Squamous Cell Carcinoma of the Buccopharyngeal Region

IN recent years many attempts have been made to correlate the histological appearances of new growths with their clinical behaviour and radio-sensitivity.These studies have disclosed the existence of a group of ill-differentiated highly malignant but equally highly radiosensitive buccopharyngeal carcinomata of uncertain histogenesis.While much attention has been paid to their morphology, the literature yields but scant information of value regarding the relative malig- nancy of these tumours.Varying nomenclature, inadequate follow-up, and an insufficiency of cases, render many of the views expressed little more than conjectures.The purpose of this paper is to elucidate further the natural history of this group.This we have attempted through an analysis of 408 cases of cancer in the neighbourhood of the mouth.The frankly keratinizing members of our series we have taken as a standard with which to compare the behaviour of our remaining histological types.The morphological features of the more differentiated epitheliomata have been so completely evaluated that any further discussion would be superfluous.Duval and Lacassagne (1922) have probably provided the most complete classification of these growths, but made no attempt to correlate structure with potential malignancy.The most widely known study with this end in view is that of Broders (1920), who grouped the squamous cancers into four grades on the basis of cell differentiation.The anaplastic growths of Grade IV merit a brief descrip- tion.They are characterized by their large, polygonal, clearly demarcated cells, which are distributed in groups of two or three, in sheets, columns, or as a diffuse infiltration.The cytoplasm is eosinophil in reaction, while the sharply cut, round or oval nucleus houses a coarse chromatin network with a prominent nucleolus.Such growths belong to that poorly differentiated group which has aroused such interest during the past two decades, a group which has become a 'A Vol.I, N o. 1. r\14i