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Deng J, Ouyang K, Zhu C. An elderly man with tongue swelling and dysphagia. Oral Oncol 2025; 165:107313. [PMID: 40252456 DOI: 10.1016/j.oraloncology.2025.107313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2025] [Accepted: 04/15/2025] [Indexed: 04/21/2025]
Affiliation(s)
- Jie Deng
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, China
| | - Kexiong Ouyang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, China
| | - Chuandong Zhu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, China.
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Poorna TA, Chandra K, Joshna EK, John B. Retrieval of Migrated Embedded Sewing Machine Needle from the Tongue. Indian J Otolaryngol Head Neck Surg 2022; 74:5696-5698. [PMID: 36742650 PMCID: PMC9895458 DOI: 10.1007/s12070-021-03028-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
Foreign body in the oral cavity can be encountered by Head and Neck Surgeons in their clinical practice. Here, we report a rare case of an embedded sewing machine needle in the posterior tongue that migrated by tongue movements, and was retrieved successfully by surgical intervention.
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Affiliation(s)
| | | | - E. K. Joshna
- Government Medical College, Kottayam, Kerala India
| | - Bobby John
- Government Medical College, Kottayam, Kerala India
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Jiang ZH, Xv R, Xia L. Foreign body granuloma in the tongue differentiated from tongue cancer: A case report. World J Clin Cases 2022; 10:6247-6253. [PMID: 35949813 PMCID: PMC9254197 DOI: 10.12998/wjcc.v10.i18.6247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/12/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Embedded foreign bodies in the tongue are rarely seen in clinical settings. An untreated foreign body can cause a granuloma which often presents as an enlarged tongue mass. However, if foreign body ingestion status is unknown, physical examination and magnetic resonance imaging (MRI) tend to lead to suspicion of tongue cancer, especially in older patients. Thus, differential diagnosis of an enlarged tongue mass is important, especially because it is closely related to the choice of treatment method.
CASE SUMMARY A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 mo. She had no previous medical history. MRI revealed abnormal signal intensities that were indicative of a neoplasm. Thus, the oral surgeon and radiologist arrived at a primary diagnosis of tongue cancer. The patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the tongue. The ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body (bone) in the tongue, even though the patient denied any history of foreign body ingestion. Complete surgical enucleation of the lesion was conducted. The mass which included a fish bone was completely removed. The post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers, macrophages and chronic inflammatory cells. The patient recovered without complications over a 2 mo follow-up period.
CONCLUSION We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue cancer. The MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the tongue. The granuloma, which contained a fish bone, was completely removed via surgery and confirmed via biopsy. Differential diagnosis of the enlarged tongue mass was critical to the selection of treatment method.
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Affiliation(s)
- Zhen-Hua Jiang
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
| | - Ran Xv
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
| | - Li Xia
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
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Characteristics of Retained Foreign Bodies in the Tongue: A Retrospective Study of 35 Cases. J Oral Maxillofac Surg 2022; 80:1062-1068. [PMID: 35395225 DOI: 10.1016/j.joms.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE There are only a few case reports of foreign bodies (FBs) in the tongue. Delayed diagnosis or misdiagnosis is not uncommonly reported. The purpose of this study was to identify the demographic, clinical, and radiological features that might facilitate the diagnosis of retained FBs in the tongue. METHODS A retrospective case series was performed. Clinical and imaging data of patients with FBs in the tongue at Wuhan University Hospital of Stomatology were reviewed. The outcome variable was a preliminary, radiological, intraoperative, or pathological diagnosis. Covariates included age, sex, FB-related history, symptoms and signs, duration, and computed tomography (CT) imaging features. Descriptive statistics were computed for each study variable. RESULTS Thirty-five patients were included. The sample's mean age was 54.5 ± 11.2 years, included 19 males (54.3%). Eighty percent of the patients reported FB-related history with a mean duration of 4 weeks. More than 70% of the patients presented with tongue swelling. Approximately half of the 35 cases were preliminarily misdiagnosed, and 15 of them were initially suspected to be tumors. After CT examinations, 33 of the 35 cases were diagnosed as FB. Characteristic CT imaging feature of the FB was a radiopaque line. Most FBs were located at the anterior two-thirds and marginal area of the tongue and in an oblique direction. The depth of FB was 0.61 ± 0.42 cm. The superficial ends of most FBs were close to the surface of the dorsum and the tongue margin. CONCLUSIONS The possibility of a retained FB should be included in the differential diagnosis of a nonhealing wound or tongue enlargement when a radiopaque line is present on CT images of patients presenting with or without FB-related history. It may be easier to detect a FB in the tongue when a CT imaging postprocessing protocol, including thin-slice reconstruction and multiplanar reformation visualization and careful interpretation, is used.
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Leigh N, Anteby R, Awan T, Sinclair C. Lingual Osseous Choristoma Causing Odynophagia in a Young Female. EAR, NOSE & THROAT JOURNAL 2020; 101:NP305-NP307. [PMID: 33095676 PMCID: PMC7585807 DOI: 10.1177/0145561320968928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Natasha Leigh
- Department of Otorhinolaryngology, Mt. Sinai West Hospital, New York, NY, USA
| | - Roi Anteby
- Faculty of Medicine, Tel Aviv University, Israel
| | - Tauhid Awan
- Department of Pathology, Molecular and Cell Based Medicine, Mount Sinai West Hospital, New York, NY, USA
| | - Catherine Sinclair
- Department of Otorhinolaryngology, Mt. Sinai West Hospital, New York, NY, USA
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Corlianò F, Falco P, Cambi J, Brindisi L. Iron supplement tablet embedded in the oral cavity mimicking neoplasm: a case report. J Korean Assoc Oral Maxillofac Surg 2016; 42:111-4. [PMID: 27162752 PMCID: PMC4860376 DOI: 10.5125/jkaoms.2016.42.2.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/28/2015] [Accepted: 08/04/2015] [Indexed: 12/28/2022] Open
Abstract
The detection of foreign bodies in the upper-aerodigestive tract is a fairly frequent event and can occur in various areas and for various reasons. In rare cases, foreign bodies can simulate a neoplasia. We evaluated similar cases during emergency regimen with an oral cavity mucosal lesion, causing lockjaw, sore throat, dysphagia, and swelling of the submandibular and laterocervical region. Physical examination revealed an extensive mucosal ulceration in the floor of the mouth and the lateral surface of the tongue, comparable to oral cancer. During a second, more accurate assessment, a partially deteriorated iron supplement tablet was found embedded in a mucosal pocket. After removing the tablet, gradual normalization of the tissue was observed without any sequelae. This is one of the many reasons why it is advisable and useful in cases of oral lesions to collect a detailed medical history and to perform an accurate clinical evaluation, including inspection and palpation of the lesion, before proceeding to further diagnostic assessments, especially in elderly patients taking many medications. However unlikely, it is possible that difficulty in swallowing pills or tablets could generate tumorlike lesions.
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Affiliation(s)
- Fabrizio Corlianò
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
| | - Paola Falco
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
| | - Jacopo Cambi
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
| | - Leopoldo Brindisi
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
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Smith ME, Riffat F, Berman LH, Jani P. Intraoperative ultrasound to facilitate removal of a submucosal foreign body. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:565-568. [PMID: 25145586 DOI: 10.1002/jcu.22226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 07/22/2014] [Accepted: 07/23/2014] [Indexed: 06/03/2023]
Abstract
A 61-year-old man with a history of fish bone ingestion and poorly localized symptoms was seen. His clinical examination was unremarkable, but CT demonstrated a foreign body deeply embedded within his tongue. Intraoperative ultrasound (US) guidance facilitated identification of a bone, allowing a needle to be placed as a guide to dissection. Repeat US scanning through the incision permitted precisely targeted surgery. CT and US are the most effective imaging techniques for localizing fish bones. Intraoperative US can be used to accurately locate a submucosal fish bone in mobile tissue such as the tongue, and focused, image-guided dissection can reduce surgical tissue trauma.
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Affiliation(s)
- Matthew E Smith
- Department of ENT Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, United Kingdom, CB2 0QQ
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8
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Foreign body induced neuralgia: a diagnostic challenge. Case Rep Dent 2013; 2013:352671. [PMID: 23819067 PMCID: PMC3681214 DOI: 10.1155/2013/352671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/05/2013] [Indexed: 11/29/2022] Open
Abstract
Neuropathic pain is caused by neural injury or painful states associated with either peripheral or central nerve injury. One of the aetiologies of this type of pain is iatrogenic trauma. This case highlights the features of peripheral neuropathic pain caused by foreign body left in the mental foramen following a previous surgical procedure. The foreign body was detected on routine radiographic evaluation. Once the foreign body was removed by surgical intervention, the pain resolved. This stresses the importance of routine radiographic evaluation in proper diagnosis and treatment planning in the management of neuropathic pain. This paper also sheds light on the role of iatrogenic mechanical cause of peripheral neuropathic pain and warrants a tough degree of caution on the part of oral clinicians.
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10
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de Santana Santos T, Melo AR, Pinheiro RTA, Antunes AA, de Carvalho RWF, Dourado E. Tooth embedded in tongue following firearm trauma: report of two cases. Dent Traumatol 2011; 27:309-13. [PMID: 21645242 DOI: 10.1111/j.1600-9657.2011.00994.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.
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Affiliation(s)
- Thiago de Santana Santos
- Oral and Maxillofacial Surgery, Post-Graduate Program of Pernambuco Dentistry College, Camaragibe, Pernambuco, Brazil.
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McDermott M, Branstetter BF, Escott EJ. What's in your mouth? The CT appearance of comestible intraoral foreign bodies. AJNR Am J Neuroradiol 2008; 29:1552-5. [PMID: 18499787 DOI: 10.3174/ajnr.a1127] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Comestible or chewable intraoral foreign bodies (IOFB), such as candies, gum, and chewing tobacco, are seen incidentally on many CT scans of the head and neck. If these foreign bodies are misinterpreted as pathology, patients may be subjected to unnecessary distress or unneeded radiation from additional imaging. The purpose of this study was to characterize the CT appearance of comestible IOFBs and to find characteristics that distinguish them from true pathology. MATERIALS AND METHODS With institutional review board approval, 30 patients who were already scheduled to undergo CT examinations of the head and neck were enrolled in this study. Nine typical IOFBs with different physical characteristics were selected for inclusion. Each patient placed 1 IOFB in his or her mouth before the initiation of the routine clinical scan. The resulting scans were evaluated by 2 head and neck radiologists. In vivo and ex vivo attenuation measurements were obtained for each IOFB. RESULTS The attenuation of comestible IOFBs ranged from 184 to 475 Hounsfield units. Large, hard IOFBs were most easily distinguished from mucosal lesions, but might be mistaken for odontogenic or bone tumors. Small, hard IOFBs could be mistaken for calculi, tooth fragments, or enhancing vessels. Soft IOFBs generally had more confusing configurations and more heterogeneous densities and, thus, might be mistaken for enhancing mucosal lesions. Foci of gas were often identified within chewable IOFBs, mimicking an abscess. Because all of the IOFBs had higher densities than soft tissue, they could all be mistaken for calcified, enhancing, or bony lesions. CONCLUSION Radiologists frequently encounter IOFBs on CT examinations of the head and neck. Familiarity with the expected appearance of these incidental pseudolesions is important to prevent misdiagnosis as a true pathologic process.
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Affiliation(s)
- M McDermott
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa., USA
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Verma R, Sikka K, Thakar A. Autologous embedded foreign body of mobile tongue. Indian J Otolaryngol Head Neck Surg 2007; 59:291-2. [PMID: 23120456 PMCID: PMC3452105 DOI: 10.1007/s12070-007-0084-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Foreign bodies of upper aerodigestive tract are common otorhinolarygological emergencies. The foreign bodies of mobile tongue are however very rare and there are only limited case reports in literature. The case of a young female with an autologous foreign body mobile tongue with unusual presentation is presented.
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Affiliation(s)
- Rohit Verma
- Department of Otorhinolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 USA
| | - Kapil Sikka
- Department of Otorhinolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 USA
| | - A. Thakar
- Department of Otorhinolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 USA
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Kondoh A, Akasaka E, Yamamoto K, Mizutani K, Iwashita K, Umezawa Y, Ohta Y, Matsuyama T, Ozawa A. A case of implantation dermatosis that formed a tumor. J Dermatol 2006; 33:122-7. [PMID: 16556281 DOI: 10.1111/j.1346-8138.2006.00026.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 51-year-old man visited our hospital complaining of a tumor located above his lip. He had been hit on his upper left lip by a chopstick holder 2 months previously. The lesion turned into a tumor and gradually enlarged. The tumor was well circumscribed, smooth and covered with reddish, partially milk-white skin. During surgery to remove the tumor, a piece of a chopstick was found in the subcutaneous tissue, and a diagnosis of implantation dermatosis (ID) was made. On histology, the tumor appeared as an abscess that had increased fibroblasts, small vessels and a large number of neutrophils. In the Japanese published work, we found 86 cases of ID; three were similar to our case and had been clinically diagnosed as adnexal tumors. There were also six cases that showed abscess formation similar to our case on histology. In a survey of the published work from other countries, there were 44 ID cases. There were no common features found among the cases reported in the published work.
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Affiliation(s)
- Akio Kondoh
- Division of Specialized Clinical Science (Dermatology), Tokai University School of Medicine, Kanagawa, Japan.
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Uguz MZ, Kazikdas KC, Erdogan N, Aydogdu V. An unusual foreign body in the floor of the mouth presenting as a gradually growing mass. Eur Arch Otorhinolaryngol 2005; 262:875-7. [PMID: 16187134 DOI: 10.1007/s00405-004-0908-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Accepted: 12/01/2004] [Indexed: 12/29/2022]
Abstract
Foreign bodies in the upper aerodigestive tract represent one of the most common ENT emergencies, but patients with foreign bodies in the floor of the mouth rarely present to the otolaryngologist. Only a very small number of these foreign bodies are embedded under normal mucosa and can result in lethal complications. In this article, we report the case of a 3-year-old girl with a gradually enlarging mass in the floor of the mouth. On physical examination at admission, there was a 2x3-cm, elastic, tender mass on the left side of the floor of the mouth, with the overlying mucosa intact and normal in color. Taking the palpable lymph nodes into consideration, a congenital lesion or a pediatric malignancy was suspected initially. A blue pen cap with a surrounding pneumatocele was found intraoperatively. After a careful reevaluation of a previous MRI, a check valve mechanism at the possible site of entry was detected, leading to a pneumatocele, thus explaining the constant growth of the mass. This is a unique case of a foreign body in the floor of the mouth, mimicking a congenital lesion or a pediatric malignancy. Thus, the possibility of a foreign body should not be underestimated when evaluating a child with swelling in the floor of the mouth.
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Affiliation(s)
- M Zafer Uguz
- First ENT Clinic, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
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Hermes D, Schweiger U, Warnecke KK, Trübger D, Hakim SG, Sieg P. [Incorporation of multiple foreign bodies due to borderline personality disorder]. ACTA ACUST UNITED AC 2004; 9:53-8. [PMID: 15599616 DOI: 10.1007/s10006-004-0583-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autoaggressive behaviour is one of the pathognomonic characteristics in patients with borderline personality disorder. Clinical symptoms of such behaviour can be the self-induced incorporation of foreign bodies. In the head and neck area, this form of autoaggressivity causes primary or secondary infectious complications with different clinical manifestations. Below follows a description of diagnosis, therapy and follow-up of such a case, comparing our own findings with the corresponding literature. CASE REPORT A 24-year-old woman with manifest borderline personality disorder was referred to the Department of Maxillofacial Surgery after developing a swelling in the infra-auricular region. After antibiotic therapy failed to reduce inflammatory symptoms, local revision was performed including excision of two metallic foreign bodies. Comprehensive radiological evaluation identified multiple foreign bodies in the head and neck region and lower arms. A total of 76 metallic foreign bodies was removed surgically. During early surgical follow-up and subsequent psychiatric treatment, the patient incorporated new foreign bodies. DISCUSSION The case reported represents a pattern of foreign body incorporation which is unusual based on review of the literature but characteristic for patients with borderline personality disorder. Diagnostics and therapy require an individual concept which only can be implemented in close co-operation with psychiatrists. Secondary clinical benefit derived from surgical diagnostics and therapy as well as the possibility of autoaggressive relapse have to be taken into consideration.
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Affiliation(s)
- D Hermes
- Klinik für Kiefer- und Gesichtschirurgie, Universitätsklinikum Schleswig-Holstein/Campus Lübeck.
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