Oral cavity and oropharyngeal squamous cell cancer: key imaging findings for staging and treatment planning

The imaging findings in squamous cell carcinoma (SCC) of the oral cavity and oropharynx vary widely, depending on the site of origin of the primary tumor and the extent of its involvement of other regions. Knowledge of the complex anatomy of the oral cavity and oropharynx, as well as the most common routes by which SCC spreads from various anatomic sites, allows the radiologist to accurately determine the extent of disease and help clinicians plan appropriate treatment. SCCs that originate in the oral cavity tend to behave differently than those that originate in the oropharynx, with the latter group exhibiting more aggressive growth. Furthermore, primary tumors in certain anatomic subsites within the oral cavity or oropharynx have a greater propensity to spread by direct extension along muscle, bone, or neurovascular bundles or to be disseminated along lymphatic drainage pathways to regional or distant nodes. Imaging findings of deep muscular, neurovascular, osseous, or nodal involvement are indicative of an advanced stage of disease for which management options are limited.