A 78-Year-Old Man With a Lingual Ulcerative Lesion

Talib A. Najjar, DMD, MDS, PhD; Prabhjot Singh, DDS

Disclosures

July 21, 2016

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.

Background

A 78-year-old man presents to the oral surgery clinic with discomfort along the left lateral border of his tongue. He states that he first noticed a lesion on his tongue approximately 4 weeks ago, and since that time, it has progressively become larger and more bothersome. The patient denies having any fever, chills, drainage at the site of the lesion, or generalized swelling of the head and neck.

A blade implant was placed in the patient's left mandible 15 years ago to restore the lower left first and second premolar teeth. (A blade implant is an older system to replace missing teeth; this has been replaced by the use of single or multiple titanium implants). He has no known chronic medical conditions. He has no allergies and does not take any medications. He reports a 30–pack-year history of smoking, as well as occasional alcohol use.

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