Work

Diagnostic dilemma in a non-healing ulcer of the tongue

Year: 2024

Type: article

Abstract: Chronic solitary ulcers over the tongue are challenging to diagnose as they are caused by various etiological factors. Differential diagnoses are chronic traumatic ulcers, ulcers due to squamous cell carcinoma, syphilis, fungal, viral, and tuberculosis (TB). Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. The commonly affected sites are the ventral and lateral borders of the tongue, the floor of the mouth, and the lower lip. A 63-year-old female patient presented with a non-healing (more than a month) and extremely painful ulcer on the lateral border of the tongue. Conventional oral examination, Velscope screening, and Toluidine Blue staining were performed and diagnosis of traumatic ulcer was set. The purpose of this article is to describe a case report of the confirmatory testing done due to a suspicious previous underdiagnosis. Because of the time of persistence and continuous present pain, further investigation was welcome. We did an incisional biopsy, additional tissue staining, and immunohistochemical analysis with a pan-cytokeratin test of the specimen (PAN CK [AE1/AE3]). Carcinoma planocellulare invasium was diagnosed. The diagnosis of oral ulcer is often intricate and necessitates a complete medical history, as well as subtle clinical and laboratory examination. This case depicts the importance of the Pan-CK marker as a very potent diagnostic and prognostic tumor marker.

Source: International Dental Journal

DOI: 10.1016/j.identj.2024.07.123