Featured Patient Case #9

Contributor: Dr. Jessica Gradoville

A 67-year-old female presents with a nonwipeable lesion on the gingiva buccal to tooth #26.
The lesion has been present for an unknown duration.
The patient is a former smoker.

Which of the following should be included on the differential diagnosis?

Leukoplakia

Frictional keratosis

Verrucous carcinoma

All of the above

A and B

What is the most appropriate next step for diagnosing this lesion?

Culture and sensitivity

Cytology

Fine-needle aspiration

Incisional biopsy

Based on the histopathology what is the correct diagnosis?

Hyperkeratosis

Mild dysplasia

Moderate dysplasia

Severe dysplasia

Squamous cell carcinoma

How is this lesion best managed?

Periodic follow-up after the diagnosis

Laser ablation of the biopsy site

Topical corticosteroids

Resection, chemotherapy and radiation

Radiation only