# Single ulcers on the tongue dorsum: differential diagnosis between paracoccidioidomycosis and squamous cell carcinoma

## TL;DR

This study compares paracoccidioidomycosis and oral squamous cell carcinoma as possible causes of single ulcers on the tongue dorsum, emphasizing the need for biopsy to confirm diagnosis.

## Contribution

The study highlights the differential diagnosis of rare tongue dorsum ulcers between PCM and OSCC, emphasizing the importance of biopsy.

## Key findings

- Nine patients with single tongue dorsum ulcers were diagnosed with either PCM or OSCC.
- OSCC was the main clinical hypothesis despite PCM being a significant differential diagnosis.
- Biopsy is essential for accurate diagnosis and treatment planning.

## Abstract

Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC.

A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated.

A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis.

Although uncommon, PCM and OSCC should be considered as a diferential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Iincisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.

Key words:Paracoccidioidomycosis, oral squamous cell carcinoma, oral ulcer, tongue dorsum.