patient complains of bleeding and swelling since 2-3months, history of pouch tobacco, what's ur take on it.....regards

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Erythroplakia Gingival hyperplasia Hyperkeratosis

its a clinically proven SCC alive plus. refer to a surgical oncologist to take biopsy. so that the biopsy may not need to be repeated. if u wish to take biopsy. involve lesion and normal tissues. also the center of lesion. yet I would suggest to refer, since the primary doc must feel a better choice to take proper biopsy. no scaling or extraction to be performed in such lesion

shud I wait for the swelling to subside ?

Any suggestions, how much tissue shud be cut for biopsy ?

it's very nice that whoever shares this post on watsapp, it notifies me

it may be subside a bit aftr u do subgingival scaling....but as u say ..h/o tobacco pouch on same region then high chances of pre mal lesion.

DD-erathroplakiea , gigival hyeperpladiea, hyperkeratosis, ca situ , ulcerative gingivitis.

the history is not significant in such scenario, most of the time pt don't notice symptoms for a long time. more over ca is asymptomatic for a long time. pt might not have a present with actual history also because of lack of health motivation. anyway if u plan to take a biopsy atleast send to a good path lab like Lal or SRL, who's reports are well accepted in any center

provisional diagnosis ?

yes ur correct

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