Oral Growths, masses and tumors

Tumors in the mouth represent up to 6% of all tumors encountered on the body. While there are many specific types of tumors, in general they can be divided into a few categories.

• Tumors that have generally benign behavior tend to grow to a small or moderate size but do not cause major destruction and do not require extensive treatment. Many small (pea to cherry size) oral growths fall into this category.

• The intermediate category would be tumors that are locally aggressive but do not spread elsewhere in the body. These can grow large, but typically slowly. 

• The last category of tumors would be tumors with more malignant behavior. These would be tumors that spread elsewhere in the body or have very aggressive local growth and occasional spread.  Tumors in this category require immediate and aggressive treatment for the best possible outcome. These tumors can be massive - (Think orange to grapefruit or larger)

The biggest difficulty in managing oral tumors is that until initial diagnostics are done, a pea-sized growth in your pet’s mouth could fall into any of these categories.

The most important things to determine when assessing a tumor are answering the questions:

• What is it? Is getting a specific diagnosis for the type of tumor, and this is obtained by getting a biopsy and sending it to a pathologist.

• Where is it? Represents how extensive the spread has been based on the tumor type. The main areas of spread for oral tumors are the local lymph nodes, or the lungs.

• How bad is it? Refers to the grade, or how quickly we think it’s growing, which is typically assessed also on the initial biopsy sample.

When we address oral tumors, there are often multiple procedures involved. The first will be an information gathering and preparatory procedure where we collect biopsies and address any other disease within the mouth.

Once we have a firm diagnosis for what type of tumor and have an understanding of the local extent of the tumor, we decide on whether full body imaging is necessary or not necessary.

Once that information has been obtained, we determine what definitive treatment is required for the tumor.

For small masses and benign masses often local removal is all that is needed.

For locally aggressive, non metastatic masses (masses which don't spread elsewhere in the body), a larger local surgery is often performed, but we typically have an excellent long-term prognosis.

For malignant masses larger surgery is also usually required but may be followed up with a recommendation to pursue chemotherapy or radiation therapy. Larger tumor removal surgeries may be referred to a surgical oncologist if it is beyond what can be reasonably and safely done in our hospital.