensive damage zone, complex therapy is used.

One of the provoking reasons is the frequent impact of irritants on the oral mucosa

The disease is characterized by increased energization of the tissue mucosa, the foci is localized on the inner side of the pitch, the corners of the mouth, the language.

One of the provoking reasons is the frequent effect of irritants on the oral mucosa.

It can be both bad habits (tobacco, alcohol) and acute or hot food.

Create favorable conditions For the development of leukoplakia, an incorrect shape of a dental prosthesis can.

Symptoms:

• light burning;
• tightening the mucous membrane, which creates discomfort when talking and receiving food;
• the formation of plaques of white or gray (diameter 2-4 mm).

The essence of treatment is to eliminate annoying factors, receiving a vitamin complex with large content Vitamins A and E, the processing of foci with special solutions or surgical intervention.

The scheme is selected individually, depending on the form of leukoplakia.

Papilloma

Provoke an active meal of papilloma as stressful situationsand injuries

Recognize the disease is simply on the intensively generated by Papillomam's mucosa.

Provice active growth can both stressful situations and injuries.

Symptoms:

• formation on the mucosa of the mouth of rounded papillom on the leg with a wart, grainy or folded surface (sizes 0.2-2 cm);
• localization is predominantly on a solid and soft nurse, language;
• pain, bleeding, deterioration of the physical condition of man is not marked.

Papillic treatment includes surgical intervention to cut-off formation from mucous membranes, as well as antiviral and immunomodulatory therapy.

The flow of disease occurs in acute form and with a benign clinical picture

Erosion formations are localized on the mucous membrane of the mouth and lips.

The flow of disease occurs in acute form and with a benign clinical picture.

Accurate provoking factors are not identified, but there is an opinion that ulcers and erosion appear as a result of sensitization to various infections, as well as in failures immune system.

Symptoms:

• the appearance of many red spots, which are transformed into erosion and ulcers;
• sensations of dryness and roughness in the mouth;
• in the zone of foci, the surface is covered with a fibrinous hearth.

The treatment diagram includes the use of antifungal, anti-inflammatory, painkillers.

Also prescribe sedative, immunostimulating agents, vitamins. If necessary, physiotherapy methods are used: phonophoresis, electrophoresis. In difficult cases resort to surgical intervention.

Complication of radiation disease leads to the development of post-bead stomatitis

It is formed after the procedures with the use of ionizing radiation conducted with violations.

The disease can provoke a careless handling of radioactive isotopes, as a result of which burns are formed on the mucous membrane.

Complication of radiation disease leads to the development of post-radiot stomatitis.

Symptoms:

• dizziness, physical weakness;
• facial mattness;
• dry mouth;
• pallor mucosa;
• the formation of white spots in the mouth;
• sharing the teeth.

Anamnesis is used to diagnose the problem clinical picture Diseases, blood test.

Treatment scheme includes:

• development of a special diet;
• careful savage of the oral cavity;
• processing with the mucous membrane by antiseptic solution.

Symptoms

The following signs may be for referring to a specialist:

Development phases

The neoplasms of even benign origin, after some time, reborn into a malignant tumor, which under progression takes three stages of development:

• Initial form It is characterized by unusual phenomena for a patient in the form of painful sensations, yasers, seals in the oral cavity.
• Developed form Diseases - Yazovki acquire the type of cracks, pain appear, giving out of the oral cavity to different parts of the head. There are cases when the patient does not feel pain at this stage.
• Launched form - The active phase of the oncological disease, when the foci extends quickly. There is also a concomitant symptoms: pain in the mouth, difficulties with swallowing food, a sharp decline in body weight, a change in voice.

Stages

Oncological disease It has several stages of development.

Each stage is characterized by certain tumor parameters and the extensity of the lesion zone:

Diagnostics

When suspected the defeat of bone tissues, the doctor discharges the direction of radiography

The oral cancer is diagnosed with a visual inspection and palpation method.

When contacting with the neoplascence, the location, structure density, degree of growth is taken into account.

When suspected the defeat of bone tissues, the doctor discharges the direction of radiography.

Put the diagnosis helps differential diagnosisWhen the set of symptoms compare with other or accompanying diseases.

The following studies help clarify the picture: Ultrasound, CT, MRI.

The final diagnosis is made after receiving the result of biopsy. The study is carried out by a laboratory in the seizitive part of the tumor.

Treatment

In medicine, several methods for the treatment of mucosa cancer are practiced.

When choosing a method, the following factors are taken into account:

• health condition of the patient, the presence of chronic diseases;
• neow formation form;
• stage of development of oncology.

Surgery

After surgical intervention, procedures for the restoration of patient and appearance health

This method is used to cut off the neoplasm in order to prevent the tumor growth and the propagation of metastases for nearby tissues, bones and organs.

After surgery, procedures for restoring the patient's health and appearance are carried out.

Sometimes the patient needs psychological rehabilitation (mainly with an amputation of the organ).

Radiation therapy

A popular way to combat oncological disease is widely used to treat cancer in the oral cavity. It is used both independently and after the surgical intervention.

If the tumor parameters are small rationally to use radiation therapy without additional manipulations.

With extensive neoplasms fits more comprehensive treatment. Procedures neutralize the residue of cancer cells, they will stop pain, improve the possibility of swallowing.

In some cases, the patient is prescribed brachytherapy. This method provides for the introduction of special rods directly into a tumor in order to irradiate it from the inside.

Chemotherapy

This method of treatment provides for the reception of special preparations that have the ability to reduce tumor parameters.

Medicinal products They are selected individually taking into account the stage of the disease and form of the neoplasm. Chemotherapy is used in combination with a surgical method, radiotherapy and independently.

Feature impact chemical substances It is to destroy cancer cells and reduce the tumor almost twice. But to ensure complete recovery when independent application The method cannot.

Forecast

Completely overcome the disease is possible only in case early diagnosis and right choice Treatment method

The forecast is to fully overcome the disease only in the case of early diagnosis and the right choice of the treatment method.

The result also depends on the shape of cancer.

For example, the papillary variety is much easier to cure. The most difficult thing is with ulcerative neoplasm.

The randomless period (up to 5 years) after the course of isolated therapy is 70-85%, with the development of neoplasm at the bottom of the oral cavity, the indicator below (46-66%).

When diagnosing the cavity cancer of the PTA 3, according to statistics, the absence of recurrences is observed in 15-25%.

Disease history

In the early stages, the disease can occur without manifestation of explicit signs or has scarce clinical symptoms. With an external inspection of the oral cavity, they are detected: cracks, ulcers, seals.

Education does not pass for a long time, even if they carry out the processing of foci by invalid means. Total a quarter of patients feel characteristic symptoms: Pain in the oral cavity, inflammatory processes Nasopharynx, dysen and teeth.

With the development of the disease, the manifestations become more pronounced, and the tumor increases in size. Painfulness Start to give to the ear, head, neck.

Due to irritation of the mucous membrane of the mouth, the decay of cancer cells is marked with a reinforcement of sowing, the cavity exudes the rotten smell. An increase in tumor parameters is reflected in the symmetry of the face. At the third stage of deformation becomes noticeable.

The lymph nodes located in the neck area increase, which is detected during the pulpate. For some time after lesion of lymph nodes, they retain mobility, in the active phase of the third stage, their soldering occurs with the surrounding tissues.

Metastases are ejected in the launched form of tumors.

Malignant oral tumors of the oral cavity are developing in men 5-7 times more often than women. People aged 60-70 are most often sick.

Among the neoplasms of the oral cavity, 65% falls on malignant tumors of the language, 12.9% fall on the mucous cheeks, 10.9% - at the bottom of the oral cavity, 8.9 - on the mucous membrane of the alveolar process of the upper jaw and solid sky, 6.2% - On the mild sky, 5.9% - on the mucous membrane of the alveolar outflow of the lower jaw, 1.5% - on the tongue of the soft sky, 1.3% - on the front palas.

Preiodine States:

Bondnate prediction: Bowen's disease and erytoplasia Caera.

Optional presets: the verrup and erosive form of leukoplakia, papilloma and papillomatomatosis of the gum.

Background diseases: leukoplakia smokers, leukoplakia flat, chronic ozels of the oral cavity.

Factors contributing to malignancy:

harmful household habits (smoking, alcohol abuse, use of "NASA", Betel's chewing);

harmful production factors (chemical production, hot workshops, work in dusting premises, permanent stay in the open air, in a humid medium at low temperatures, excessive insolation);

nutrition nature (insufficient content in food vitamin A or impaired its digestibility, systematic use of too hot food, sharp dishes);

chronic mechanical injury to a crown of a destroyed tooth, a sharp edge of a seal or a poorly made prosthetic;

single mechanical injury (biting language or cheeks during food or conversation, damage to the mucous membrane tool during the treatment or removal of the tooth.

International Histological Classification of Malignant Oral Tumors:

Intraepithelial carcinoma (Carcinoma in Citu).

Flake carcation cancer - germinates the connective tissue.

Varieties of flat-stacked cancer:

iirnory plane carcinoma cancer (drover carcinoma);

non-propelled flat-belling cancer;

the low-differentiated cancer consists of the cells of the spin-like shape resembling the sarcoma. This type of cancer is significantly malignant compared to previous.

Sarcomathe occurrences of the oral cavity are quite diverse, but it is rarely found than malignant tumors of epithelial origin.

They distinguish between the Fibrospar, Liposarcoma, Leiomiosarcoma, Rabdomiosarcoma, Chondrosarcom, Hemangioendothelioma (Angiosarcoma), hemangioperation.

There are four stages of cancer of the oral mucous membrane.

I. stage - Tumor (papillary), infiltration or ulcer in diameter up to 2 cm, not beyond what kind of oral cavity (cheek, gum, heaven, bottom of the oral cavity) is limited to the mucous membrane. In regional lymph nodes, metastases are not defined.

II. stage - The defeat of the same or larger diameter, which is not beyond what one of the oral cavity department, although propagating in the submucoscent layer. In regional lymph nodes - single moving metastases.

III stage - The tumor was introduced into the toed soft fabrics (but not deeper the periosa of the jaw), spread to the neighboring collapse of the oral cavity (for example, from the cheek per gum). In regional lymph nodes - multiple movable or limited moving metastases with dimensions up to 2 cm in diameter. A smaller tumor can be determined, but in regional lymph nodes, limited mobile or bilateral metastases are determined.

IV. stage - The lesion applies to several departments of the oral cavity and deeply infiltrates the fabrics, the bones of the face, ulcerate its skin. In regional lymph nodes - fixed or disintegrating metastases. A tumor of smaller sizes can be determined, but with the presence of remote metastases.

Cancer Languageit is often found in the middle third of the side surface of the organ (62-70%) and in the root. The bottom surface, the back (7%) and the tip of the tongue (3%) are greatly affected. Language root cancer occurs in 20-40% of patients. Flake carcury cancer of the front of the language is more often 1-2 degrees of malignancy and comes from small salivary glands.

Classification. According to the degree of propagation distinguish between four stages of language cancer:

I. stage - limited tumor or ulcer with dimensions from 0.5 to 1 cm in diameter, located in the thickness of the mucous membrane and the submucosal base. Metastasis in regional nodes is not yet.

II. stage - The tumor or ulcer of large sizes is up to 2 cm in diameter, turbulent into the thickness of the muscular fabric, but not beyond the limits of half of the language. In submandibular and chin areas, single moving metastases are noted.

III stage - The tumor or ulcer occupies half the language and moves for its average line or at the bottom of the oral cavity. Long mobility is limited. Movable multiple regional metastases or single, but limitedly movable.

IV. stage - A large tumor or ulcer, striking most of the tongue, applies not only to neighboring soft tissues, but also on the bones of the facial skeleton. There are multiple regional, limited movable, or single, but fixed, metastases.

Malignant tumors of the patients are often detected independently and pretty early (exception - hard-to-reach distal departments). This occurs as a result of the appearance of painful sensations, early emerging functional disorders (chewing, swallowing, speech). With the help of the mirror, patients often inspect the patient part of the tongue, detecting pathological formations. At palpation, the presence of dense tumor infiltrate at the base of ulcers is determined. Sometimes it strikes the inconsistency of the size of small ulcers and a large, deep infiltrate around it. The size of the tumor tumor increases in the direction from the tip to the root. It is necessary to take into account the possibility of spreading the tumor for the average language line. Pains for cancer of the tongue at first have a localized character, a small intensity. As the tumor grows, they acquire constant character, are becoming more intense, irradiated along the branches of the trigeminal nerve. In terminal stages, patients are hardly talking, they often can't take ordinary food and even drink. It is possible to break the breathing in distal localizations due to the obturation of the tumor of the oral chub.

A characteristic feature of the malignant tumors of the language is frequent and early metastasis in regional lymph nodes. The presence of a thick lymph network, a large number of lymphovenous anastomoses between the vessels of both half of the language explains the frequency of contralateral and bilateral metastases. The direct lining of the lymphatic vessels of the distal language in the deep lymph nodes of the upper third of the neck leads to early detection of metastases in this group of lymph nodes. Often patients discover the tumor node on the neck, not in the language of the language, and turn to a general surgeon or therapist. If the doctor evaluates these manifestations like lymphadenitis, then incorrect medical tactics leads to the neglence of the tumor process.

Cancer of the mouth of the mouth.Pretty men aged 50-70 years are sick. The topographic and anatomical features are associated with the proximity and, consequently, the possibility of spreading to the lower surface of the language, the alveolar outflow of the lower jaw, the opposite side of the oral bottom of the oral cavity, which is a bad prognostic sign. In the terminal stage, the muscles of the mouth of the oral cavity will geruple the muscles of the oral gland, making it difficult to determine the initial point of growth. Often the proliferation of the tumor occurs paravazally on the system of the gear artery. Initially, patients note a tumor that is sensible. In the ulceration, pain appear, hypersion; When talking and receiving food, pain is enhanced. Repeated bleeding are possible. Sometimes, as with a cancer language, the first sign is a metastatic node on the neck. When localizations in the rear sections of the oral mouth often has the appearance of the gap. According to the histological type of the tumor of this localization, the planellic racks are most often.

Cancer mucosa sheath. In the initial stage, malignant tumor is difficult to distinguish from banal ulcers. Typichnaya Localization of cancer sensations of cheeks: Corners of the mouth, the line of closure of the teeth, the retromolar region.

Symptoms: pain when talking, meals, when swallowing. The damage to the distal departments of the region leads to the restriction of the opening of the mouth due to germination of chewing or inner wing like muscles. The loss of the mucous membrane of the cheek is more common in men of more elderly than malignant tumors of other localities of the oral cavity.

Sky mucosa cancer. On the solid sky, malignant tumors made of small salivary glands (cylinders, adenokystous carcinomas) occur more often. Flat-cell cancer of this localization is rare. The secondary tumors often occur as a result of the spread of cancer of the upper jaw, the nasal cavity.

On the soft sky, on the contrary, there are more commonly plane bakery cancers. The morphological features of tumors of this localization are reflected in their clinical flow. The solid sky cancer is quickly ulcerated, causing an unpleasant feeling first, and later pain, increasing during food and conversation. New-forming from small salivary glands for a long time may have small dimensions, increasing slowly, painlessly. In such patients, the first and main complaint - for the presence of a tumor on the solid sky. As the tumor grows and increase the pressure on the mucous membrane, it is ulcerated, the secondary infection is joined. Pain appear. Early engaged in the tumor process to be palaced.

Cancer Front Sky Dress- more differentiated and less prone to metastasis. It is usually found in men aged 60-70 years. Complaints on unpleasant feelings in the throat, later - pain, increasing when swallowing. The restriction of the opening of the mouth and repetitive bleeding belongs to the late and prognostically bad symptoms.

Cancer mucosa Alveolar's top and lower jaw processes. Almost always has the structure of flat-belling cancer. It manifests itself pretty early, because The teeth are involved in the process and the toggie pain occurs. It may pass the doctor to the wrong way. In the initial period, the tumor is local and bleed with a slight touch. Infiltration of the bone tissue occurs in a few months and is considered as a late manifestation of the disease. The degree of propagation on the bone is determined by radiographically. Regional metastasis is observed in third of the patients.

Features of regional metastasis of malignant oral tumors. The oral cancer cancer usually metastasizes in surface and deep neck lymph nodes. The frequency of metastasis is high and, according to various sources, is 40-70%.

With the damage to the mucous membrane of the cheek, the bottom of the oral cavity and the alveolar trails of the lower jaw metastases are found in the subband lymph nodes. The chin lymph nodes are affected by metastases rarely when localizing tumors in the front sections of the listed organs.

Cancer tumors of the dystal oral cavity are more often metastasized in the middle and upper jugular lymph nodes. With the damage to the mucous membrane of the oral surface of the alveolar processions of the upper jaw, the metastasis occurs in the surviving lymph nodes, inaccessible to palpation and surgical removal.

Remote metastases when cancer of the oral cavity are rare. According to the US oncologists, they are diagnosed in 1-5% of patients. Remote metastases can affect light, heart, liver, brain, skeleton bones. Their diagnosis is very complex and in some patients are detected only on autopsy.

Treatment Malignant oily formations of the oral cavity is a very complex problem.

Conditionally treatment can be divided into two stages:

1. Treatment of primary hearth;

2. Treatment of regional metastases.

For the treatment of primary focus, radiation, surgical and combined methods are used. One of the most common methods for treating tumors of this localization is radial. It is used in 89% of patients with malignant oral tumors.

Many authors indicate the advantages of combined radiation therapy, when the remote outer exposure in soda is used in the first stage of the course, and then go to the intra-breasted irradiation technique, giving an additional dose of about 30-35 gr.

The use of chemotherapy, especially a complex of chemotherapy, allowed to ensure regression of tumors in some cases than 50% of the initial value. In this case, it turned out that the flat-belling cancer of the oral cavity is sensitive, mainly to two drugs: methotrexate and bleomycin.

The surgical method of treatment of malignant oral tumors is carried out by all the rules adopted in oncology: i.e. The resection of the affected organ should be carried out within the limits of healthy tissues, retreat from visible and palpable tumor boundaries by 2.5-3.0 cm. An isolated surgical method with this localization of the neoplasms is practically no applied due to their special malignancy.

Most common to date type surgical interventions When cancer, the language is hemiglossectomy (half resection). For the first time this operation was performed by the Pimperhell Dane in 1916.