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Oral Squamous Cell Carcinoma

Oral Pathology & Microbiology • NEET MDS Study Guide • AI-Generated Notes

⭐ High-Yield Facts for Exam

  • OSCC = >90% of oral malignancies.
  • Lateral tongue and floor of mouth are classic sites.
  • Keratin pearls = well-differentiated SCC.
  • Verrucous carcinoma = pushing margins, good prognosis.
  • TNM staging is high-yield and drives prognosis.

Oral Squamous Cell Carcinoma (OSCC)

OSCC is the most common oral malignancy (>90% of oral cancers). Major risk factors: tobacco (smoked and smokeless), areca nut, alcohol (synergistic with tobacco), and HPV (notably oropharynx).

Sites & Presentation

Common sites include the lateral border of the tongue and floor of mouth. Presents as a non-healing ulcer with rolled/indurated margins, or an exophytic/verrucous mass.

Histopathology

Invasive islands and cords of malignant squamous epithelium with keratin pearls and individual cell keratinisation in well-differentiated tumours. Grading: well, moderately, poorly differentiated.

Verrucous Carcinoma (Ackerman tumour)

A low-grade variant with broad pushing (not infiltrating) margins; locally invasive but rarely metastasises → good prognosis.

Staging

TNM staging (tumour size, nodal involvement, metastasis) guides treatment and prognosis and is high-yield. Nodal metastasis markedly worsens prognosis.

Exam Tips ⭐

Keratin pearls = well-differentiated SCC. Verrucous carcinoma = pushing borders + good prognosis. Lateral tongue is a classic site.

📝 Practice MCQs — Oral Squamous Cell Carcinoma

Q1. The most common malignancy of the oral cavity is:
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Melanoma
D. Lymphoma
Show Answer
✅ Answer: B
OSCC accounts for the vast majority of oral cancers.
Q2. Keratin pearls are a histologic feature of:
A. Adenoid cystic carcinoma
B. Well-differentiated SCC
C. Pleomorphic adenoma
D. Ameloblastoma
Show Answer
✅ Answer: B
Keratin pearls indicate keratinisation in well-differentiated SCC.
Q3. Verrucous carcinoma is characterised by:
A. Early metastasis
B. Broad pushing margins and good prognosis
C. Perineural invasion
D. Ghost cells
Show Answer
✅ Answer: B
Verrucous (Ackerman) carcinoma has pushing borders and rarely metastasises.
Q4. A classic high-risk site for OSCC is the:
A. Hard palate
B. Lateral border of tongue
C. Attached gingiva
D. Dorsum of tongue
Show Answer
✅ Answer: B
The lateral border of the tongue and floor of mouth are high-risk sites.
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Related Topics

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