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Gingival Squamous Cell Carcinoma
C. Grace Petrikowski, DDS, MSc, FRCD(C)
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Squamous cell carcinoma (SCCa)
            • Definitions

              • Invasive malignant neoplasm of squamous epithelium arising in gingiva
                • Because gingiva is ≤ 2-3 mm thick, strong predilection for bone invasion to underlying alveolus
                • Primary intraosseous SCCa extremely rare

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    • Nuclear Medicine Findings

                      • Radiographic Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Cheng CS et al: Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: A new classification. Head Neck. 38(3):339-46, 2016
                                              2. Yang X et al: Clinicopathological characteristics and outcome predictors in squamous cell carcinoma of the maxillary gingiva and hard palate. J Oral Maxillofac Surg. 73(7):1429-36, 2015
                                              3. Arya S et al: Oral cavity squamous cell carcinoma: role of pretreatment imaging and its influence on management. Clin Radiol. 69(9):916-30, 2014
                                              4. Pires FR et al: Oral squamous cell carcinoma: clinicopathological features from 346 cases from a single oral pathology service during an 8-year period. J Appl Oral Sci. 21(5):460-7, 2013
                                              5. Fitzpatrick SG et al: The clinical and histologic presentation of gingival squamous cell carcinoma: a study of 519 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 114(4):509-15, 2012
                                              6. Bagan J et al: Oral cancer: clinical features. Oral Oncol. 46(6):414-7, 2010
                                              7. Civantos FJ et al: Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 28(8):1395-400, 2010
                                              8. Coughlin A et al: Oral cavity squamous cell carcinoma and the clinically n0 neck: the past, present, and future of sentinel lymph node biopsy. Curr Oncol Rep. 12(2):129-35, 2010
                                              9. Jerjes W et al: Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Oncol. 2:9, 2010
                                              10. Mourouzis C et al: Squamous cell carcinoma of the maxillary gingiva, alveolus, and hard palate: is there a need for elective neck dissection? Br J Oral Maxillofac Surg. 48(5):345-8, 2010
                                              11. Valentini V et al: Management of clinically negative neck in maxillary carcinoma. J Craniofac Surg. 21(3):759-62, 2010
                                              12. Viet CT et al: Understanding oral cancer in the genome era. Head Neck. 32(9):1246-68, 2010
                                              13. Wang TC et al: Risk factors affect the survival outcome of hard palatal and maxillary alveolus squamous cell carcinoma: 10-year review in a tertiary referral center. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 110(1):11-7, 2010
                                              14. Gomez DR et al: Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers. Int J Radiat Oncol Biol Phys. 73(4):1096-103, 2009
                                              15. Lin HW et al: Survival impact of nodal disease in hard palate and maxillary alveolus cancer. Laryngoscope. 119(2):312-5, 2009
                                              16. Razfar A et al: Incidence and patterns of regional metastasis in early oral squamous cell cancers: feasibility of submandibular gland preservation. Head Neck. 31(12):1619-23, 2009
                                              17. Kirsch C: Oral cavity cancer. Top Magn Reson Imaging. 18(4):269-80, 2007
                                              18. Ong CK et al: Imaging of tongue carcinoma. Cancer Imaging. 6:186-93, 2006
                                              19. Simental AA Jr et al: Cervical metastasis from squamous cell carcinoma of the maxillary alveolus and hard palate. Laryngoscope. 116(9):1682-4, 2006
                                              20. Chong V: Oral cavity cancer. Cancer Imaging. 5 Spec No A:S49-52, 2005
                                              21. Brown JS et al: Patterns of invasion and routes of tumor entry into the mandible by oral squamous cell carcinoma. Head Neck. 24(4):370-83, 2002
                                              22. Makridis SD et al: Squamous cell carcinoma of gingiva and edentulous alveolar ridge: a clinicopathologic study. Int J Periodontics Restorative Dent. 18(3):292-8, 1998
                                              23. Cleary KR et al: Oral squamous cell carcinoma and the mandible. Ann Otol Rhinol Laryngol. 104(12):977-9, 1995
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Squamous cell carcinoma (SCCa)
                                                        • Definitions

                                                          • Invasive malignant neoplasm of squamous epithelium arising in gingiva
                                                            • Because gingiva is ≤ 2-3 mm thick, strong predilection for bone invasion to underlying alveolus
                                                            • Primary intraosseous SCCa extremely rare

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Imaging Recommendations

                                                                • Nuclear Medicine Findings

                                                                  • Radiographic Findings

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Cheng CS et al: Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: A new classification. Head Neck. 38(3):339-46, 2016
                                                                                          2. Yang X et al: Clinicopathological characteristics and outcome predictors in squamous cell carcinoma of the maxillary gingiva and hard palate. J Oral Maxillofac Surg. 73(7):1429-36, 2015
                                                                                          3. Arya S et al: Oral cavity squamous cell carcinoma: role of pretreatment imaging and its influence on management. Clin Radiol. 69(9):916-30, 2014
                                                                                          4. Pires FR et al: Oral squamous cell carcinoma: clinicopathological features from 346 cases from a single oral pathology service during an 8-year period. J Appl Oral Sci. 21(5):460-7, 2013
                                                                                          5. Fitzpatrick SG et al: The clinical and histologic presentation of gingival squamous cell carcinoma: a study of 519 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 114(4):509-15, 2012
                                                                                          6. Bagan J et al: Oral cancer: clinical features. Oral Oncol. 46(6):414-7, 2010
                                                                                          7. Civantos FJ et al: Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 28(8):1395-400, 2010
                                                                                          8. Coughlin A et al: Oral cavity squamous cell carcinoma and the clinically n0 neck: the past, present, and future of sentinel lymph node biopsy. Curr Oncol Rep. 12(2):129-35, 2010
                                                                                          9. Jerjes W et al: Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Oncol. 2:9, 2010
                                                                                          10. Mourouzis C et al: Squamous cell carcinoma of the maxillary gingiva, alveolus, and hard palate: is there a need for elective neck dissection? Br J Oral Maxillofac Surg. 48(5):345-8, 2010
                                                                                          11. Valentini V et al: Management of clinically negative neck in maxillary carcinoma. J Craniofac Surg. 21(3):759-62, 2010
                                                                                          12. Viet CT et al: Understanding oral cancer in the genome era. Head Neck. 32(9):1246-68, 2010
                                                                                          13. Wang TC et al: Risk factors affect the survival outcome of hard palatal and maxillary alveolus squamous cell carcinoma: 10-year review in a tertiary referral center. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 110(1):11-7, 2010
                                                                                          14. Gomez DR et al: Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers. Int J Radiat Oncol Biol Phys. 73(4):1096-103, 2009
                                                                                          15. Lin HW et al: Survival impact of nodal disease in hard palate and maxillary alveolus cancer. Laryngoscope. 119(2):312-5, 2009
                                                                                          16. Razfar A et al: Incidence and patterns of regional metastasis in early oral squamous cell cancers: feasibility of submandibular gland preservation. Head Neck. 31(12):1619-23, 2009
                                                                                          17. Kirsch C: Oral cavity cancer. Top Magn Reson Imaging. 18(4):269-80, 2007
                                                                                          18. Ong CK et al: Imaging of tongue carcinoma. Cancer Imaging. 6:186-93, 2006
                                                                                          19. Simental AA Jr et al: Cervical metastasis from squamous cell carcinoma of the maxillary alveolus and hard palate. Laryngoscope. 116(9):1682-4, 2006
                                                                                          20. Chong V: Oral cavity cancer. Cancer Imaging. 5 Spec No A:S49-52, 2005
                                                                                          21. Brown JS et al: Patterns of invasion and routes of tumor entry into the mandible by oral squamous cell carcinoma. Head Neck. 24(4):370-83, 2002
                                                                                          22. Makridis SD et al: Squamous cell carcinoma of gingiva and edentulous alveolar ridge: a clinicopathologic study. Int J Periodontics Restorative Dent. 18(3):292-8, 1998
                                                                                          23. Cleary KR et al: Oral squamous cell carcinoma and the mandible. Ann Otol Rhinol Laryngol. 104(12):977-9, 1995