Diagnostic dilemma in a non-healing ulcer of the tongue

Nikolovski, Bruno and Radojkova-Nikolovska, Vera and Evrosimovska, Biljana and Spirov, Vancho and Petrovski, Mihajlo and Rogoleva Gjurovski, Sonja and Susak, Zoran and Zlatanovska, Katerina and Trpevska, Vesna and Mijoska, Aneta and Zarkova, Julija and Longurova, Natasa (2024) Diagnostic dilemma in a non-healing ulcer of the tongue. In: FDI World Dental Congress 2024 (FDIWDC24), 12-15 Sept 2024, Istanbul, Turkiye.

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Abstract

Introduction: Chronic solitary ulcers of the tongue are challenging to diagnose as they are caused by various etiological factors. Differential diagnosis are chronic traumatic ulcers, ulcers due to squamous cell carcinoma, syphilis, fungal, viral, tuberculosis (TB).
Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. The commonly affected sites are ventral and lateral borders of the tongue, the floor of the mouth, and lower lip.
Aim: The purpose of this article is to describe a case report of the confirmatory testing done due to a suspicious previous under-diagnose of a non-healing ulcer of the tongue.
Case Description: A 63-year-old female patient had presented with a non-healing (more than a month) and extremely painful ulcer on the lateral border of the tongue. Conventional oral examination, Velscope sreening and Toluidine Blue staining had been performed and diagnosis of traumatic ulcer was set.
Discussion: Because of the time of persistence and continuously present pain, further investigation was welcomed. We did incisional biopsy, additional tissue staining and immunohistochemical analysis with pan-cytokeratin test of the specimen (PAN CK [AE1/AE3]). Carcinoma planocellulare invasivum was diagnosed.
Conclusion: The diagnosis of oral ulcer is often intricate and necessitates a complete medical history, as well as clinical and laboratory examination. This case depicts the importance of the Pan-CK marker as a very potent diagnostic and prognostic marker.

Keywords: non-healing ulcer, tongue ulcer, carcinoma, immunohistochemistry, CK-AE1/AE3.

Item Type:	Conference or Workshop Item (Poster)
Impact Factor Value:	3.2
Subjects:	Medical and Health Sciences > Basic medicine Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health biotechnology Medical and Health Sciences > Health sciences Medical and Health Sciences > Other medical sciences
Divisions:	Faculty of Medical Science
Depositing User:	Bruno Nikolovski
Date Deposited:	22 Oct 2024 10:14
Last Modified:	22 Oct 2024 10:14
URI:	https://eprints.ugd.edu.mk/id/eprint/34870

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