Tongue Ulceration

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Posted on By Paul Kozy DDS In Other

Diagnosis and treatment of tongue lesion is described.

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Dear Dr. Kozy,
May I complement you on a very comprehensive documentation of the procedure. However, I have a few reservations with regard to the use of the Oral brush biopsy/ Oral CDX for lesions like these which are very amenable to open biopsy. Lesions on the lateral tongue, and particularly so those which are not habit associated have a propensity for regional node metastasis , and a number of pointers for the same are available in open biopsy, particularly tumour thickness. It is established with some degree of certainty that lateral tongue squamous carcinomas of tumour thickness 4mm or greater have a high chance of regional node mets even if it is a clinically N-0 neck. This is information that is not available on a brush biopsy and prevents the patient from making an informed decision with regard elective neck dissection at the time of primary surgery and the wait and watch game with these tumours is often futile.This is my humble opinion based on 17 years of practice of Maxillofacial Pathology.
Regards
Narayan


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Narayan,
Thank you for the information. I totally agree. My first choice was not brush Bx but excisional. I did want to get the patient seen ASAP and I wanted the cancer surgeon to see and excise the lesion himself. I did the brush mainly to impress on the patient that this lesion could be serious.
BTW, can you enlighten us on any of these histo slides?
thanks again.


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