oprm-web-case-op-st-5

Oral Pathology:  Soft Tissue Case #5

 

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Patient: Adult patient, either sex.

Chief Complaint:
The patient complains of a persistent, progressive, erythematous area of three months duration involving the mandibular left retromolar pad. The area is slightly sore. Topical therapy with Nystatin and Triamcinolone acetonide have had no effect on the lesion.

Medical History:
No abnormalities are identified.

Dental History:
The patient has worn complete maxillary and mandibular dentures for seven years. The current dentures are six years old. The patient does not wear the dentures at night.

Clinical Findings:
The lesion is a localized erythematous area involving the crest and lingual aspect of the mandibular left retromolar pad. The lesion is nonpalpable, mildly tender, and fixed to surface mucosa but not to underlying structures.

Clinical Images
left mandibular retromolar pad region left mandibular retromolar pad region
Left Mandibular Retromolar Pad Region Intraoral View with Dentures in Place
left mandibular retromolar pad region  
Close-up of Left Mandibular Retromolar Pad  

 

Radiographs
periapical radiograph
Periapical Radiograph

 

There are no lab reports available for this case.

There are no charts available for this case.

Summary:
This is an erythematous surface lesion.
  ~There is no history of trauma to the area.
  ~The lesion is persistent and progressive.

Lesions to Exclude from Differential Diagonsis:
All vesicular-ulcerated-erythematous surface lesions with painful ulcers, erosions, or erythematous areas.

Lesions to Include in the Differential Diagnosis:
Erythroplasia (Erythroplakia), which includes:
  ~Epithelial dysplasia
  ~Carcinoma-in-situ
  ~Squamous Cell Carcinoma

Management:
Biopsy to obtain a definitive diagnosis
  ~Could be premalignant or malignant
  ~Palpate cervical lymph nodes to detect possible metastatic lesions
Patient Education
  ~Nature of the lesion, differential diagnosis, and importance of the biopsy.

Final Diagnosis:
Carcinoma-in-situ