Violation

A 65 year old patient presents with an ulcerated lesion of 1cm diameter on the side of the tongue which has been present for two months. What is the most appropriate initial management?

Excise a portion of the ulceration and adjacent normal tissue

Perform cytologic examination

Excise the entire lesion

Refer for implantation of radium needles

Refer for radiotherapy

Please describe the matter of abuse