Patient with Oropharyngeal carcinoma

[Akam ahz]

Hi,
In some case-solving problems in oral pathology, I came across this one:

A 79 year- old man came to the clinic complaining from a pain when wearing his lower denture which he wears for 4 years now, he also complained from bleeding and difficulty in speaking.

The first thing that came to my mind is oropharyngeal squamous cell carcinoma.
But I wonder is there another benign diseases that may cause such symptoms? Because I really can't think of any more, or in other words, I think it is 90% would be an oropharyngeal carcinoma

Hope you don't see this as some homework questions, I just want you to share your knowledge.

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[Saddleshoes]

From and academic point of view your response is right!

From a "people smart" point of view consider this possibility...
...The guy likely has just not worn his lower denture in 4 years. He decided to put in and wear it for the first time 2 weeks ago because he was going to his granddaughter's wedding. The flange on the denture was too long when it was originally made but the stubborn old coot would not return to have it adjusted, so he just didn't wear it. So here we are 4 years later, doing the initial adjustments.

 

[TanMan]

To add on to this, if it's oropharyngeal SCC, it's out of the scope of our GP practice. First thing you should always do is look rather than rely on the patient's subjective complaint. Bleeding could be coming from anywhere. Depending on the extent, you might be able to visualize something, but I never ever tell the patient that it's cancer because we can't make that ruling unless a biopsy is performed. Also, you put them through a lot of stress and worry, especially if it's nothing. If you can't see it, refer to ENT. If you can see it, refer to OS. Can't lose either way.

Disclaimer: I suck at ddx... failed opath a few times.

To test the theory that the patient was really wearing the dentures or not, ask them to put it on. If they slip it on like a pro, they've been wearing it. If they fumble with them, then more likely, they haven't been wearing them. Also, you gotta look at the intraoral aspect of the denture bearing surface. If there's denture trauma (thickening of the ridge or ulcerations), then they are probably wearing them.

When I used to touch dentures, I'd propose a chairside soft or hard reline and flange adjustments. I am thankful that those days are behind me.

 

[Akam ahz]

Is pyogenic granuloma an option?

Also, the patient has been wearing the denture for the past 4 years, he didn't stop wearing it. Sorry for not clarifying this in the original post.