Cancer of the oral cavity and oropharynx

Abstract

Tumours in the oral cavity and oropharynx differ in presentation and prognosis and the detection of spread of tumour from one subsite to another is essential for the T-staging. This article reviews the anatomy and describes the pattern of spread of different cancers arising in the oral cavity and oropharynx; the imaging findings on computerized tomography and magnetic resonance imaging are also described. Brief mention is made on the role of newer imaging modalities such as [18F]fluorodeoxyglucose-positron emission tomography/computed tomography, perfusion studies and diffusion-weighted magnetic resonance imaging.

Saliva as a Diagnostic Fluid

“…Classically, clinical diagnosis of oral cancer has been based on visual and palpation assessment, followed by biopsy and histopathological evaluation. However, this clinical assessment has been broadened by use of magnetic resonance imaging and computerized tomography [79]; toluidine blue staining [80] and light-based detection techniques [81]. More recently, detection of biomarkers in saliva has emerged as a novel approach for the diagnosis of OSCC and its developmental stages including, initial process, invasion, recurrence and treatment.…”

Accuracy of imaging methods for detection of bone tissue invasion in patients with oral squamous cell carcinoma

“…5 For malignant tumours such as SCC, rapid growth may occur even though there are no previous clinical signs. 6 For this reason, clinical examination must be complemented by radiological examination 7 for the assessment of size, thickness and depth of the tumour 8 as well as the degree of bone tissue invasion. [9][10][11] This bone tissue invasion detection, cortical or medullary, is indicative of a T4 tumour stage.…”

Pathways involved in the spread of buccal carcinoma on contrast-enhanced multislice CT

“…As disease evolved, carcinoma infiltrated the underlying submucosa and muscle and extended submucosally and posteriorly along the buccinator muscle to the PMR, which was considered the most common spread pattern, [5][6][7] and anteriorly to the orbicularis oris and lip ( Figure 1). Following infiltrative growth, buccal SCCA might extend to the subcutaneous fat tissue and dermis in the cheek, including the investing fascia, which presented as linear reticulations in the subcutaneous fat, skin thickening and sagging on CEMSCT (Figure 1).…”

“…Because the buccinator muscle originated from the alveolar processes of the maxilla and mandible, buccal carcinoma could erode the underlying alveolar ridges of maxilla and mandible, which was the most common spread pattern for buccal carcinoma. [5][6][7] Involvement of the posterior aspect of the maxilla might allow superior spread into the proximal maxillary sinus. Seven cases that involved the ramus of mandible were erosive; of these, five cases involved local invasion in the anterior aspect of the ascending ramus ( Figure 3d).…”

“…1,5,6 To the best of our knowledge, no extensive studies had been performed to assess the extent of buccal carcinoma. On the other hand, buccal carcinoma could also involve multiple sites, which requires further discussion.…”