Oral diseases · 2026
Clinical Variability in Oral Squamous Cell Carcinoma: A Retrospective Analysis Proposing a Practical Morphological Classification.
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de Mendonca Nathalia Felix, Bonan Paulo Rogerio Ferreti, Junior Hercílio Martelli, Perez Danyel Elias da Cruz, Villa Alessandro, Kowalski Luiz Paulo, Lopes Márcio Ajudarte, Pires Fabio Ramoa, Alves Fabio Abreu
Аннотация
OBJECTIVE: To propose a clinical classification system for oral squamous cell carcinoma (OSCC) based on lesion characteristics, aiming to enhance early recognition and initial clinical diagnostic hypothesis rate in clinical practice.
METHODS: A retrospective analysis of 422 OSCC cases was conducted from 2005 to 2023. Lesions were clinically categorized through clinical photographs as either "conventional" (including non-ulcerated plaques; red, white, or mixed and ulcerated infiltrative lesions with raised indurated margins) or "atypical" (different from the one described above) based on their presentation. Atypical cases were further subclassified into morphological types.
RESULTS: Of the 422 OSCC cases, 316 (74.9%) were classified as conventional and 106 (25.1%) as atypical. Conventional cases were predominantly ulcerative or leukoplakic, while atypical cases exhibited fissure-like and exophytic patterns. Tongue border was most commonly affected in conventional OSCC, while floor of the mouth and buccal mucosa predominated in atypical forms.
CONCLUSION: Approximately one-quarter of OSCC cases present with atypical clinical features. The proposed classification provides a practical tool for clinicians to recognize these variants. However, further prospective validation is warranted to determine whether its application improves clinical recognition and diagnostic accuracy.
METHODS: A retrospective analysis of 422 OSCC cases was conducted from 2005 to 2023. Lesions were clinically categorized through clinical photographs as either "conventional" (including non-ulcerated plaques; red, white, or mixed and ulcerated infiltrative lesions with raised indurated margins) or "atypical" (different from the one described above) based on their presentation. Atypical cases were further subclassified into morphological types.
RESULTS: Of the 422 OSCC cases, 316 (74.9%) were classified as conventional and 106 (25.1%) as atypical. Conventional cases were predominantly ulcerative or leukoplakic, while atypical cases exhibited fissure-like and exophytic patterns. Tongue border was most commonly affected in conventional OSCC, while floor of the mouth and buccal mucosa predominated in atypical forms.
CONCLUSION: Approximately one-quarter of OSCC cases present with atypical clinical features. The proposed classification provides a practical tool for clinicians to recognize these variants. However, further prospective validation is warranted to determine whether its application improves clinical recognition and diagnostic accuracy.