When does a pediatric oral lesion need biopsy rather than indefinite observation?
Investigate a persistent, suspicious, or non-self-limiting lesion; generally biopsy persistence beyond 2 weeks after removing the suspected cause or empirical treatment.
- Record history, differential, working diagnosis, size/site, and interval change.
- Suspected malignancy or failed empirical medication also supports biopsy/referral; do not wait for an arbitrary interval when suspicious.
- Obtain adequate size/depth, use appropriate fixative (e.g., 10% formalin), and follow the pathology report.
- Cytobrush and fine-needle aspiration are adjuncts, not substitutes for definitive tissue diagnosis.