felis - Articles
Mouth: squamous cell carcinoma
Introduction
- Oral neoplasia forms 10% of all feline neoplasia.
- Most common oral tumor in cats: 70-80% of feline oral neoplasms are squamous cell carcinoma (SCC) Squamous cell carcinoma.
- Tongue, pharynx, and tonsils are common sites.
- Other malignant oral neoplasms include fibrosarcoma (second most common) and lymphosarcoma (less common) plus a few rare types.
- Tonsillar SCC is more malignant Tonsil: squamous cell carcinoma.
- Cause: risk of developing oral SCC increased by 4-fold with the use of flea collars and high intake of canned food (specifically tuna fish). Exposure to tobacco smoke increased the risk of oral SCC by 2-fold. Clumping clay cat litter increased the risk factors for SCC with an odds ratio of 1.66.
- Signs: hypersalivation, dysphagia, facial asymmetry.
- Diagnosis: biopsy required to confirm tumor type, CT scan helps to establish extent of disease.
- Treatment: surgical excision +/- radiotherapy. Palliative radiotherapy. Chemotherapy is unrewarding.
- Prognosis: poor in general. Mandibulectomy may allow prolonged survival (1 year +), but sublingual SCC hard to treat. Print off the owner factsheet Oral squamous cell carcinoma to give to your client.
Presenting signs
- Facial asymmetry.
- Oral mass.
- Hypersalivation, bloody discharge.
- Anorexia.
- Loose teeth.
- Dysphagia.
- Weight loss.
- Halitosis.
- Non-healing oral ulceration.
Age predisposition
- Older cat (mean 10-12 years).
Breed/Species predisposition
- No clear predispositions.
Cost considerations
- Staging Neoplasia: TNM staging with CT scan and aspirates of lymph nodes under ultrasound guidance.
- Initial treatment (surgery, radiotherapy) likely to be expensive.
- Follow-up consultations/restaging.
Pathogenesis
Pathophysiology
- Malignant transformation of oral stratified squamous epithelium covering tongue or buccal mucosa → mixed proliferative and ulcerative lesion → local invasion loosens teeth and destroys bone → spread to regional lymph nodes → distant metastasis.
- Irregular proliferative or ulcerative epithelial lesions at any site in upper or lower dental arcade → destruction of periodontal tissues and loosening teeth → bone invasion (70-77% of cases) → regional lymph node metastases (31% of cases) → distant metastases (10% of cases).
- Hypercalcemia reported in 2 cases.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Noall L, Lee S, Burton J H, Marquardt T M, Cermak J et al (2023) A multi-institutional epidemiologic study evaluating environmental risk factors for feline oral squamous cell carcinoma. Vet Comp Oncol 21(3), 509-519 PubMed.
- Sequeira I, Pires MdA, Leitã J, Henriques J, Viegas C, Requicha J (2022) Feline Oral Squamous Cell Carcinoma: A Critical Review of Etiologic Factors. Vet Sci 9, 558 PubMed.
- Wiles V, Hohenhaus A, Lamb K, Zaidi B, Camps-Palau M, Leibman N (2016) Retrospective evaluation of toceranib phosphate (Palladia) in cats with oral squamous cell carcinoma J Feline Med Surg 19(2), 185-193 PubMed.
- Bilgic O, Duda L, Sánchez M D, Lewis J R (2015) Feline Oral Squamous Cell Carcinoma: Clinical Manifestations and Literature Review. J Vet Dent 32(1), 30-40 PubMed.
- Sabhlok A, Ayl R (2014) Palliative radiation therapy outcomes for cats with oral squamous cell carcinoma (1999-2005). Vet Radiol Ultrasound 55(5), 565-570 PubMed.
- Soltero-Rivera M M, Krick E L, Reiter A M, Brown D C, Lewis J R (2014) Prevalence of regional and distant metastasis in cats with advanced oral squamous cell carcinoma: 49 cases (2005–2011). J Feline Med Surg 16(2),164–169 PubMed.
- Poirier V J, Kaser-Hotz B, Vail DM, Straw R C (2013) Efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral squamous cell carcinoma. Vet Radiol ultrasound 54(1), 81-88 PubMed.
- Fidel J, Lyons J, Tripp C, Houston R, Wheeler B, Ruiz A (2011) Treatment of Oral Squamous Cell Carcinoma with Accelerated Radiation Therapy and Concomitant Carboplatin in Cats. JVIM 25(3), 504-510 PubMed.
- Hayes A M, Adams V J, Scase T J, Murphy S (2007) Survival of 54 cats with oral squamous cell carcinoma in United Kingdom general practice. JSAP 48(7), 394-399 PubMed.
- Bertone E R, Snyder L A, Moore A S (2003) Environmental and Lifestyle Risk Factors for Oral Squamous Cell Carcinoma in Domestic Cats. JVIM 17(4), 557-562 PubMed.
- Bregazzi V S, LaRue S E, Powers B E et al (2001) Response of feline oral squamous cell carcinoma to palliative radiation therapy. Vet Rad Ultra 42 (1), 77-79 PubMed.
- Schmidt B R, Glickman N W, DeNichola D B et al (2001) Evaluation of prioxicam for the treatment of oral squamous cell carcinoma in dogs. JAVMA 218 (11), 1783-1786 PubMed.
- Frew D G & Dobson J M (1992) Radiological assessment of 50 cases of incisive or maxillary neoplasia in the dog. JSAP 33 (1), 11-18 VetMedResource.
- White R A S (1991) Mandibulectomy and maxillectomy in the dog: long term survival in 100 cases. JSAP 32 (2), 69-74 VetMedResource.
- Dobson J M & White R A S (1990) Oral tumours in dogs and cats. In Practice 12 (4), 135-146 PubMed.
- White R A S, Gorman N T, Watkins S B et al (1985) The surgical management of bone-involved oral tumours in the dog. JSAP 26 (12), 693-708 VetMedResource.
Other sources of information
- Withrow S J & MacEwen E G (2020) Small Animal Clinical Oncology. 6th edition. Philadelphia: W B Saunders. ISBN 978-0-323-59496-7. (Up-to-date reference on all aspects of small animal clinical oncology.)
- White R A S (1990) In: The Manual of Small Animal Dentistry, pp 101-112. Cheltenham: BSAVA. (Affordable source, very readable.)