A 68-Year-Old Man with a Long History of Using Chewing

question 767

Multiple Choice

A 68-year-old man with a long history of using chewing tobacco comes to the office for follow up of squamous cell carcinoma (SCC) of the oral cavity.  A month ago, the patient was diagnosed with SCC of the left lateral tongue.  He underwent resection, the surgical specimen showed clear margins, and he started additional treatment.  The patient recently noticed a second ulcerative lesion on the right lateral tongue.  Biopsy is performed and it also shows SCC.  The second tumor most likely arose from which of the following mechanisms?

• A)Chemotherapy-induced malignancy
• B)Field cancerization
• C)Hematogenous spread
• D)Immunologic privilege
• E)Impaired wound healing
• F)Lymphatic spread

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Definitions:

Puberty

The period of life when a person's sexual and physical characteristics mature due to hormonal changes, marking the capability of reproduction.

Early Adulthood

A developmental phase typically ranging from the late teens through the twenties, characterized by exploration, establishing independence, and building foundations in career and relationships.

Synaptic Pruning

The natural and necessary process of shedding excess neurons and synapses during brain development to increase the efficiency of neuronal transmissions.

Synapses

The junctions through which neurons communicate with each other, using chemical or electrical signals.