Invasive Oral Squamous Cell Carcinoma Induce by Consumption ofSmokeless Tobacco : Presentation of Five Cases with Review of Literature

Background: Smokeless tobacco represents a group of compounds used with intra-oral method.There is a marked prevalence of consumption of smokeless tobacco (snuff) in south-eastern ofIran. Overall , there is sufficient evidence that smokeless tobacco causes pre-cancerous oral lesionssuch as leukoplakia and also oral cancer in humans.Methods: The present report are the clinical presentations of five case who had been developedaggressive squamous cell carcinoma at the exact site where they used to place snuff regularly foryears. All patients were referred from Sistan and Baluchistan province to the department of oralmedicine , Kerman dental school.Result: Five cases consisted four men (between ۴۸ to ۷۹ years old) and a-۶۰-year-old woman. Theclinical pictures were miscellaneous in relation to the frequency , duration and the site of theapplication of snuff. In its mildest form , the lesions were noted as wrinkles of the mucosa whereashigh consumers displayed necrotic and leathery white lesions which contained ulcerations.Gingival retraction was the most common adjunctive finding. Histopathologic evaluation for thesecases showed the features : hyperkeratosis , acanthosis and severe dysplasia beyond the epithelialbasement membrane which is called :”invasive squamous cell carcinoma”.Conclusion: Early diagnosis and surgical excision are the most appropriate treatment modality ofsuch lesions. It is important for clinicians to be aware of the danger of these products for human’shealth and they should inform their patients regarding this issue.