A 21-year-old woman, with no previous history of interest, who initially consulted the Emergency Department of her Health Center for a clinical picture of odynophagia amoxicillin and fever, was diagnosed with acute pharyngitis.
At the end of the treatment, the patient came to her primary care physician, referring to a remission of fever but with the persistence of odynophagia, which related to a left lateral border lesion.
The examination revealed an ulcerated lesion of whitish color, approximately 1 cm in diameter, on the lateral border of the tongue, about 3.4 cm from the tip.
No adenopathies or other oropharyngeal lesions were found.
The lesion was labelled as a lingual frenulum, in the context of a post-infectious condition, indicating symptomatic treatment to relieve the discomfort.
After 15 days, the lesion did not show any improvement, and in the re-interrogatory of the patient it was found that the lesion could have preceded that of the infectious picture, with these data a biopsy of the patient was performed.
Intraoperative biopsy diagnosed squamous cell carcinoma that reached the surgical edge.
The microscopic description recognizes an ulcerated neoformation located at the edge of the deep resection without reaching it.
Neoformation consists of epithelial cells available in nests or cords.
These cells have a low mitotic rate and tend to form corneal balloons.
The diagnosis is well differentiated epidermoid carcinoma extending close to the edge of the surgical resection.
Subsequently, a biopsy of fibrotic cervical lymph node fragment containing 25 lymph nodes was performed, 25 of which were negative for tumor cells.
The patient underwent a surgical intervention where a functional neck dissection and a left hemiglossectomy with CO2 laser were performed.
The evolution was satisfactory, being asymptomatic until now and without signs of recurrence.
