The road less travelled: Skeletal muscle invasion in oral squamous cell carcinoma

Oral squamous carcinoma (OSCC) is one of the most challenging global constraint and currently the third most common cancer in India. Malignant cells exhibit anomalous morphological characteristics like increased and abnormal mitosis which might suffice as a prognostic indicator. Skeletal muscles present in close approximation with the oral epithelium are often encountered by the tumor cells of OSCC which is an uncharted territory and might serve as a critical parameter in assessing the outcome of OSCC. Amalgamation of mitotic count and skeletal muscle invasion can put forward cogent paths in discerning the behavior of these lesions.

A total of 60 histopathologically diagnosed cases of well, moderately and poorly-differentiated OSCC cases were obtained from the archives. Hematoxylin and eosin-stained slides were examined for Mitotic count and Skeletal muscle invasion.

There was a statistically significant increase in Mitotic count from well-differentiated to poorly-differentiated OSCC. Despite the statistically insignificant difference there was a distinct rise of skeletal muscle invasion from well-differentiated to poorly-differentiated OSCC.

The rise in mitotic count with increasing grades of OSCC suggests an increase in their proliferation rate. Owing to the marked elevation of skeletal muscle invasion in higher grades of OSCC, we can assume it to be a reliable predictor of aggressiveness and outcome. Further studies with a uniform sample size and site specificity might help in solidifying their role in assessing the prognosis of OSCC.