Introduction

Oral squamous cell carcinoma (OSCC) is the most frequent cancer in the oral cavity; because of its aggressiveness, clinicians should diagnose it in its early stages (T1 and T2) to minimize post-operative complications and surgical invasiveness. In low-stage lesions, a pre-operative evaluation with Intraoral High-Definition Ultrasound (IHDS) is recommended for assessing lateral margins and depth of invasion with a diode laser (DL) surgery, which avoids any bleeding during excision or complications, resulting in a less invasive surgical treatment that is minimally damaging to irradiated tissues.

We describe a case of a tongue carcinoma entirely excised with DL after a pre-operative assessment by IHDUS.

Methods

A patient referred to our Complex Unit of University of Bari “Aldo Moro” complained of a painful ulcerated swelling of the right tongue margin. An IHDUS of the lesion revealed a hypoechogenic area measuring 2,7 mm in depth. Surgical excisional biopsy was performed with a diode laser (4W, c.w.; Lasotronix, Poland), also including wide perilesional margins. The specimen was sent for histopathological exam. No stiches were needed.

Results

The histopathological exam confirmed the diagnosis of highly differentiated OSCC.

Clinical follow-ups were performed weekly for 1 month and monthly for 6 months; complete healing was observed in 30 days. No complications or recurrences were detected.

Conclusion

OSCCs must be intercepted and treated in their early stages (T1 and T2) to reduce mortality incidence and to possibly avoid surgical invasiveness associated with tumor size. Histological examination is the gold standard for staging and diagnosis; diode laser excisional biopsy of early-stage OSCCs is recommended to reduce surgical bleeding or complications and to minimize damage to perilesional tissues.