Examination of a patient who is an intense smoker revealed a 1 ´ 2 cm indurated red mass in the floor of his mouth. Submandibular lymph nodes on the same side were asymptomatic and indurated. This patient should be suspected of having:

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The presence of an indurated red mass in the floor of the mouth, combined with asymptomatic and indurated submandibular lymph nodes, is highly suggestive of squamous cell carcinoma. This is especially true in the context of the patient's history of intense smoking, which is a well-known risk factor for this type of cancer. Lichen planus and erythroplakia are also associated with increased risk for oral cancer, but neither of these conditions is likely to present with the same combination of symptoms as observed in this case. Carcinoma in situ represents an early, non-invasive stage of cancer development, but it is less common in the oral cavity compared to other sites.

Examination of a Patient Who Is an Intense Smoker Revealed