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Wie erkenne ich, ob eine Veränderung bösartig ist?

Case Summary

The patient presents with a single, exophytic nodular lesion on the left lateral border of the tongue featuring central superficial erosion. The patient reports the lesion has persisted for more than two weeks (Q01) and describes it as a growth/ulceration that does not resolve (Q03). Significant systemic and risk factors are present, including daily alcohol consumption, a family history of head and neck cancer, and systemic symptoms such as unexplained weight loss and dysphagia. The patient specifically asks, „Ist es Krebs?“ (Is it cancer?). While a definitive diagnosis cannot be made clinically, the constellation of high-risk site, morphology, and systemic red flags is highly concerning for malignancy.

Extracted Variables

new_lesion: yes
malignancy_suspected: yes
cause_plausible: no
residual_uncertainty: yes
regression_after_2w: not assessable
complete_regression_after_4w: not assessable
brush_cytology_result: not performed
histology_result: not performed

Red Flag Analysis

ulceration or erosion: present
red-white inhomogeneous: not detectable (focal erythema present)
pronounced hyperkeratosis: not mentioned
bleeding: not mentioned
conspicuous vascular pattern: not mentioned
exophytic / raised / mass-like: present
induration: not mentioned (palpation data missing)
progressive / duration unclear / new: present (persists > 2 weeks)
no plausible cause: present
conspicuous lymph nodes: not mentioned

Triage Level

TRIAGE A
Justification: The patient exhibits a high clinical suspicion of malignancy based on the „high-risk“ location (lateral tongue), the exophytic nodular morphology with central ulceration, and severe systemic red flags (weight loss, dysphagia, and positive family history). According to the algorithm, the combination of multiple strong red flags and high clinical concern necessitates the highest triage level.

Next Step Recommendation

Immediate referral to an oral and maxillofacial surgeon or a head and neck specialist for urgent diagnostic work-up, including biopsy and staging (imaging/lymph node assessment).

Follow-up Questions

Is the lesion palpable as indurated (firm/hard)?
Are there any palpable cervical lymph nodes?
Exactly how long has this specific lesion been present?
Do you use tobacco products in any form?
Have you noticed any new numbness (paresthesia) in the tongue?

Please provide the Vision model report (the ${VISION_OUTPUT} data).

The patient’s history answers provided (Q1–Q10) indicate several high-risk factors, including persistent mucosal changes, hard swellings/ulcerations, chronic alcohol consumption, family history of head and neck cancer, and systemic symptoms (weight loss, dysphagia). However, as a research adjudicator, I cannot perform the AWMF S2k 007-092 walk, compute the AIDOCVISION-rev index, or determine model concordance without the corresponding image analysis report from the vision model.

Standing by for the ${VISION_OUTPUT} input to complete the Research Assessment Record.

Termin vereinbaren

Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien

Telefon 01 408 95 00 66
Email ordination@smile.wien

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