The Etiologic Role of Chewing Tobacco in Cancer of the Mouth

Verrucous carcinoma (carcinoma cuniculatum) of the head and neck: what do we know now that we did not know a decade ago?

“…Verrucous carcinoma was Wrst reported by Friedell and Rosenthal [1], who described eight lesions of a verrucoid nature in the buccal mucosa and alveolar ridge of tobacco chewers. In 1948, one of the deans of US surgical pathology, Lauren V. Ackerman [2] reported on a vexing lesion arising in the head and neck region.…”

Betel Quid Carcinogenesis in the Baboon

“…India leads the world with its high rate of oral cancer, particularly buccal mucosal carcinoma [1,2], Paymaster found a 34.9% incidence of oral/pharyngeal cancer in an urban Indian hospital cancer popula tion in contrast to a 3.4 percentage of oral cancer in a similar United States population [I], Many investigators have postulated a definite relationship between the high rate of oral cancer in India with the prevalent habit of chewing betel [2,3,4,5,6], Calcium hydroxide ('lime') is one of the 4 principal ingredients found in the standard betel chew, which is known in India as 'pan'. The other major constituents are: betel pepper leaf, areca palm nut, and catechu [3,7], Tobacco is also often added to the betel quid.…”

“…Accord ing to individual taste, custom, or financial ability to purchase them, spicy substances such as nutmeg, amber, camphor, musk cardamon, and cloves are mixed with the standard chew to enhance its flavor [7], Each of the 4 principal ingredients of the basic betel quid may play some role in cancer formation, either directly, as a carcinogenic sub stance, or indirectly, as a co-carcinogen. Previous clinical investigations indicate that buccal carcinoma is much more prevalent among Indians who do incorporate tobacco in their betel chew [2,3,4,5,6], Lime, a weak alkali and known tissue irritant, has also been suggested as a possible carcinogen [4,8,9], Wahi discovered an incidence of 31.9% for oral and pharyngeal cancer in Uttar Pradesh after reviewing a total of 6,010 malignant specimens from a hospital tumor population [10], After examining 10,000 randomly selected Indians in Lucknow, Uttar Pradesh, Pindborg found 24 persons (0.24%) who demonstrated buccal carcinoma. All of them had one or several smoking and/or chewing habits [11], South Indians exhibit a similar propensity for oral cancer [6], Oral cancer in the Kanyakumari District of Madras ranked exceptionally high in its cancer registry for 1965-1967, comprising 542 out of 899 new cancer cases reported (60%) [12].…”

Verrucous carcinoma: a retrospective diagnosis in three historic patients

“…This tumor was first recognized in 1941 by Friedell and Rosenthal [1]; they reported on eight patients with oral cavity tumors. All had a habit of tobacco chewing.…”

“…Some studies indicate that up to 10 % of all laryngeal verrucous carcinomas are of the hybrid type [8]. Even Friedell and Rosenthal [1], and Ackerman [2] found regional metastases in their cases.…”