A smoker has a 3 mm ulcerated lesion on the lateral border of the tongue that has persisted for several weeks. What is the most appropriate management?

Correct answer: A. Perform a biopsy — squamous cell carcinoma must be ruled out

• A. Correct. The lateral tongue is the most common intraoral site for squamous cell carcinoma, and a smoker with a persistent ulcer is high-risk. A persistent lesion (>2 weeks) requires biopsy.
• B. Incorrect. Delaying diagnosis of a possible malignancy is dangerous; persistent lesions are not 'watched' for months.
• C. Incorrect. Steroids treat inflammatory/immune lesions and could mask a malignancy without establishing a diagnosis.
• D. Incorrect. There is nothing to suggest candidiasis; antifungals would only delay the needed biopsy.