Hypothesis on the Origin of the Carcinoma of the Hard Palate

Reverse smoking of home-made cigars is a very common habit in the women of the district of Visakhapatnam on the East Coast of India as also carcinoma of hard palate. Proof is presented to show that the pyrolytic products of the tobacco could probably enter through the ducts of the glands of the hard palate and cause initially hyperplasia of the glands. The ducts undergo squamous metaplasia and the normally keratinized mucous membrane in between the ducts of the glands undergoes hyperorthokeratosis. In a few the squamous metaplastic epithelium might become atypical and may ultimately become carcinoma. But in a majority on long continued reverse smoking the metaplastic epithelium differentiates and keratinizes and keratotic plugging of the ducts in continuity with surface keratin occurs, resulting in atrophy of the glands and the palate becomes thickened with flat papules with small depressions without any carcinoma. The localization of the carcinoma of the hard palate to the glandular zone of hard palate could be explained only by this way.