Oral Cavity Generalities

  • The oral cavity represents the entrance to the upper aerodigestive tract:
    • Which begins at the lips and ends at the anterior surface of the faucial arch
    • It is lined by:
      • Squamous epithelium with interspersed minor salivary glands
  • The oral cavity also contains the:
    • Dentoalveolar structures:
      • With the upper and lower dentition
  • The oral cavity is continuously exposed to inhaled and ingested carcinogens:
    • Thus it is the most common site for the origin of malignant epithelial neoplasms in the head and neck region
    • Known carcinogens for oral cavity carcinoma include:
      • Those present in tobacco, alcohol, and betel nuts
      • The association of human papilloma virus with oral cancer is not as well established as in oropharyngeal cancers
  • Primary tumors of the oral cavity may arise from the:
    • Surface epithelium
    • Minor salivary glands
    • Submucosal soft tissues
    • Lesions of dentoalveolar origin:
      • Representing a unique group of neoplasms and cysts
  • The various anatomic sites within the oral cavity as described by the American Joint Committee on Cancer (AJCC) and International Union Against Cancer (UICC) staging system are shown below:
Anatomic sites within the oral cavity.
  • More than 90% of malignant tumors in the oral cavity are:
    • Squamous cell carcinomas:
      • The remainder are:
        • Minor salivary gland carcinomas and other rare tumors
  • Most patients with cancer in the oral cavity are men:
    • Although the incidence of tongue cancer in women in the United States has progressively increased over the past several decades
      • In the Western world:
        • The tongue and floor of the mouth:
          • Are the most common sites of origin for primary squamous cell carcinomas in the oral cavity:
            • However, the retromolar trigone and buccal mucosa are the most frequently encountered primary sites in areas of the world where chewing of tobacco and / or betel nuts is common
  • The site distribution of various primary cancers in the oral cavity in the United States is shown bowls:
The site distribution of primary cancers in the oral cavity
(MSKCC data 1985 to 2015; all patients re-staged according to AJCC 8th edition
criteria).



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