Diagnosis

It is important to inspect the mouth for the appearance of the lesion, its location and any effect on adjacent tissues. Radiographs may be necessary to establish the tumor effect on the adjacent bone. Although cytology, either by smears of fine needle aspiration (FNA) is commonly used to diagnosis cancer at other sites in the body, its use in oral cancer is limited with exception of the investigation of an enlarged lymph node. If oral cancer is suspected, the most appropriate diagnostic test is a tissue biopsy of the lesion.⁶ In most instances a biopsy of a suspicious lesion can be undertaken using local anesthesia. It is important that the biopsy is large enough and representative of the lesion. For most lesions it is appropriate to sample the center of the lesion and ensure that it is deep enough to include connective tissue at the base. Placement of the biopsy specimen on a piece of thick paper (connective tissue side down on the paper) helps to support the specimen during fixation, minimize tissue curling and aids orientation for the pathologist.