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Clinicopathologic Conference
Necrotic lesion in the palate
A 38-year-old female patient was referred to our department of oral pathology with a chief complaint of a painless and nonhealing “hole in her palate” with an evolution time of 30 days. Clinical examination revealed an area of necrosis affecting the left posterior region of the hard palate (Figure 1), and imaging examinations demonstrated no sign of oronasal communication. No palpable cervical lymph node was found. The patient reported a 3-year history of cigarette smoking, approximately 40 cigarettes per day, and she presented with a nonproductive cough lasting for 6 months, considered a complication of the smoking habit.A nodule in the palatal mucosa
A 67-year-old male patient was referred to our service with a complaint of an asymptomatic nodule in the hard palate; the nodule had evolved over 12 months and displayed slow growth. The patient did not report any alcoholism or smoking, and his past medical history was noncontributory. Upon general examination, the patient appeared well oriented, and there were no signs of any systemic illnesses or lymphadenopathy. The intraoral examination revealed a dome-shaped nodule with a smooth surface, exhibiting normal-colored overlying mucosa.An ulcer on the ventral tip of tongue
A 55-year-old male patient was referred to our department with the chief complaint of a painful and nonhealing ulcer of 1-month duration in the ventral tip of the tongue. He also complained of difficulty chewing and swallowing. The patient smoked 20 cigarettes per day for 15 years. The patient reported unintentional weight loss of 4 lb during the last 2 months and presented an unproductive cough lasting for 5 years, considered a complication of his smoking habit. Additional past medical and surgical histories were unremarkable.A mixed image in the maxillary sinus
A 19-year-old male patient complaining of a diffuse swelling of 4 months' duration on the right side of his face was referred to our department. No palpable cervical lymph node was found, and patient's past medical history was noncontributory. Intraoral examination did not reveal any significant visual alteration in the right maxillary mucosa; however, a slight swelling in the maxilla, extending from the first to the third molars, could be noted during local palpation, demonstrating a hard consistency suggestive of bone cortical expansion (Figure 1A).
