Traumatic Ulceration Mimicking Oral Squamous Cell Carcinoma Recurrence in an Insensate Flap

Abstract

We repo rt our experience with a patient who developed an ulcer within afreeflap 2 month sf ollowing resection ofan oral squamous cell carci noma. We discuss this clini cal problem and the issues it raised, with parti cula r attention to early tumo r recurrence and the restoration ofsensation in free-fla p reconstructions.

Long‐standing oral ulcers: proposal for a new `S‐C‐D classification system’

“…An important feature to establish is whether one or more than one ulcer is present and whether the remaining mucosa is healthy, because a spectrum of conditions usually manifest themselves as single lesions (Table 1). When a patient presents a single and isolated oral ulcer in a given site, a differential diagnosis should always include: chronic trauma, neoplasms (such as OSCC), haematological neoplasms and salivary gland malignancies (mucoepidermoid and adenoid cystic carcinoma) (3), although unusual causes, such as tuberculosis, necrotizing sialometaplasia and syphilis could also be considered (11–13). Solitary ulcers persisting for more than 2 weeks after treatment without signs of evident healing must be taken seriously and a biopsy is mandatory.…”

“…Diagnosis is contingent upon a carefully elicited history and detailed physical examination. The most important feature of an ulcer is its chronic outcome, because a persistent ulcer can be a sign of squamous cell carcinoma, particularly when associated with any induration (3). Other distinguishing features are the number, shape, size and border features (2, 5).…”

“…Oral erosions are characterized as the partial loss of epithelial thickness; in contrast, an oral ulcer or ulceration is characterized by the complete loss of epithelium accompanied by a variable loss of the underlying connective tissue, resulting in a crateriform appearance, which may be augmented by oedema and/or a proliferation of the surrounding tissue (1). Ulcers and erosions are the final common manifestation of a spectrum of conditions ranging from autoimmune diseases to neoplastic, traumatic, infectious lesions, nutritional deficiencies and drug reactions (2–4), and they represent a diagnostic challenge for dental practitioners.…”

Correlation of serum ANA and direct immunofluorescence studies in elderly Thai patients with red and white oral lesions

“…These oral lesions may share similar manifestations that can make it difficult to make a differential diagnosis by clinical appearance alone. Most persisting oral ulcerations are a sign of squamous cell carcinoma . Long‐standing red and white lesions have to be treated with concern and require a definitive diagnosis.…”