2018 Volume 39 Issue 1 Pages 23-27
In recent years persons with severe motor and intellectual disabilities （SMID） who have lived in institutions for persons with SMID have reached advanced ages, and so diseases caused by aging are increasing. Here we report a case of a white lesion of the tongue detected by the staff of the ward, which was diagnosed by excisional biopsy as early tongue cancer.
The patient was a 63-year-old female who had lived in our institution for persons with SMID due to sequela of meningitis. During oral care on the ward, a white lesion was found on the left lower tongue surface. Half a year later, I was consulted about gingival pain and the white lesion on the left lower tongue surface.
A white lesion of 12×10mm was found on the left lower tongue surface, and leukoplakia was suspected. Because it was difficult to perform a biopsy subconsciously, an excisional biopsy was performed under general anesthesia. The pathological diagnosis was carcinoma in situ of the tongue. The postoperative course was good, and 2.5 years have passed with no recurrence seen.
In institutions for persons with SMID, due to aging, the proportion of malignant tumors as a cause of death is increasing. Persons with SMID cannot express subjective symptoms verbally, so it is difficult to find cancer at an early stage. Especially if cancer in the oral cavity progresses, it can deprive them of their greatest enjoyment of eating. The importance of observation based on expertise in SMID care was once again recognized because observation during oral care by the ward staff led to the early detection of cancer.
