<prompt>  A 70 Year old male complains of ulceration on Lower lip since 1 moth with Lymph node involvement. Patient has history of tobacco chewing since 30 years 6-7 times per day, patient also complains of loss of weight since 2 months and change in voice since one monthA reliable clinical condition to consider for the diagnosis as malignancy isAn ulcerative lesionAn ulcerative and painful lesionUlceration and fixation of the lymph nodeBilateral involvement of lymph node 