Marsha Tran

Mayra Quiroz
Becca DeLord
Oral Pathology: Case Study Report/Presentation

Group 7

Melanoma is a malignant tumor of melanocytes that most commonly rises on the skin as

a result of prolonged exposure to sunlight. Although primary melanoma of the oral cavity is rare,

melanomas that arise on the skin may metastasize to the oral cavity. It usually presents as a

rapidly enlarging, blue-to-black mass and demonstrates an aggressive and unpredictable

behavior with early metastasis. The most common intraoral locations are the palate and maxillary

gingiva. These neoplasms usually occur in adults older than 40 years of age. The prognosis for

oral melanoma is poor.

Squamous cell carcinoma, also known as epidermoid carcinoma, is a malignant tumor of

squamous epithelium and is the most common primary malignancy of the oral cavity. It usually

metastasizes to lymph nodes of the neck and then to more distant sites such as the lungs and

liver. Clinically it presents as an exophytic ulcerative mass, but early tumors may be white and

plaque-like, red and plaque-like, or a mixture of red and white areas. This carcinoma usually

occurs in patients over 40 years of age.

Basal cell carcinoma is a malignant skin tumor associated with sun exposure that is

composed of a proliferation of basal cells derived from the surface stratified squamous

epithelium. This particular neoplasm does not occur in the oral cavity. It frequently arises on the

skin of the face and appears as a non-healing ulcer with characteristic rolled borders. The ulcer

develops a crusted surface that suggests healing, but the ulcer persists. It begins as a small 0.5
Marsha Tran
Mayra Quiroz
Becca DeLord
cm ulcer but will continue to enlarge slowly with destruction of underlying structures. Metastasis

however, is extremely rare. Most cases occur in white adults, especially those with fair

complexions, blond or red hair, and blue or green eyes.

Seborrheic Keratosis is a benign tumor of the skin that occurs in individuals of all ages,

including children as young as 15 years of age. In addition to a genetic predisposition, risk factors

include Human Papilloma Virus and sunlight exposure. The common site of involvement includes

the trunk, particularly the interscapular area, sides of the neck, the face and the arms. The tumors

are not, however, seen on the mucous membranes. Lesions appear as tan-to-brown coin-like,

sharply demarcated, exophytic lesions and are “stuck on the skin” with a verrucous or punched-

out surface. Flat lesions often have a smooth surface and are scarcely elevated above the surface

of the skin.

Actinic keratosis is a common intra-epidermal neoplasm that lies on a continuum with

squamous cell carcinoma. It is tightly linked to ultraviolet irradiation and occurs in areas of

prolonged sun exposure. It appears as pink to skin-colored, scaly papules and small plaques on

chronically exposed areas of light-skinned individuals. They are most commonly located on the

face, ears, balding scalp, extensor forearms, and dorsal hands.

Marsha Tran
Mayra Quiroz
Becca DeLord

We believe that the diagnosis for the lesion the patient has is Basal Cell Carcinoma. In the case

history, the patient stated that he has worked in outdoor construction for over 20 years. This

neoplasia is associated with sun exposure. In the case examination, the lesion measured 7mm

and exhibited a rolled and hard border with a depressed crusted center. This description exactly

matches the clinical appearance of Basal Cell Carcinoma.

Although Melanoma is also related to prolonged sun exposure, it is not the correct diagnosis

since it’s clinical appearance is a black-to-blue mass. The patient’s lesion is depressed and has a

red color.

Squamous Cell Carcinoma can have a red and plaque-like appearance, similar to what the

patient’s lesion looks like. However, it also presents as an exophytic ulcerative mass, opposite of

what the patient’s depressed lesion looks like.

Seborrheic keratosis has sunlight exposure as a risk factor as well, but it appears as a tan-to-

brown lesion with a punched-out verrucous surface or a flat lesion with a smooth surface. The

patient’s lesion does not have a brown color nor does it have a verrucous surface.

Actinic Keratosis appears as pink to skin-colored, scaly papules. The patient’s lesion does not have

a pink color and is not raised like a papule.

Marsha Tran
Mayra Quiroz
Becca DeLord
References

Ibsen, O. A., RDH, MS, & Phelan, J. A., MS, DDS. (2018). Oral Pathology for the Dental

Hygienist with General Pathology Introductions (7th ed.). St. Louis, Missouri: Elsevier.

Ibrahim, S. F., & Brown, M. D. (2009, July). Actinic Keratoses: A Comprehensive Update.

Retrieved October 22, 2017, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924136/

Phulari, R. G., Buddhdev, K., Rathore, R., & Patel, S. (2014, May). Seborrheic keratosis.

Retrieved October 29, 2017, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196312/