Unilateral hypertrophy of the face associated with infiltrating lipomatosis.
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PURPOSE: This article analyzes osseous lesions in the tongue with regard to the clinical and histologic features and discusses the pathogenesis and terminology of these lesions. MATERIALS AND METHODS: Thirty-eight cases of lingual osseous lesions were retrieved from the English language literature, and two new cases were added. RESULTS: The lesions had a female predilection, with a female-to-male ratio of 2.3:1. Mean age of the patients at time of diagnosis was 31.4 years. The lesions were located in the posterior third of the dorsum of the tongue in 67.5% of the cases, in the lateral margins in 25%, and in the mid-third of the tongue in 7.5%. Size ranged from 0.5 to 5.0 cm. Duration of the lesions ranged from several months to 50 years. In eight cases, there was information that the lesions had increased in size. Histologically, the lesions appeared a well-circumscribed mass of vital bone under the surface epithelium. The two new cases, when examined by polarized light, showed a mixture of woven and mature bone. CONCLUSION: The osseous lesions of the tongue represent a heterogeneous group of lesions in which some may represent a developmental malformation, and others may be a reactive lesion after trauma or irritation. Some lesions behave as true neoplasms and others as choristomas. It is suggested that the descriptive term "osseous tumorlike lesion of the tongue" may be more appropriate for this group.
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Numerous studies have been devoted to the various histopathologic changes of the surface of the tongue. The muscles of the tongue and their changes in the process of ageing as well as in neurogenic atrophies, however, have not been systematically examined so far. Enlarging upon previous studies, an autopsy material of 170 tongues from all age groups was histologically examined in order to identify the steps in the development of age-related atrophy. These are characterized by a histometrically documented atrophy of the musculature with progressive lipomatosis. Fatty infiltration starts in the 2nd/3rd decade at three sites of predilection: body, root and tip of the tongue in the region of the anterior lingual gland (NUHN). The age-dependent atrophy and the known clinical behaviour of neurogenic atrophies of the tongue are correlated with the histopathology of three typical forms: a neurogenic myasthenic atrophy of the tongue with high-grade symmetrical fatty replacement as an expression of a progressive myasthenic denervation; a lipomatous atrophy of the tongue as a late stage of poliomyelitis and long-term treatment in the "Iron Lung", and a lipomatous hemiatrophy due to posttraumatic extracranial hypoglossus paresis. The paretic part of this tongue consists of 85-90% fatty tissue. The different degrees of muscular atrophy of the tongue are largely compensated by metaplasia of fatty tissue in the perimysium following muscular degeneration (in the sense of a fatty replacement). With the exception of general and severe myasthenic atrophy, size, form and function of the tongue fail to show any significant changes in age-related atrophy and hemiatrophy.
PURPOSE: Early mobile tongue cancer can be controlled with interstitial radiotherapy (ISRT). We carried out a Phase III trial to compare the treatment results of low-dose-rate (LDR) ISRT and high-dose-rate (HDR) ISRT for early mobile tongue cancer. METHODS AND MATERIALS: From April 1992 through October 1996, 59 patients with cancer of the early mobile tongue were registered in this Phase III study. Eight patients were excluded from the evaluation because of violations of the requirements for this study. Of 51 eligible patients, 26 patients were treated with LDR-ISRT (70 Gy/4-9 days) and 25 patients with HDR-ISRT (60 Gy/10 fractions/1 week). For the hyperfractionated HDR-ISRT, the time interval between 2 fractions was more than 6 h. RESULTS: Five-year local control rates of the LDR and HDR groups were 84% and 87% respectively. Nodal metastasis occurred in 6 patients in each group. Five-year nodal control rates of the LDR and HDR groups were 77% and 76%, respectively. CONCLUSION: Hyperfractionated HDR-ISRT for early mobile tongue cancer has the same local control compared with continuous LDR-ISRT. Hyperfractionated HDR-ISRT is an alternative treatment for continuous LDR-ISRT.
Lingual thyroid is a well-known developmental abnormality, malignant transformation of which is rare. This is a case report of a papillary carcinoma located in ectopic lingual thyroid tissue, in a 28-year-old white male. A search of the literature revealed only one more such report.
Selective transcatheter arterial embolization, using Gelfoam, was performed in 2 patients with bleeding from tongue arteries due to carcinoma. Though the patients were in poor general condition, being in the terminal stage of cancer, there were no complications and the bleeding was successfully controlled. This method was effective in controlling haemorrhage from the tongue due to carcinoma of the tongue.
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Extrarenal angiomyolipoma is a rare subtype of benign lipomatous tumor composed of adipose tissue, blood vessels, and smooth muscle. We report a 60-year-old woman who developed an angiomyolipomatous tumor of the tongue and discuss the differential diagnosis along with a review of the literature. The term angiomyolipomatous hamartoma is proposed for the present lesion to distinguish it from classic oral angiomyolipoma.
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A patient with tongue malignancy associated with a black hairy tongue is presented. Specimens from e area fo the black hairy tongue and from a normally appearing part were studied with the scanning electron microscope. The "hairs" consisted of elongated filiform papillae due to accumulated keratinized layers. In-between these layers, fungi and bacteria were found. The aetiology of the blck hairy tongue in this patient is discussed.
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Actinomycotic infections of the cervicofacial region are not uncommon. However, actinomycosis of the tongue is rare. A mass that may mimic both benign and malignant neoplasms can be seen at clinical presentation and may mislead the diagnosis. We report a patient who presented with a tumour-like tongue mass causing speech disturbance, diagnosed as actinomycosis.
Choristomas and mixed hamartomas of the oral cavity are uncommon lesions that show a variety of clinical presentations, histological appearances and growth patterns. We report a case of an unusual mixed hamartoma of the posterior tongue composed of dermoid cyst, sebaceous and glial elements. Magnetic resonance imaging indicated a predominantly cystic lesion limited to the pharyngeal and posterior part of the anterior tongue. A conservative approach was adopted and the lesion has shown minimal growth for 2 years following diagnosis.
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OBJECTIVE: The aim of this study was to assess the prevalence of nine tongue conditions and relate to data obtained about oral hygiene or habits in Turkish dental outpatients. SUBJECTS: A total of 5150 subjects (2837 women, 2313 men) were included in this study. RESULTS: Of the 5150 subjects, 2690 subjects were detected as having tongue lesions with a prevalence of 44.2 and 62.0% for women and men, respectively. The difference was found to be statistically significant (P < 0.0001). There was a strong correlation between tongue lesions and increasing age. There was also a strong association between tongue lesions and smoking, black tea drinking, and fair or poor oral hygiene. Hairy and coated tongue was significantly higher in males. Contrary to this, papillary atrophy was more prominent in women. CONCLUSION: A strong correlation was found between tongue lesions and age, sex, oral hygiene and habits in Turkish dental outpatients. An efficient oral health program such as the elimination of risk habits and attention to cultural practices may improve tongue hygiene.
Oral cancer in young adults is fortunately uncommon in the UK. However, since it is so rare, when cases present they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This may, in turn, lead to a poorer prognosis for these patients. It is debatable if oral cancer in younger adults carries an inherently poor prognosis and presents with more aggressive tumours. Three cases of oral cancer in young adults, aged under 30 years are presented and the literature reviewed with respect to oral cancer in this group of patients.
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