Oral lesions may present with or without symptoms and require close monitoring and often intervention by an Oral Maxillofacial Surgeon. Many oral lesions are benign but in those that are malignant, they are often primary lesions and rarely from metastasis. We present a case of a lesion in the soft palate of a completely edentulous lung adenocarcinoma patient on pembrolizumab. At the time of presentation, his lung cancer was thought to be well-controlled with immunotherapy. His oral lesion was biopsied and initially reported to be “poorly-differentiated carcinoma.” Given his history of lung adenocarcinoma, through immunohistochemical comparison of the palatal specimen with previous lung specimen, the findings supported metastatic lung adenocarcinoma to the soft palate.
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