Palate Squamous Cell Carcinomas:A Ten-Year Single Institute Experience

Abstract

The literature date estimated that about 5% of all oral cavity cancers are hard palate cancers while soft palate cancers account for about 5-12% of oropharyngeal cancers. Although rare, usually these tumors had a more aggressively behavior than other oral cancer sites. That is why our study aimed to investigate comparatively the epidemiological, clinical and histopathological peculiarities of the two palatal sites of oral squamous cell carcinomas. We conducted a retrospective study limited to a period of 10 years in a single medical institution to investigate the morphoclinical profile of such tumors. We found that patients with hard palate SCCs had an average age slightly larger compared to those who developed soft palate tumors. Also, those with hard palate tumors are mostly diagnosed in less advanced stages compared to those at the level of the soft palate, and implicitly the former had a longer survival time. Histopathologically the most encountered hard palate SCC were the conventional well-differentiated tumor, and from the peculiar SCC variant the papillary and verrucous forms while for the soft palate SCC prevailed the moderate and poor differentiated conventional SCC and from the peculiar SCC variant the basaloid and acantholytic forms. In conclusion hard palate tumors differ in many aspects from those of the soft palate, and thus specification of the origin tumor site become important for the assessment of prognosis, treatment and survival outcome of such patients.

Keywords: Epidemiology; histopathology; oral cavity; palate; squamous cell carcinomas.

Figure 1

Palate Squamous Cell Carcinoma (SCC). A. Palate mucosa with SCC composed of invasive islands and cords of malignant squamous epithelial cells. HE staining, x50; B. Well-differentiated SCC, neoplastic proliferations with squamous epithelial architecture and dyskeratosis with keratin pearls formation. HE staining, x100; C. Moderate- differentiated SCC, neoplastic proliferation with obvious malignancy appearances and few keratin pearls formation. HE staining, x100; D. Poor-differentiated SCC, the neoplastic proliferations do no longer resembles squamous epithelium, keratinization is minimal and nuclear atypia are evident. HE staining, x100; E. Papillary SCC, a papillary tumor growth composed of numerous, thin, finger-like papillary projections. HE staining, x100; F. Verrucous SCC, neoplastic proliferation with abundant keratosis and parakeratosis in an acanthotic squamous epithelium accomplishing the “church spires” appearance. HE staining, x25

Figure 2

Palate Squamous Cell Carcinoma (SCC). A. Basaloid SCC, neoplastic proliferation consisting of invasive solid, trabecular, cords, and nests tumor proliferations that sometimes present obvious peripheral palisading. HE staining, x100; B. Acantholytic SCC, with islands and sheets of neoplastic squamous cell carcinoma with central prominent acantholysis that create a false appearance of glandular differentiation. HE staining, x50; C. SCC invading the palate bone. HE staining, x50; D. Moderate- differentiated SCC invasive in muscle fibers. HE staining, x100; E. Lymph node with SCC metastasis. HE staining, x25; F. SCC invading nerve bundles. HE staining, x200

Figure 3

Statistical difference ratios for Palate Squamous Cell Carcinoma (SCC) tumors of the soft palate and hard palate in what it regards adenopathy (A), histopathological type (B), T and N stages (C and D). All values on the OY axe represent the actual number of cases