ca dan keganasan 2013

8/14/2019 CA Dan Keganasan 2013

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KeganasanRonggaMulut

goeno subagyo


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Smiles for Life

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Speaking

Chewing

Tasting

Swallowing

Laughing

Smilling

Kissing

Happiness

Crying

Socializing

You are not healthy withoutgood oral health.

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The essence of our humanity

Kesehatan Oral - Kesehatan Umum

C.Everett Koop


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Inter-Relationships Between Oral

and Systemic Health and Disease

SISTEMIKORAL

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Its a Two-Way Street

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The mouth mirrors the body

Penyakit mulut dapat mempengaruhi perawatan

penyakit sistemik

Perawatan penyakit sistemik dapat mempengaruhi

kesehatan mulut

Penyakit mulut dapat meningkatkan risiko penyakit

sistemikKesehatan mulut mempengaruhi kualitas hidup


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dokter gigi mempunyai tanggung jawab

profesional dan moral untuk mempelajarikesehatan umum pasien sebelummemberikan perawatan dental


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Wanita usia 65 tahun dengan polimedikasi

untuk penyakit kardiovaskuler, dengan

rampant caries (karies yang berkembangcepatmelibatkan beberapa gigi)


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drill fill bill75year-oldwomenwithpolymedicationforcardiovasculardiseases


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WHO Oral Health Program

(a) oral health is integral and essential to general

health,

(b) oral health is a determinant factor for quality of life

(c) oral health and general health are interrelated

(d) proper oral health care reduces premature mortality

(Petersen 2003).


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ManifestasiKeganasandiMulut

Sistemik

Keganasan

Lokal


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Manifestasi Oral keganasan

Non-Hodgkin lymphoma

(large ulcer on the soft palate)


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Manifestasi Oral Keganasan

Chronic lymphocytic leukemia(severe gingival enlargement and ulcerations)


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Spontaneous gingival bleeding of

same patient with cirrhosis


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Swollen, shiny, bleeding gingiva ofa patient with acute myelogenous leukemia


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KEGANASAN

ANEMIA


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Laki-laki 60 tahun dengan

ulkus kronis pada sisi lateral

lidah kiri. Mempunyai kebia-

saan merokok dan minum

minuman keras.


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Laki-laki perokok 57 th.dg nonpainful lesion

pd dasar mulut

selama 7 bln.

Leukoplakia

Candidiasis

Lichen Planus

Oral Cancer


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Oral Cancer

ORO-PHARYNGEAL CANCER

IS THE ELEVENTH

MOST COMMON CANCER WORLDWIDE

World Health Organization 2005


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Oral Cancer

30,000newcasesdiagnosedyearly

8,000deathseachyear

5yearsurvivalrate:50%

Oral cancer is the sixth most common cancer among men

IncidenceandSurvivalofOral

orPharyngealCancer


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Oral Cancer

A 5 -year survival rate for African

American men with oral cancer is

approximately 34%.

With early detection and treatment, the 5-

year year survival rate can increase up to

85%.


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Oral Cancer

EarlyDetectionSavesLives

5-year survival for localized disease is 85%

5-year survival for metastatic disease is 19%


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A Precancerous LesionAmorphologicallyalteredtissueinwhichcancerismorelikelytooccurthaninits

apparentlynormalcounterpart

(WHO publication,1997))

Potentially malignant disorders

(WHO 2005)


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The risk of malignancy being present in a lesion

or condition either at the time of initial diagnosis

or at a future date.


(WHO 2005)


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Clinical Lesions


LeukoplakiaErythroplakia

Lichenplanus


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WhiteLesions

Lichen planus

Frictional keratosis

Tobacco pouch keratosisNicotine stomatitis

Actinic cheilitis

Leukoedema

Linea alba

Hypertrophic candidiasis

Hairy leukoplakia

White spongue nevusSquamous cell carcinoma

etc


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Leukoplakia: Clinical Features

Leukoplakia usually affects people over

the age of 40 years (average age is 60

years).

Prevalence increases rapidly with age

particularly in males.

Approximately 8 % of the males over the

age of 70 years are reportedly affected.


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Leukoplakia: Clinical Features

Approximately 70 % of the oral leukoplakiasare found on the lip vermilion, buccal

mucosa and gingiva.

Note: Lesions of the tongue, l ip verm i lionand f loo r of the mouth account for more

than 90 % of those that show dysplas iaor

carc inomaupon histologic examination.


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Clinical classification1. Homogeneous oral leukoplakia

Most common type

Consists of uniformly

white plaques

Occurs mainly on buccal

mucosa

Low transformation

potential


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2. Non-homogeneousleukoplakia

Nodular leukoplakia

Small aggregated hemispherical red or white surfacealterations or excrescences, may show a red background or

substrate.Stronger risk of dysplasia or malignant potential than

in homogeneous leukoplakia.

Speckeled leukoplakia

Speckled leukoplakia

Less common More serious

Consists of white flecks or fine nodules

on an atrophic erythematous base

Stronger malignant potential than

homogeneous leukoplakia

Regarded as a combination of or a transition

between leukoplakia and erythroplasia.


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http://2.bp.blogspot.com/-XucD6KJXuik/TsE4K9SjOCI/AAAAAAAAEPs/ix1XKxVv3iE/s1600/Homogeneous+leukoplakia.png


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http://3.bp.blogspot.com/-h7DrudY7Nv8/TsE4ciddr8I/AAAAAAAAEP0/ZuSlcTkOgIM/s1600/Speckled+leukoplakia..png


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http://4.bp.blogspot.com/-8QLHzl4tFsI/TsE5oqhYZaI/AAAAAAAAEP8/5wNgpMDhv_k/s1600/Hairy+leukoplakia..png


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Homogeneousleukoplakia


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NON-HOMOGENEOUS LEUKOPLAKIA

Nodular (N) and Verrucous (V) leukoplakia

NV


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Erythroplakia

Definition:A red patch that canno t be cl in ically or

pathologically diagnosed as any other condition

Most (~90%) do represent epithelial dysplasia,carcinoma in situ, or squamous cell carcinoma

May be combined with leukoplakic areas =

erythroleukoplakia, speckled leukoplakia


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Erythroplakia

-Erythroplakia

- histology: SCC


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Lichenplanus

-Lichenplanusisaninflammotorydisease

ofskinandmucosaofunknown

aetiology,thoughalterationsincell-

mediatedimmunitymaybeimportant.


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A predominantly white lesion withverrucous,nodular, ulcerated or erythematous

features.


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Annular form of lichen planuson the right buccal mucosa. Note thepigmentation and the ring-like pattern of Wickham striae(yellow

arrows).
http://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=Wickham%20striae&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=Wickham%20striae&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&img


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A reticularform of lichen planus. Note the

bilaterally symmetrical patterns, which arecharacteristic of lichen planus.
http://screening.iarc.fr/atlasoralglossdef.php?key=reticular&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=reticular&img


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Annular form of lichen planuson the right buccalmucosa. Note the ring-like pattern of white striae

(yellow arrows).
http://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&img


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Tanda & Gejala Awal Oral Cancer

Lesi putih atau merah yang menetap Ulkus yang tidak sembuh

Pembengkakkan yang progresif

Perubahan ciri permukaan yang tidakwajar

Gigi goyah tanpa penyebab jelas

Perdarahan /mimisan yang tidak wajar Suara serak yang berkepanjangan


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O l C


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Rolled borderIndurated margins

Bleeding and friable

Verrucous

Ulcerated

Swelling

Oral Cancer

Clinical features:


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What to look for during screening?

1. Oral mucosal changes

2. Bony changes

3. Tooth movements

Changesinthemouth:

Screening Examination


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ScreeningExamination

forOralCancer

Screening exam requires:

Good light

Use of a dental or laryngeal mirror Inspection of high-risk areas

Palpation


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Dengan melaksanakan tiga langkah pemeriksaan diri

sendiri dapat menyelamatkan hidup anda. Dengan cara

demikian dapat membantu menemukan kanker muluttahap dini, sehingga perawatan kanker dapat dilakukan

sedini mungkin.

Bibir Lidah

Dasarmulut

Tigalangkahpemeriksaandirisendiri


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Dasar Mulut Denganmenggunakanujunglidah,

sentuhlahpermukaandasarmulut,

rasakanadakahabnormalitas? Bukalahmulutlebar,amatidasarmulut

danpermukaanventrallidah.


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t l di h i


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pertanyaanyangperludipahami

Mengapa harus melakukan pemeriksaan mulut

sendiri?

(agar kanker dapat di deteksi dini)

Kapan waktu yang paling baik untuk memeriksa

mulut?(setiap 2 bulan sekali setelah membersihkan mulut

dan gigi)

Langkah apa yang harus dilakukan setelah

menemukan abnormalitas di mulut?

(memeriksakan diri ke dokter gigi )


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PENUTUP


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PENUTUP Manifestasi oral keganasan bervariasi karena

keganasan lokal di mulut atau manifestasi keganasandi tempat lain/sistemik.

Mencermati dan mewasdai tandagejala keganasan

di mulut merupakan cara deteksi dini oral cancer.

Deteksi dini oral cancer akan menyelamatkan jiwa

penderitanya

Pemebelajaran pemeriksaan diri sendiri dapat

menjadi salah satu sarana untuk deteksi dini kankermulut, sehingga pemeriksaan dan perawatan dapat

segera dlakukan.


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