Ca tongue in a tobacco chewer aged 26 years.Has multiple nec | Figure 1

ProfDrVaidya

Case Overview

Ca tongue in a tobacco chewer aged 26 years. Has multiple neck nodes. Currently on chemo.

Cases

  1. 36yrs/f patient complains of swelling in her upper lip region since past 8 months which was of spontaneous onset. The patient has a history of tobacco chewing since past 20 years and no systemic symptoms. The swelling is non-growing. On examination, it has a size of about 5X5 mm, sessile, soft, non-tender, normal surface texture, no colour changes in the surface or surrounding skin, mobile with defined margins. She has poor oral hygiene with chronic generalized gingivitis. It is not responsive to antibiotics. Kindly suggest ddx and further management.

  2. Severe periodontitis in an elderly Indigenous woman in remote Australia where no dental clinic is available most of the year. Gingiva is hyper inflamed, tender, soft, and bleeds easily. Subgingival calculus ++++ offensive odour. Pt is aware of gums but not bothered by it. Lesion inside lip is from chewing tobacco daily, put declined biopsy #periodontitis

  3. 32yo F with small growth as pictured above, right lower inside lip is the only lesion. Pt states lesion is not painful or sensitive, zero exudate noted. Growth has come and gone several times in same area but only over the last several months, less than a year.

  4. 59 to male presenting with a four-week history of pharyngitis. Initially presented to local ED, where he was prescribed amoxicillin and Prednisone, after which symptoms improved, but returned soon after the regimen was completed. Physical exam showed him to be in NAD, temp of 99 F, mild bilateral anterior cervical lymphadenopathy, and the above mass, which was nontender and hard to palpation. Reports quitting smoking 20 years ago, denies any history of chewing tobacco. HIV, CT pending, but presentation makes me suspect neoplasm with oral candidiasis from recent Prednisone and abx.

Additional Cases

  1. A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

  2. A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

  3. A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

  4. patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?