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ENT General 9afad981

A 70-year-old male who has been chewing tobacco for the past 50 years presents with six months history of large, fungating, soft papillary lesions in the oral cavity. The lesion has penetrated into the mandible. Lymph nodes are not palpable. Two biopsies taken from the lesion proper show benign appearing papillomatosis with hyperkeratosis and acanthosis infiltrating the subjacent tissues. The most likely diagnosis is:

A
Squamous cell papilloma
B
Squamous cell carcinoma
C
Verrucous carcinoma
D
Malignant mixed tumor
High-Yield Explanation
Although M/C variety of buccal cancer is squamous cell cancer, Verrucous carcinoma is a variety of well-differentiated squamous cell carcinoma which is locally aggressive involving the bone but lymph node metastasis is uncommon. Histologically. these tumors show marked hyperkeratosis and acanthosis with dysplasia limited to deeper layers. Repeated biopsies repo it as squamous papilloma. .

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