Tongue

Squamous cell carcinoma of the buccal mucosa: A retrospective analysis of 22 cases

September 25, 2008     Doris Lin, MD, M. Kara Bucci, MD, David W. Eisele, MD, and Steven J. Wang, MD
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Abstract

We examined our institution's experience with 22 cases of previously untreated buccal squamous cell carcinoma via a retrospective chart review. Eleven of these patients had been treated with a combination of surgical excision and postoperative radiation therapy, 8 patients with surgical excision alone, and 3 patients with radiation therapy alone. The overall 3-year locoregional recurrence rate was 32% (n = 7). The 3-year survival rates were 82% after surgery plus radiation (9 of 11 patients), 63% after surgery alone (5 of 8), and 33% after radiation alone (1 of 3). Three-year T-category–specific survival rates were 100% for category T1 tumors (3 of 3 patients), 73% for T2 (8 of 11), 50% for T3 (3 of 6), and 50% for T4 (1 of 2). Although the small size of our study precluded any statistically significant conclusions, we believe that locoregional control and survival rates may be greater with surgical excision plus postoperative radiation than with treatment with either modality alone.

Lingual hematoma and heparin-induced thrombocytopenia: A case report

March 1, 2008     Geoffrey S. Getnick, MD, Samuel J. Lin, MD, Joseph R. Raviv, MD, William E. Walsh, MD, and Kenneth W. Altman, MD, PhD
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Abstract

Lingual hematoma is a rare but potentially fatal cause of upper airway obstruction. Patients receiving anticoagulants such as heparin can suffer from significant complications of these medications. Not only does heparin exert effects directly on the coagulation cascade, but it has the potential to cause thrombocytopenia by stimulating formation of antibodies against platelets. We present the case of a patient being treated with heparin for a deep-vein thrombosis, who subsequently developed heparin-induced thrombocytopenia and lingual hematoma, necessitating tracheotomy.

Isolated lingual mucormycosis in an infant with Down syndrome

January 1, 2008     Subhaschandra Shetty, MS, DNB, Usha Kini, MD, DCP, DNB, and Rajeev Joy, MBBS, DLO
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Abstract

Mucormycosis is characterized by severe infection with rapid progression and a high mortality rate. In immunocompromised hosts, the most common type is the rhinocerebral form of mucormycosis. Invasive mucormycosis affecting only the tongue is extremely rare. We report one such case that occurred in an immunocompromised 4-month-old girl with Down syndrome who had been hospitalized for acute gastroenteritis. The infant had metabolic acidosis secondary to diarrhea. It was suspected that the infection had been contracted through the use of a wooden tongue depressor during oral examination. We present this case report in the hope that it will discourage clinicians from using wooden tongue depressors in vulnerable infants. We also wish to emphasize that mucormycosis should be considered in all patients—regardless of age—who pre-sent with localized bluish-black discolored mucosa of the oral mucosa and/or tongue.

Two cases of neurilemmoma of the tongue

October 31, 2007     Kadambari Batra, DLO, DNB, Anil Kumar Rai, MS, Neena Chaudhary, MS, and Sameer Topno, MBBS
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Abstract

Neurilemmomas of the tongue are uncommon. When they do occur, treatment is simple. However, diagnosis is invariably delayed because of the vagueness of symptoms. We encountered 2 cases of this unusual tumor within weeks of each other. In 1 of these cases, the definitive diagnosis was delayed because of the atypical clinical picture—that is, an abscess in the tongue that had caused respiratory distress. We describe our management of these 2 cases, and we discuss what has been published in the literature regarding the presentation, diagnosis, histopathology, treatment, and prognosis for patients with glossal neuri-lemmoma.

Median rhomboid glossitis

September 30, 2007     Brenda L. Nelson, DDS; Lester D.R. Thompson, MD, FASCP
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Median rhomboid glossitis-also known as central papillary atrophy and posterior midline atrophic candidiasis-is a type of erythematous candidiasis unique to the midline posterior tongue. It occurs in as many as 1% of adults.

Burkitt's lymphoma of the base of the tongue: A case report and review of the literature

May 31, 2007     Steven M. Feinberg, MD; S.H. Ignatius Ou, MD, PhD; Mai Gu, MD, PhD; Terry Y. Shibuya, MD
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Tongue erosions and diet cola

March 31, 2007     Sharon E. Jacob, MD; Tace Steele, BA
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Endoscopic view of a hypermobile tongue in the nasopharynx

August 31, 2006     Adam J. LeVay, MD; Eiji Yanagisawa, MD
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Thyroglossal duct cyst: An unusual presentation

June 30, 2006     Kishore Chandra Prasad, MS, DLO; Naveen Kumar Dannana, MBBS, MS; Sampath Chandra Prasad, MBBS
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Abstract
Most thyroglossal duct cysts are located at or very close to the midline. They generally manifest as painless neck swellings, and they move on protrusion of the tongue and during deglutition. We describe a case of thyroglossal duct cyst that was unusual in that the cyst was located far from the midline, it did not move on protrusion of the tongue, and it was associated with symptoms of dysphagia and extensive neck swelling that mimicked a colloid goiter

Bilateral pleomorphic adenoma of the anterior tongue: A case report

December 1, 2005     Ramandeep S. Virk, MS; Harbir Hundal, MS
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Abstract
We report a case of bilateral pleomorphic adenoma of the anterior two-thirds of the tongue in a 38-year-old man. Both tumors were excised via a transoral route. To the best of our knowledge, this is the first reported case of a bilateral pleomorphic adenoma of the anterior tongue.

Polymorphous low-grade adenocarcinoma at the base of the tongue: An unusual location

December 1, 2005     Alfio J. Tincani, MD, PhD; Albina Altemani, MD, PhD; Antonio S. Martins, MD, PhD; Gilson Barreto, MD; João B. Valério, MD; André Del Negro, MD; Priscila P.C. Araújo, MD
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Abstract
Polymorphous low-grade adenocarcinoma (PLGA) is a malignant neoplasm of low aggressiveness that occurs almost exclusively in the minor salivary glands, primarily those in the palate. We report a case of PLGA that arose in the base of the tongue and subsequently metastasized to the neck. The tumor was resected through the oral cavity with wide margins and dissection. The neck metastasis was treated with radical neck dissection and radiotherapy. The patient recovered and remained disease-free at follow-up 30 months later. This case shows that PLGA, which has a variable morphologic appearance, can occur at sites other than the salivary glands.

Macroglossia secondary to systemic amyloidosis: Case report and literature review

May 31, 2005     Sandra Doria Xavier, MD; Ivo Bussoloti Filho, PhD; Helena Müller, MD
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Abstract
Amyloidosis is characterized by an abnormal extracellular deposition of amyloid in different tissues and organs, where it usually causes some type of dysfunction. Its cause is unknown. The two main forms of amyloidosis are systemic and localized; the latter is rare. No satisfactory treatment for systemic amyloidosis has been discovered, and mean survival is poor, ranging from 5 to 15 months depending on the presence or absence of multiple myeloma. We report a case of primary systemic amyloidosis in a 71-year-old man. The diagnosis of amyloidosis was established by tongue biopsy, and its systemic nature was identified by analysis of aspirated abdominal fat. At the 1-year follow-up, the patient's clinical condition had not changed, and he was thereafter lost to follow-up.
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