Question:

My mom’s pathology report found moderate to advanced dysplasia and the oral pathologist wants a deeper tissue sample of the muscle layer of her tongue.

Can squamous cell cancer be present in deeper layer and only show dysplasia cells in the epithelial tissue? Also is it possible that her dysplasia arose from her lichen planus? What are the treatment options for her stage of dysplasia? Thanks.

Answer:

Dysplasia basically refers to a precancerous condition. The higher the grade (mild vs. severe), the higher the chance of developing an invasive process.
 
Many pathologists do not distinguish between severe dysplasia and a process called “carcinoma in situ” which is basically a similar condition that sits on the border between pre-cancer and an invasive cancer.

Sometimes biopsies that are superficial only assess the epithelial layer (outer lining) and may not be able to assess for whether there was any invasion of this process into the deeper tissues.

The data regarding the association of lichen planus with the development of oral cancer is inconclusive and is still under study.

It is best to have your questions regarding treatment addressed by an oral surgeon or otolaryngologist (ENT) who can go over the diagnosis and treatment options in detail.

For more information:

Go to the Oral Cancer health topic.