03-03-2007, 05:25 PM
5. A 67-year-old man comes to the office for an initial visit. He says his daughter, who is a patient in your practice, "made me come" because of a lesion in his mouth under his tongue. He is a farmer from the South who is visiting his daughter, and he is not concerned about the lesion. He says, "It has been present for a couple of months, and although I can feel it with the tip of my tongue and it is slightly sore, it doesn't give me any trouble." He has always been healthy and takes no medication. He drinks alcohol in small amounts on weekends, and he uses tobacco in a variety of forms. On physical examination, a 2H2-cm, raised, roughened gray lesion on the oral mucosa of the left side of the floor of the mouth is noted extending to the base of the tongue. You decide the lesion is highly suggestive of a malignancy and that a biopsy should be obtained. Based on the patient's history and incidence of lesions in this location, the lesion is most likely which of the following? A) Adenocarcinoma B) Basal cell carcinoma C) Leukoplakia D) Lymphoma E) Squamous cell carcinoma