A 51-year-old man presented with a 2-year history of severe oral ulcerative lesions of the left side of the tongue and buccal mucosa that had been slowly enlarging. He had been treated by various emergency departments with antibiotics without resolution. He also reported occasional hemoptysis with blood-tinged sputum, and a 22.7-kg weight loss owing to pain that prevented him from eating. He denied any neck mass, difficulty breathing, skin lesions, epistaxis, or voice changes. He was a former smoker, having quit 3 years prior, but had an extensive history of tobacco use.
Winters R, Hebert AF, Eisbrenner K. Pathology Quiz Case 1. JAMA Otolaryngol Head Neck Surg. 2013;139(4):423. doi:10.1001/jamaoto.2013.119a
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