Squamous-Cell Carcinoma of the Tongue

A 73-year-old woman presented with a persistent ulcer and white patch on the right margin of the tongue. Intraoral examination revealed a superficial ulcer with a homogeneous base, an indurated upper border, and an adjacent speckled red and white patch at the lower border. A 73-year-old woman presented with a 1-year history of a persistent ulcer and white patch on the right margin of the tongue and soreness while eating. She did not smoke or drink alcohol. Extraoral examination revealed no cervical lymphadenopathy. Intraoral examination revealed a well-circumscribed superficial ulcer, measuring 7 mm by 3 mm in the greatest dimensions, with a homogeneous base, an indurated upper border, and an adjacent speckled red and white patch at the lower border (Panel A). Incisional biopsy of the indurated upper border revealed invasive squamous-cell carcinoma (Panel B; hematoxylin and eosin). Incisional biopsy of the speckled area . . .