The Confluence of Chronic Mechanical Trauma and Psychosocial Stress in Early-Stage Carcinoma: A Diagnostic and Management Challenge in a Geriatric Patient with Multiple Comorbidities. – A Case Report.

Abstract

This case report details the diagnosis and management of early-stage squamous cell carcinoma (SCC) of the tongue in a 75-year-old female with multiple comorbidities, including diabetes, hypertension, osteoporosis, a cardiac pacemaker, and a history of breast cancer treated with surgery, radiotherapy, and chemotherapy.
The patient had a recurrent ulcer on the border of the left lateral tongue, which was clinically linked to sharp, carious teeth and occurred during a time when the patient was under a lot of caregiver stress. She had a successful partial glossectomy with selective neck dissection after biopsy confirmation and staging (pT2N0Mx). No adjuvant therapy was needed, and at one year, there was no recurrence.
This scenario emphasises the dentist's vital role in early cancer diagnosis and highlights that, regardless of an apparent traumatic aetiology, a biopsy is necessary for persistent oral ulcers. It also emphasises the possible synergistic effect of severe psychological stress and persistent mechanical irritation in the development of oral cancer. It promotes a customised, interdisciplinary approach to treating elderly cancer patients.