Chronic Ulcer Mimicking Oral Squamous Cell Carcinoma (A Case Report)

Fitria Mailiza, Rifani Rifani


Introduction: Chronic ulcers are considered as the most common ulcerations and can be differentiated with oral squamous cell carcinoma (OSCC) by the presentation of its features. OSCC define as a malignant epithelial neoplasm and the most common neoplasm of the oral cavity. OSCC appears as a mixed white or reddish proliferative growth-like lesion from chronic trauma. Case and management: A 50 years old female came with a painful non-healing ulcer on the lateral right side of the tongue which had been exist since 6 months prior. There had been a gradual increase in the size of the ulcer over the past 6 months. The patient did not have any sistemic disease or bad habits such as chewing or smoking and did not consume alcohol either. Based on the examination, the right submandibular lymphnodes were palpable, tender, firmed and mobile.  And there was also a single oval-shaped ulcer with irregular border on the lateral aspect of the tongue in parallel with fractured and decayed lower first molar. The ulcer size was 2x1 cm in diameter, with the base covered by yellowish pseudomembran slough with indurated border. The grinding of the sharp cusp of the tooth was done, followed by the prescription of multivitamins, antibacterial mouthwash and topical corticosteroid. She was also referred to have routine blood test done. She came for the second visit after 14 days, showing improvement of the ulcer. The blood test showed no abnormal values. Discussion: Based on clinical features, the presented lesion was mimicking OSCC. According to the patient’s history taking, clinical examination and appropriate investigation, the patient was diagnosed with traumatic ulcer. Ulcer resolves and heals on the removal of causative factors. Conclusion: Chronic ulcer is one of the most common solitary ulcer presenting in the oral cavity that mimicking OSCC by the presentation of its features. In this reported case, the ulcer arises due to its constant contact with lateral right of the tongue Improvement during the treatment by eliminating suspected risk factors can ruled out the possibility of OSCC thus prevent the unnecessary treatment.


Chronic Ulcer; Mimicking; OSCC

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Nalin AS, Mary J, Leukose T, Sreedhar S, Padiath S. Traumatic ulcer – mimicking squamous cell carcinoma J. of Dental and Medical Science 2016 Vol. 15(3): 83-86

Ghadage M, Ishaquddin S, Maya D. Traumatic ulcer or squamous cell carcinoma of the tongue: a case report. International Journal of Healthcare and Biomedical Research 2013. Vol.2 (1): 57-60

Mortazavi H, Safi Y, Baharvand M, Rahmani S. Diagnostic features of common oral ulcerative lesions: an updated decision tree. International Journal of Dentistry 2016: 1-14

Friedlander PL, Schantz SP, Shaha AR, Yu G, Shah JP. Squamous cell carcinoma of the tongue in young patients: A Matched-pair Analysis. Head & Neck J. of The Sciences and Specialties of The Head and Neck. 1998. 20: 363-8

Llewellyn CD, Johnson NW, Warnakulasuriya KAAS. Risk factors for squamous cell carcinoma of the oral cavity in young people – a comprehensive literature review. Oral Oncology 2001 July; 37(5): 401-18

Hirota SK, Dante AM, Sugaya NN. Oral squamous cell carcinoma in a young patient – case report and literature review. Anais Brasileiros de Dermatologia 2006 June; 81(3): 251-4

Myers SL, Curran AE. General and oral pathology for dental hygiene practice. Philadelphia: F.A. Davis Company; 2014

Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology 3rd ed. Missouri: Elsevier; 2016

Hegde ND, Hegde MN, Aastha P, Raksha B. Differential diagnosis of long term tongue ulcers. International Research Journal of Pharmacy 2012; 3(8): 145-8

Pawar SK, Pawar HS. A rare clinical manifestation of oral squamous cell carcinoma: a case report. Int. J. of Applied Dental Sciences 2017; 3(2): 11-13

Falaki F, Delavarian Z, Pakfetrat A, Mohtasham N, Shirazian S. Oral squamous cell carcinoma with an unusual clinical manifestation: a case report. Cases Journal 2009 Apr 20;2: 6608

Gupta A, Shinde KJ, Bhardwaj I. Primary lingual tuberculosis: a case report. The Journal of Laryngology & Otology 1998 Jan; 112(1): 86-7

Randhawa T, Shameena PM, Sudha S, Nair RG. Squamous cell carcinoma of tongue in a 19-year-old female. Indian Journal of Cancer 2008; 45(3): 128-130

Apriasari ML. The management of chronic traumatic ulcer in oral cavity. Dental Journal (Majalah Kedokteran Gigi) 2012; 45(2):68-72

Brandizzi D, Gandolfo M, Velazco ML, Cabrini RL, Lanfranchi HE. Clinical features and evolution of oral cancer: A study of 274 cases in Buenos Aires, Argentina. Med. Oral Patol. Oral Cir. Bucal. 2008 Sep 1; 13(9): E544-8

Bolesina N, Femopase FL, de Blanc SAL, Morelatto RA, Olmos MA. Oral squamous cell carcinoma clinical aspects. In Oral Cancer, Edited K.U.E. Ogbureke, Intech 2012. p. 21-46

Anura A. Traumatic oral mucosal lesions: a mini review and clinical update. Oral Health Dent. Manag. 2014 Jun; 13(2): 254-9

Barker BF. Barker GJ. Oral management of the patient with cancer in the head and neck region. Journal California Dental Association 2010 Aug; 29(8): 619-23

Speight P, Warnakulasuriya S, Ogden G. British Dental Association (BDA). Early detection and prevention of oral cancer: a management strategy for dental practice. London: BDA. 2010

Tyagi N, Tyagi R. Squamous cell carcinoma (well differentiated): a case report. Journal of Dentistry and Oral Hygiene 2013 Apr; 5(4): 31-34

Fourie J, Boy SC. Oral mucosal ulceration – a clinician’s guide to diagnosis and treatment-communication. South African Dental Journal 2016 Nov; 71(10): 500-8




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