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i have been treated for squamous cell carcinoma from an area of severe dysplasia in the right floor of my mouth. i still have sereve dysplasia at margin i have had surgey to have the tumor removed can u tell me the risk of another tumor coming back in my mouth or elsewhere with severe dypslasia still a factor plz email back a.s.a.p.

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Based on the experience with squamous cell carcinoma of the uterine cervix, a pathway to invasive malignancy has been mapped. The first step along the path is the development of """dysplasia,""" a change that precedes malignant transformation of epithelial cells. In the oral cavity, this change manifests as a lesion known as """mucosal dysplasia.""" In the second step, malignant transformation (anaplasia) has taken place stopping short of invasion. This transformation produces a lesion called """carcinoma-in-situ,""" a term meaning """cancer-in-place""" and implying that invasion has not occurred. Mucosal dysplasia and carcinoma-in-situ are well-recognized precursors to invasive oral SCC.

While chronic traumatic irritation may play a role, mucosal dysplasia is most commonly associated with tobacco or alcohol abuse (but can occur with no risk factor associated). While theoretically reversible, it is assumed that if the etiologic factors continue and the mucosal dysplasia is not removed, it will inexorably continue along the path to invasive SCC.

Because it is impossible to diagnose mucosal dysplasia from clinical examination, it is necessary to biopsy all lesions of the oral mucosa. Small lesions may be excised while larger ones may need to be removed in sections once the diagnosis is made. Since, by definition, there is no malignant transformation or invasion, mucosal dysplasia should not recur if the irritants that produced it are removed too.

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