What is the most likely diagnosis for an ulcerated lesion on the lower lip of a farmer present for several months?

• A. Mucocele
• B. Squamous cell carcinoma
• C. Apthous ulcer
• D. Traumatic burn

Answer: (B)

The presence of an ulcerated lesion on the lower lip of a farmer that has been present for several months raises concern for squamous cell carcinoma. This type of cancer is one of the most common malignancies affecting the lip, particularly in individuals with significant sun exposure, such as farmers.

Several characteristics support this diagnosis:

1. Chronicity: The lesion has been present for several months, and squamous cell carcinoma can present as a chronic ulcer that does not heal, contrasting with more transient lesions like apthous ulcers or minor traumatic burns.

2. Location: The lower lip is a common site for squamous cell carcinoma due to its exposure to ultraviolet light and environmental insults, especially in individuals who spend considerable time outdoors.

3. Ulcerated Appearance: An ulcerative lesion suggests a breakdown in surface integrity, which is a hallmark of malignancies like squamous cell carcinoma. Unlike benign conditions such as mucoceles, which typically appear as fluid-filled swellings, or apthous ulcers, which are painful but self-limiting, squamous cell carcinoma can manifest as an ulcer with indurated edges.

Considering these factors, squamous cell carcinoma not only fits the presentation but is also the most