PRECANCEROUS DISEASES OF THE LIP, TONGUE AND ORAL MUCOSA

A person contacts the outside world through the oral cavity, respectively, it is there that the development of inflammatory processes is most likely, which can become the main factors in the development of a tumor. Let’s focus on precancerous tumors of the oral mucosa. Cancer of the lower lip mucosa quite often occurs, seemingly without visible external causes, on a healthy mucosa. As with other cancers, cancer of the lower lip mucosa is preceded by a number of different painful processes. It is established that among the causes of such processes, a prominent place is occupied by various environmental stimuli: prolonged exposure to cold and dry air, sunburn, constant weathering, exposure to too hot food, Smoking, poor oral hygiene (spoiled teeth with sharp edges, significant deposition of Tartar on them, as a result of which the lip mucosa is constantly injured and small wounds, abrasions, cracks occur on it). In addition, when Smoking (most often cigarettes), there are imperceptible, small, but permanent burns or constant exposure to heat, and when Smoking a pipe, it injures the mucous membrane of the lower lip. Under the influence of the above-described irritations, there is keratinization of the mucous membrane (the lips constantly dry and peel) – the so-called hyperkeratosis, persistent, unhealed cracks and even small ulcers appear.

Then they pass into limited areas of hyperkeratosis or into small, dense to the touch nodules covered with normal mucous membrane or dense warty protrusions. Very often, the mucous membrane with such changes ulcerates, becomes covered with a dry crust, the patient soaks it or simply peels it off, a drop of blood appears, then the crust is formed again. In the future, these thickening of the horn layer of the red border of the lower lip undergo deeper changes, standing already at the border, close to the transition to true cancer. These are so-called dyskeratoses, i.e. disorders of keratinization of the epithelium of the lower lip mucosa. They can occur by the type of destruction of the elements of the mucous membrane (destructive form) and by the type of formation of a new, larger than necessary, product of epithelial origin (productive form). With a destructive form, a superficial epithelial defect appears on the red border of the lower lip mucosa, which seems to be a simple abrasion. But if you examine it under a magnifying glass, you will see a superficial ulcer with a smooth bottom and slightly thickened edges. Sometimes the epithelial defect occurs in the form of a crack that persistently does not heal and can exist in a similar state usually for many months, but by the time of transition to cancer at the edges, and then at the base of the defect, there is a tumor hardening, expressed in a thickening of the edges, forming a kind of rim, similar to a roller. It is especially visible if you stretch the lip mucosa with two fingers in front of the mirror. To the touch, it is a rough, Horny protrusion. Sometimes it appears as a small conical elevation of yellowish-whitish color.

Much less common are plaques of grayish-white color-leukoplakia. In both cases, the hard surface of these formations differs sharply from the completely soft underlying layers of lip tissue. On the lower lip, papilloma (warty or papillary tumor) often occurs. It is covered with Horny lumps and has a hemispherical shape. As to the touch and in appearance papilloma is clearly different from the surrounding healthy tissue. All the described signs of precancerous diseases of the lower lip mucosa are easy to recognize. Their treatment consists primarily in eliminating the irritating factor, in the use of emollient creams and ointments. For special indications, surgical removal is performed with subsequent examination under a microscope. The latter is done in order not to miss the transition of precancerous diseases to cancer, since then the treatment methods are more radical. Cancer of the tongue belongs to the forms of oral cancer, in which early diagnosis is possible in the phase of precancerous diseases, since these “preparatory” precancerous changes are observed on the tongue more often and more clearly than in any other part of the body. By localization and accompanying unpleasant sensations, they attract the attention of patients themselves and can be accurately detected and cured by a doctor. At the same time, you do not need special tools to make a diagnosis, just an examination and a gentle finger feeling are enough. To clarify the diagnosis, a fingerprint from a suspicious place is taken on a piece of glass and examined under a microscope. Precancerous diseases of the tongue are observed mainly at the age of 40 to 60 years.

The vast majority of patients are men. This predominance in the number of men with precancerous diseases of the tongue should be attributed to Smoking. The role of Smoking in the development of leukoplakia of the tongue is evidenced, for example, by the fact that it disappears as soon as men stop Smoking. Over the past 20-30 years, tongue cancer in women is somewhat more common. This is directly related to the fact that Smoking among women has become common in recent decades. Another predisposing factor for the occurrence of precancerous diseases of the tongue are sharp, broken and” rotten ” teeth, which constantly damage the mucous membrane of the tongue. Thus, in precancerous diseases of the tongue, the moments of chemical (tobacco) and mechanical (sharp edges of the tooth) irritation are very obvious. This is followed by the necessary measures to prevent the occurrence of precancerous diseases – sanitation (improvement) of the oral cavity and teeth, Smoking cessation. Consider a pre-cancerous disease of the tongue. With leukoplakia, plaques are formed that have the appearance of white-bluish or smoky-gray spots, located more often on the side surfaces of the tongue, almost imperceptible for finger feeling. But then at this point, the surface of the tongue becomes dirty gray, sometimes with small cracks. It is sometimes more or less painful when touched, or soft, or, conversely, compacted compared to the neighboring mucous membrane. Excision of leukoplakic plaques is the most reliable way to treat leukoplakia of the tongue, and thus prevent cancer.

Along with leukoplakia, and sometimes in the absence of it, other precancerous changes are observed in the language. These are ulcers, papillomas. As long as they are thin and uniform, soft to the touch, there is no reason to think about their dangerous nature, but the appearance of the slightest palpable finger seals of papillomas should make us carefully monitor them, eliminating all sorts of irritations (such as hot and spicy food, Smoking, spoiled teeth, poorly fitted dentures, etc.). If the papilloma or ulcer after this does not disappear in a short time, it is necessary to excise them and examine them, so as not to miss the beginning of malignant growth. In the posterior parts of the tongue, small combed papillary growths are often found, accompanied by small hemorrhages and pain. They can exist for years without any threat of malignant degeneration. These are so-called papillitis (chronic inflammation of the papillae of the tongue), which even with their significant increase do not degenerate into cancer. More dangerous are papillary nodular or ulcerative formations on the tongue, especially if they have the form of hard bumps that clearly stand out against the background of neighboring soft tissues – infiltrates. When ulceration of such infiltrates appears red “pitted” bottom of the ulcer. If any unpleasant sensations or growths appear in the language, you should consult a doctor.

The mucous membranes of the mouth, cheeks, tonsils, under the tongue, on the soft or hard palate are also often affected by various precancerous diseases. The reasons for their occurrence are the same as for cancer of the tongue. They respond well to treatment when eliminating irritating factors.

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