Clinical Approach and Bilateral Lesion Surgery on the Oral Mucosa

Description of a clinical case: A male farmer, 48 year old patient referred by the PIPCO, with social habits, and a lack of systemic diseases and rehabilitated with a removable bimaxillary prosthesis. After an intraoral examination, the patient shows changes in the jugal mucosa next to the labial commissure, star-shaped, red-white, whitish stretch marks, hard at palpation around the edges, without adenopathies, with dimensions of 1,3x0,7x0,5cm and prosthesis mucositis in the palate. Changes in the right lower lip vermillon with actinic- cheilitis and focal ulceration and crusting are visible. An excisional biopsy of the jucal mucosa bilateral lesions was performed and sun protection was advised. Discussion: The patient shows several risk factors (social habits and an excessive exposure to the sun) These erythroleukoplakialesions clinically detected are potentially premalignant lesions. Serious pathologies can be prevented with early diagnosis and correct treatment. The clinical characteristics recommend a bilateral excisional biopsy. The pieces were sent for an histological examination so that a differential diagnostic with pathologies with similar macroscopic aspects could be carried out (chronic biting lesions, keratoses, leukoplakia, erithroplakia, white sponge nevus, , lichen planus, lupus erythematosus and candidiasis). The eritroleukoplakia lesion shows a histological description of the stratified squamous epithelium with severe reactive aspects, undefined to dysplasia with infiltrated inflammatory polymorphic with no signs of malignancy. This microscopic and macroscopic description is compatible with lichenoid lesion. A lip protection as well as monitoring are recommended if the changes and the crusting/ ulceration will not disappear and thus a squamous cell carcinoma is suspected. Conclusion: The early diagnosis, the correct treatment and the follow up of these potentially malignant lesions in this patient contribute to lip and mucosa jugal tissue normalization. Keywords: Biopsy, oral cancer, lichenoid lesion