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What could be the reason for a lesion in the left cheek?

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General Surgeon
Practicing since : 1980
Answered : 2130 Questions
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hi,

I have a question for an ENT.Recently my husband quit chewing after 15 years due to a lesion on his left lower cheek. He has been to the dentist who has said the lesion is healing well. He also asked the dentist if he needed to see a specialist for a biopsy and he assured us that this was not needed. I would like to get an ENT experts opinion on the lesion. I have provided a few photos to better assist you. I tend to get very anxious about this and need to know we are doing everything we should be doing.
Both of theses photos were taken a month after he quit and the dentist said he had seen healing at this point.
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These 3 pics were taken 4 and half months after he quit.Also the red and white lesion is a cheek bite and has sense healed.In the later 2 photos the cheek is not stretched as much so you can see the lines.Are the lines normal??
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Posted Wed, 11 Apr 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Rajinder Bajoria 4 hours later
Hello
Thanks for your query.     

Any lesion in the cheeks after prolonged history of chewing tobacco must have biopsy.

I have seen many cases which seems to heal with conservative management,but instead go on spreading the deadly disease.

Time lost in late diagnosis can never be regained.

So there is no harm at all in going for biopsy in lesion of cheeks and specialist opinion.

Biopsy is the only final diagnosis in such cases


I have seen photo taken one month after quitting tobacco.

Rest of photos i could not open even after try.

So Photo can be sent to me separately to WWW.WWWW.WW to Sub:ATTN DR Rajinder Bajoria

‘Hope I have answered your query, I will be available to answer your follow up queries, “Wish you Good Health and trouble free speedy recovery”
Above answer was peer-reviewed by
 
Follow-up: What could be the reason for a lesion in the left cheek? 53 minutes later
WWW.WWWW.WW WWW.WWWW.WW
HERE are the after photos will you try to look at them again please and let me know if you can open them? Why would both our doctor and dentist not feel the need to refer us to biopsy? I just don't quit understand this?
Follow-up: What could be the reason for a lesion in the left cheek? 29 minutes later
I emailed the photos to YYYY@YYYY , I put your name in the subject and asked to be forwarded to you.I also tried to reload the links to photobucket for you to view. I hope you get them soon and can give me your opinion.Thanks.
 
 
Answered by Dr. Rajinder Bajoria 5 hours later
Hello

Nice to hear from you again

I have seen all your photographs ,no doubt there is no clear ulceration ,only mucusal alteration at places.

Your dentists are sure that it is responding & healing .They have turned down your request for referal to specialist .

Without referal insurance company is not going to pay.

As for as my knowledge goes there is no home kit to take biopsy .

In such circumstances it is always better to be vigilant & get the biopsy done if sign & symptoms alter or increase.

Hope I have answered your question well to your satisfaction. Wish you a speedy and complete recovery at the earliest.
Above answer was peer-reviewed by
 
Follow-up: What could be the reason for a lesion in the left cheek? 1 hour later
So do you think our dentist is making the right decision by saying he does not need a biopsy and that its not cancer and healing well? Should we just allow him to monitor it like he has been doing for the last 5 months or should we insists on a biopsy again? We have asked 3 times for one and every time he says it is not needed. He is very good about biopsys anything he thinks is suspious is what his staff had told me so this does give me some reassurance that he doesn't feel like this is bad to him or he would biopsy it without a doubt.
 
 
Answered by Dr. Rajinder Bajoria 4 hours later
Hello

Nice to hear from you again

It is true that chewing tobacco for 15 years (a very long time) increases the risk of malignancy manifolds.

In my practice, patient presenting with any mouth lesion after history of tobacco for long years is always subjected to biopsy. I have found about 25-30 % turn out to be positive for malignancy. So I suggest biopsy to all my patients with mouth ulcers post tobacco chewing.

It's good to hear that you have found a very good clinician. If the dentists is good at biopsy & has his own experience, may be he is right in his opinion.

So remain in touch with your dentist. Be vigilant and look for secondary changes. Discuss regarding the biopsy with him again and if he agrees, go ahead with the biopsy; as there is no harm in going for it. You and your family will be relieved a lot.

Hope I have answered your question well to your satisfaction.

Wish you good health.

Regards

Above answer was peer-reviewed by
 
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