52 yoF, #Cigarette user since teenager ,irritation at hard | Figure 1

Dih1

Dentist

52 yoF, #Cigarette user since teenager, irritation at hard palate, observe progressive expansion of lesion

More about this case

Extrahepatic metastasis of hepatocellular carcinoma (HCC) to the head and neck is unusual, especially the oral cavity/maxillofacial region. Metastatic HCC to the hard palate, however, is particularly rare. The most common site of HCC metastasis is the lung, followed by lymph nodes, bone, and adrenal gland. Importantly, oral cavity metastatic HCC may be misdiagnosed as a primary malignancy, such as a salivary gland carcinoma. In this article, we describe a young woman with metastatic HCC to the hard palate that was initially diagnosed as an acinic cell carcinoma.

Swelling felt under the mandible since 2-3 months ago, followed by difficult of swallowing, slight pain, no epistaksis nor bleeding from mouth. Clinician suspected for lethal midline granuloma. No biopsy yet.

This patient had complained of chronic ulcer on rt.palate. No h/o smoking or using any forms of tobacco products/ other forms of spices, no doma-pan except a social drinker of local drinks. Had never used tooth brushes in life, very poor oral hygiene and is anaemic. Incisional Bx confirmed OSCC.

Ulceration of hard palate for 6 months. 15 year old boy. Differentials?

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.

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.

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.

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?