Peer Reviewed

What's the Take Home?

A 49-Year-Old Man With an Oral Lesion

    Ronald N. Rubin, MD1,2Series Editor

    1Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
    2Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania

    Rubin RN. A 49-year-old man with an oral lesion. Consultant. 2021;61(1):14-16. doi:10.25270/con.2021.01.00001

    The author reports no relevant financial relationships.

    Ronald N. Rubin, MD, Temple University Hospital, 3401 N Broad St, Philadelphia, PA 19140 (


    A 49-year-old healthy man has been referred for evaluation from a dental office. During a routine cleaning visit, the dentist noted an irregular red lesion with a whitish central area near the man’s left tonsil. More detailed history reveals several weeks to months of mild discomfort with swallowing. He has had no earache, cough, dysphagia, or other local symptoms. He is a white-collar worker who works in sales. He had smoked casually when younger, but he has not done so for the past 15 years. He consumes alcohol only socially, perhaps once a week.

    Physical examination reveals normal vital signs. Focusing on the reason for referral, an irregular, round lesion measuring several centimeters is present where the left tonsil meets the palate. The lesion is mainly red but has white areas centrally. Results of a careful examination of the neck and supraclavicular and submandibular areas are negative for adenopathy.