History of Present Illness
Mary is a healthy 43-year-old-female who presents for evaluation of a tongue mass. The patient has been aware of an asymptomatic bluish discoloration on her left anterior lateral tongue for the past 5-6 years. 3 months ago this area began to swell and it has now become bothersome. She has occasionally bitten the area and it is beginning to interfere with her speech. She is concerned that she has cancer.
Extra-oral examination shows normal facial symmetry, no skin lesions, intact cranial nerve function, no trismus, and no cervical lymphadenopathy. The thyroid gland is palpable and multinodular. Intra-oral examination reveals no other mucosal lesions. The dentition is intact and oral hyigene is good with foci of mild marginal gingivitis. Periodontal probing depths are a maximum of 4 mm with focal bleeding on probing interproximally. The occulsion is class I with no evidence of temporomandibular dysfuction or paranormal habits. There is a 2.8 x 1.3 cm deep-seated nontender soft compressible mass on the left anterior dorsal and ventrolateral tongue. The mass is nonpulsatile and does not blanch. The remainder of the tongue is soft and freely mobile. Because of her concern for cancer, the patient requests that a biopsy be performed.