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Developed Leukoplakia Above A Lump On Buccal Mucosa. Is It Cancerous?

Posted on Thu, 12 Dec 2013

Question: Hello Doctor I have a lump on the side of my cheek (inside on the Buccal mucosa) which has been there for several months. While my wisdom tooth is kind of sharp on the side it is only equivalent to the other wisdom tooth on the other side and I have had my wisdom teeth for at least 7 years (I am 27 years of age now). The lump is red(well a similar colour to the rest of my cheek, and appears to be pretty much on top of one of my saliva glands next to my wisdom teeth on my cheek). I have smoked a medium amount (around 10 cigarettes a day for 11 years). I have since given up smoking about two weeks ago and have made my diet perfect in relation to fruit/vegetables/antioxidents/fluid intakes etc. However the Leukoplakia(see below) and the lump seem to have remained the same. I went to see my dentist and he put me in touch with the hospital to see a consultant two weeks from now. a few weeks ago Leukoplakia has developed above the lump on my buccal mucosa and the lump appears to have stayed around the same size. (the lump is around 0.5x0.5cm and is not painful). I have done so much research (not just scare-mongering) over the last few days and it seems to me that if this lump is not caused by my teeth and is not getting better over the course of some months it is almost certainly cancerous (the addition of Leukoplakia which is not getting better even with no smoking and a perfect diet). Is this the case or is there a possibility that it is not cancerous. Do you have any ideas or statistics on this matter? I am seeing the consultant in two weeks, is time of a huge essence here. What will be the likely next steps and what advice can you give me?

Answered by Dr. Krishna Kiran Kannepalli (52 minutes later)

Brief Answer: Does not appear cancerous Detailed Answer: Hi. Thanks for the query. I have gone through your question and also saw the photograph. From the limited view that was visible in the photograph and from the description that you have given it is very unlikely that it is cancerous. The first possibility that comes to my mind is a mucous retention cyst. The second possibility is that of a parotid duct calculous ( though this is unlikely). In any case 2 weeks of waiting will not cause any harm, moreover the appearance of the patch doesn't resemble a leuloplakia(though it is tough to say with certainty without palpating it first hand). I would suggest that you use some kind of mouth gargles, like say, chlorhexidine gargles in this 2 weeks time. This should suffice for now. Hope this answers your query. Please write back if you need further assistance. Wishing you good health. Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Krishna Kiran Kannepalli (18 hours later)

Thank you Dr Kannepalli for your prompt and detailed reply. After looking at the picture that I attached previously I noted that it doesn't really provide you with that much visibility of the lump or the white patch above it. I have enclosed three further pictures which are relatively similar to one another just one may provide a better view than one of the others. As I said the one yesterday does not provide a very good view at all (as you noted). I have purchased a Chlorhexidine gargle and am following this twice a day now. (Chlorhexidine Digluconate 0.2%) Upon looking at the new photographs would your diagnosis remain the same? Thank you very much again. XXXX

Answered by Dr. Krishna Kiran Kannepalli (2 hours later)

Brief Answer: Photographs are much better this time Detailed Answer: Hi. Thanks for providing the photographs. I can make out 2 lesions. The red colored one at the back looks like a mucous retention cyst. The white patch, I am not very sure. Leukoplakia cannot be completely ruled out. One has to really feel it with the finger to be certain. In any case, even if it is a leukoplakia, it appears to be a homogeneous leukoplakia (i.e without features suspicious for cancer). Your doctor will decide whether to biopsy it or not after palpating it. In any case there is no cause for worry. Thank you once again for choosing health care magic to post your query.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj