PMC9424045_01
Clinical photographs (April 2019), (a) Erythema is observed on the right side and left margin of the tongue, and exophytic masses are found from the center to the left side of the dorsal surface. The left maxillary anterior gingiva shows whitish change. (b) The right buccal mucosa and pharyngeal mucosa shows lichenoid striae with erythema, in which white slightly raised lesions are observed, and white plaque is found posterior to the molar. (c) The right side of lower lip, a white lesion with a diameter of 7 mm, with an indistinct border, no induration, is observed. (d) Most of the palate shows erythema. A relatively clear white ridge is observed on the right molar (Mirror image).
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The left maxillary anterior gingiva showed whitish change (Figure 1(a)). The right buccal mucosa and pharyngeal mucosa showed lichenoid striae with erythema, in which white slightly raised lesions were observed, and white plaque was found posterior to the first molar (Figure 1(b)). On the right side of lower lip, a white lesion with a diameter of 7 mm, with an indistinct border and no induration, was observed (Figure 1(c)). A relatively clear white ridge was observed on the right molar (Figure 1(d)).
Photomicrographs of surgical specimens. (a) Specimen of tongue showing severe dysplasia. (b) Specimen of the right buccal mucosa showing severe dysplasia. (c) Specimen of the right side of lower lip showing squamous cell carcinoma. (d) Specimen of the right palatal gingiva showing carcinoma in situ (hematoxylin-eosin stain:original magnification x100; (a and b), x40; (c and d) x40).
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The diagnosis of the left dorsal surface of the tongue and the right buccal mucosa was severe dysplasia, and lower lip was SCC, and the left maxillary palatal gingiva was carcinoma in situ (Figures 2(a)-(d)).
Clinical photographs (April 2021). (a) Compared to the April 2019 photograph, white lesions in the maxillary anterior gingiva have clearly developed and plaque formation is observed. (b) Surgical specimen shows severe dysplasia (hematoxylin-eosin stain, original magnification x40).
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In April 2021, a white lesion in the maxillary anterior gingiva became prominent, and a biopsy revealed severe dysplasia, resulting in surgical procedure (Figure 3).