When presented with a swollen lesion on the tongue, what is the first step in management?

In evaluating a swollen lesion on the tongue, the first step in management is to palpate the lesion to assess its firmness and induration. This tactile assessment provides crucial information regarding the lesion's characteristics, which can help differentiate between various types of lesions, such as benign versus malignant, inflammatory versus neoplastic, or vascular versus fibrous.

Understanding the texture and size of the lesion can guide further diagnostic and therapeutic decisions. For example, a firm and indurated lesion may raise concerns for possible malignancy and necessitate a biopsy, while a soft, fluctuating lesion may indicate a cyst or a vascular malformation that might not require immediate invasive procedures.

Once the lesion is palpated, the clinician can determine if further steps such as imaging studies, referral to a specialist, or potential biopsy are warranted based on the initial findings. Immediate biopsy could be premature without a thorough evaluation, while administering corticosteroids may not address the underlying cause. Similarly, a referral to an oral surgeon might be necessary, but it typically comes after a clinical assessment clarifies the nature of the lesion.

In summary, palpation aids in the initial assessment of the lesion, providing essential information that forms the basis for the next steps in management.