Читать книгу Essential Cases in Head and Neck Oncology - Группа авторов - Страница 32

A 62‐year‐old white female is seen in the office with a 3‐month history of a gradually enlarging lower lip mass. She has not had any previous biopsies, imaging, or treatment.

Her past medical history includes hypercholesterolemia, hypertension, appendectomy, and tonsillectomy. She takes Lisinopril and atorvastatin. She has a history of 30 pack‐year smoking but quit 10 years ago. She drinks a glass of wine with dinner every night.

Question: What are the other important points in history?

Answer:

 Pain and tenderness. This is an important question, as pain that is out of proportion with exam can be suggestive of perineural invasion.

 The presence of neck masses is an important finding, as advanced lower lip cancers have a high propensity for spread to the regional lymphatics.

 Voice change. It is important to screen for other head and neck cancer primaries in patients who are high risk.

 Weight loss, which is often associated with the duration and severity of symptoms.

The lesion is exquisitely painful, particularly along the right lower lip. She has not experienced any voice changes or weight loss and has not noticed any neck masses.