Αναδρομική κλινική και ιστοπαθολογική μελέτη του ακροχορδονώδους ή μυρμηκιώδους καρκινώματος της στοματικής κοιλότητας
Creators: name: Κοντοπούλου, Βάγια Διονυσίου
Publisher: name: Aristotle University of Thessaloniki
Year: 2017
Subjects: Ακροχορδονώδες καρκίνωμα
Καρκίνος του στόματος
HPV ιοί
Oral verrucous carcinoma
Oral cancer
HPV

description: Το ακροχορδονώδες ή μυρμηκιώδες καρκίνωμα της στοματικής κοιλότητας είναι μία σπάνια μορφή καλά διαφοροποιημένου ακανθοκυτταρικού καρκινώματος με χαρακτηριστική κλινική και ιστολογική εικόνα. Ο όγκος αναπτύσσεται αργά, επιφανειακά και συνήθως δε δίνει μεταστάσεις. Η χειρουργική εκτομή αποτελεί τη συνηθέστερη αντιμετώπιση. Παρά την καλή του πρόγνωση, ο όγκος μπορεί δυνητικά να υποτροπιάσει και αυτό θα πρέπει να λαμβάνεται υπόψιν κατά το σχεδιασμό της αντιμετώπισής του. Ο σκοπός της παρούσας διπλωματικής μελέτης είναι η εκτίμηση των ατομικών και κλινικών χαρακτηριστικών, καθώς και των πιθανών αιτιολογικών παραγόντων, που προκύπτουν από τη μελέτη των 17 φακέλων των ασθενών που διαγνώστηκαν με ακροχορδονώδες καρκίνωμα στην Κλινική Στοματολογίας της Οδοντιατρικής Σχολής Α.Π.Θ. από το Σεπτέμβριο του 2000 μέχρι και το Σεπτέμβριο του 2016. Επιπλέον, μελετήθηκε η αντιμετώπιση και αξιολογήθηκαν τα αποτελέσματα των επανελέγχων που διενεργήθηκαν στους ασθενείς. Συμπερασματικά, τα επιδημιολογικά στοιχεία και η αιτιοπαθογένεια του καρκινώματος χρήζουν περαιτέρω διερεύνησης για την καλύτερη κατανόηση της συχνότητας, της κατανομής και των αιτιολογικών παραγόντων εμφάνισης του στα διαφορετικά φύλα, φυλές και γεωγραφικές περιοχές και τον πληρέστερο προσδιορισμό του βιολογικού προφίλ του όγκου.
description: The purpose of this retrospective study was to evaluate the clinical, histological characteristics and the management in patients with VC of the oral cavity diagnosed at the Oral Medicine and Oral Pathology department of School of Dentistry of Aristotle University of Thessaloniki. All patients were informed and signed the relevant consent form available to the Department of Oral Medicine and Oral Pathology. Oral Verrucous Carcinoma (OVC) a rare type of well-differentiated SCC, was defined by Ackerman in 1948 as a diagnostically challenging squamous cell neoplasia involving lip, oropharyngeal and laryngeal mucosa. OVC presents predominantly as a slow growing exophytic lesion, with a pebbly, micronodular surface, which becomes locally invasive if not treated properly. It has generally characteristic morphology and specific behavior, whereas its etiopathogenesis remains unclear. The exposure to major carcinogens such as cigarette smoking and alcohol consumption are considered to be involved in OVC etiopathogenesis. However, in some countries, betel nut use has been suggested as another cause in OVC onset. The clinical behavior of VC according to exposure to different carcinogens may be not the same. Clinically, one of the intriguing aspects of this malignant tumor is its slow growth and his exophytic appearance like cauliflower, that can become locally aggressive if not treated, without any regional or distant metastasis. In some OVC cases, was reported tenderness and pain in the area of the lesion and difficulty in swallowing, while in some patients was described as fully asymptomatic. Surgery is considered as the treatment of choice. The extent of surgical margins and the adjuvant radiotherapy are still controversial. Surgeons must provide adequate specimens including the full thickness of the tumors and adjacent uninvolved mucosa for accurate diagnosis. The establishment of clinical and/or histopathological diagnosis of VC in the oral cavity may be difficult to interpret. The precise diagnosis is heavily dependent on close collaboration between clinician and histopathologist, and on the providing to the latter of a sufficiently large biopsy specimen. 17 patients with confirmed diagnosis of OVC in the oral cavity were retrieved from the files of the Department of Oral Medicine and Oral Pathology. It was recorded in detail the relevant demographic features, including their sex, age, duration/pre-existence of the lesion until the time of diagnosis, medical history in relation to the previous appearance on the body of a malignancy, smoking and alcohol consumption. Furthermore, was recorded the anatomical location, the morphology, the color of the surface and the specific clinical features such as size of the lesions. In addition, were described the signs and symptoms as reported from the patients. A correct diagnosis is founded on the precise evaluation and integration of all the findings clinical and histological. Both medical/dental clinicians and histopathologists must be aware and cautious about warty and exophytic lesions in the oral cavity. An accurate histopathological diagnosis is challenging and is facilitated by an adequate tumor sample for study and more importantly, a close collaboration between the clinician and the histopathologist.