Vol. 10, Issue 4, Part D (2024)

Introduction: The frequency of oral cancer in the Mexican population has increased in recent decades. Squamous cell carcinoma of the oral cavity is the most common, accounting for 90% of oral cancers.
Objective: This paper aims to report a case to highlight the importance of timely oral screening and diagnosis, as well as to raise awareness among patients about self-examination of the oral cavity and seeking medical attention for any unusual lesion that appears in the mouth.
Clinical Case: An 86-year-old female patient presented to a dental consultation reporting a poorly appearing oral lesion that had been present for 9 months and had increased in size, causing maladaptation of her total dental prosthesis. The patient has a history of hypertension for 30 years. Oral examination revealed total edentulism, as well as an elevated plaque-like lesion extending from the right cheek at the level of the occlusal line to the ipsilateral upper alveolar ridge, with an uneven surface and irregular segments, including white papillary projections that did not detach upon scraping.
Auxiliary Diagnostic Tests: Incisional biopsy of the lesion in the palate and right cheek, compatible with well-differentiated squamous cell carcinoma similar to verrucous type.
Clinical and Histological Diagnosis: Well-differentiated oral squamous cell carcinoma with ipsilateral neck lymph node metastasis, which is a poor prognostic factor despite the reported histological grade.
Treatment: Considering the patient's age, the decision was made not to perform excisional surgery, but to treat exclusively with intravenous chemotherapy.
Conclusion: In elderly patients, it is important to establish a protocol for self-examination of the mouth and regular dental appointments to detect the presence of oral lesions, especially in those who wear partial or complete dentures. Poor oral hygiene, coupled with improper adjustment of the prosthesis that causes friction and/or injury to adjacent tissues, are predisposing factors that could be associated with the development of epithelial dysplasia, such as the one that led to this carcinoma.