A 68-Year-Old Man with a Long History of Using Chewing

A 68-year-old man with a long history of using chewing tobacco comes to the office for follow up of squamous cell carcinoma (SCC) of the oral cavity.  A month ago, the patient was diagnosed with SCC of the left lateral tongue.  He underwent resection, the surgical specimen showed clear margins, and he started additional treatment.  The patient recently noticed a second ulcerative lesion on the right lateral tongue.  Biopsy is performed and it also shows SCC.  The second tumor most likely arose from which of the following mechanisms?

A) Chemotherapy-induced malignancy
B) Field cancerization
C) Hematogenous spread
D) Immunologic privilege
E) Impaired wound healing
F) Lymphatic spread

Correct Answer:

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