Ashlee Handeland

Meagan Payne
Katie Thigpen
DHYG 1339
September 28, 2015
Case Study Report #7
The diagnosis that we came up with from the evidence of the case is basal cell
carcinoma. We chose basal cell carcinoma because it is a skin tumor associated with
sun exposure that does not occur in the oral cavity. It usually arises on the skin of the
face as a non-healing ulcer with rolled borders.
Justification for why we did not choose melanoma, although it does arise from
exposure to sunlight on the skin, it is a blue to black mass located intraorally on the
palate and maxillary gingiva. Our patient did not present with a blue or black lesion and
it was located on the patients neck, not intraorally. We also did not choose squamous
cell carcinoma because it usually metastasizes to the lymph nodes of the neck and to
more distant sights such as the lungs and liver and usually presents as an exophytic
ulcerative mass. In early tumors it may be white and plaque like, erythematous and
plaque like, or a mixture of both. They may occur anywhere in the oral cavity but most
tumors arise on the floor of the mouth, ventrolateral tongue, soft palate, and tonsillar
pillar. In the examination, the patient did not present enlarged lymph nodes and the
lesion was not plaque like and did not occur intraorally. Actinic keratosis was not chosen

because they occur on the vermillion border of the lips and skin of the face, although
they are associated with sun exposure. Actinic keratosis was eliminated because our
patients lesion is located on the back of his neck, not on his face or lips. Seborrheic
keratosis was not fitting because it usually appears as a brown, black, or light tan
growth on the face. It also can found on the chest, shoulders, and back. The growth has
wavy, scaly, and a slightly elevated appearance and multiple growths are more
common. This did not fit the description of our patients lesion as far as color, location, or
clinical appearance.

References:
Elder D Human melanocytic neoplasms and their etiologic relationship with sunlight. J Invest
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Ibsen, Olga A.C., Joan Andersen. Phelan, and Olga A. C. Ibsen. Oral
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Pg 245, 246, 224, 230, 231, 155.

Lear JT, Tan BB, Smith AP, Bowers W, Jones PW, Heagerty AH, et al. Risk
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Ohsie SJ, Sarantopoulos GP, Cochran AJ, Binder SW.

Immunohistochemical characteristics of melanoma. J Cutan Pathol.
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