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2019年7月15日星期一

Leukoplakia and tongue carcinoma (舌白斑和舌癌)

Leukoplakia (舌白斑)
A white patch which cannot be wiped away and for which no other diagnosis is apparent. Risk factors in the development of oral cavity or tongue leukoplakia include alcohol, smoking, spice and betel nut chewing, syphilis and dental trauma. About 5% of cases become malignant. Exclusion of an associated carcinoma is essential.


Tongue carcinoma (舌癌)
Almost all tongue carcinomas are squamous in origin. There need not be any pre-existing leukoplakia.

Clinical features:
May present as an exophytic or infiltrative lump on the tongue. Pain and dysphagia are common. Referred otalgia (via lingual and glossopharyngeal nerves) may also occur. At presentation most tumours are greater than 2cm diameter and 50% have palpably involved lymph nodes.

Management:
Small lesions  Radiotherapy, using external beam or interstitial implant techniques, or surgery, in the form of a partial or hemiglossectomy are equally effective.

Large lesions – Treatment is with radiotherapy or surgery alone or a planned combination of the two. Both modalities produce quite severe functional disability in the oral cavity, especially regarding speech and swallowing.


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