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It is often challenging to determine the accurate size and shape of oral lesions through computed tomography (CT) or magnetic resonance imaging (MRI) when they are very small or obscured by metallic artifacts, such as dental prostheses. Intraoral ultrasonography (IUS) has been shown to be beneficial in obtaining precise information about total tumor extension, as well as the exact location and guiding the insertion of catheters during interstitial brachytherapy. We evaluated the role of IUS in assessing the clinical outcomes of interstitial brachytherapy with 198Au grains in tongue cancer through a retrospective medical chart review. The data from 45 patients with T1 (n = 21) and T2 (n = 24) tongue cancer, who were mainly treated with 198Au grain implants between January 2005 and April 2019, were included in this study. 198Au grain implantations were carried out, and positioning of the implants was confirmed by IUS, to ensure that 198Au grains were appropriately placed for the deep border of the tongue lesion. The five-year local control rates of T1 and T2 tongue cancers were 95.2% and 95.5%, respectively. We propose that the use of IUS to identify the extent of lesions and the position of implanted grains is effective when performing brachytherapy with 198Au grains.

Malignant pleural mesothelioma (MPM) is a rare neoplasm of the serosal membranes. MPM usually manifests as local invasion, rarely with distant haematogenous metastases in different organs. Few cases of tongue metastasis have been documented. Here, we report the case of a 68‐year‐old man diagnosed with malignant pleural epithelioid mesothelioma together with a simultaneous tongue lesion, which was found to be metastatic malignant mesothelioma. Tongue metastasis from MPM is rare and the oral symptoms it causes could be an early sign of clinical manifestation. For patients with oral symptoms and a newly discovered tongue lesion, clinicians should be aware of the possibility of tongue metastasis and search for a primary malignancy., Tongue metastasis from malignant pleural mesothelioma is rare and only a few cases have previously been documented. Here, we report a patient with MPM who presented with simultaneous tongue metastasis and review the relevant literature.

Introduction Although most tongue lacerations in children can be treated conservatively, accepted indications for suture repair include complex injury, large flaps, and active bleeding. The purpose of this article is to highlight repair of a unique, severe injury pattern in a child. Presentation and treatment A 3-year-old boy fell on a cemented floor causing a midline full-thickness laceration through the median fibrous septum, resulting in a bifid tongue. Given the midline location, neurovascular supply was protected, and following surgical repair, the patient enjoyed an uneventful recovery. Conclusion Our case outlines a surgical approach for this unique case of acquired traumatic pediatric bifid tongue, which to our knowledge, has never been reported in the English literature., Highlights • This presented case highlights a unique severe injury pattern in a child. • A 3-year-old presented with a unique acquired traumatic bifid tongue injury. • He underwent successful functional and aesthetic surgical repair. • To the best of our knowledge, this rare presentation of traumatic bifid tongue in a child has not been reported in the English literature. • The case has been presented based on SCARE guidelines.

Giant cell arteritis (GCA) is a chronic vasculitis comprising large- and medium-sized arteries branches originating from the aortic arch. GCA diagnosis might be challenging due to its several clinical characteristics. This clinical report describes a case of a 91-year-old woman who was admitted with tongue necrosis. Medical history revealed mild headache episodes and jaw numbness. Summing up clinical and laboratory findings, the diagnosis of GCA was established. Surgical debridement and corticotherapy led to complete resolution of the tongue lesion with no need for any additional intervention. In this case report, we highlight the importance of GCA early diagnosis in order to avoid more serious complications.

Background: Actinomycosis of the tongue is an uncommon, suppurative infection of lingual mucosa, caused by actinomyces. The clinical diagnosis may present serious difficulties because of its ability to mimic other lesions, including both benign and malignant neoplasms. Methods: Here, we describe the case of a 52-years-old patient affected by an asymptomatic, tumor-like tongue swelling, then diagnosed as actinomycosis. A review of tongue localization of actinomycosis is also reported, with emphasis on clinical findings and therapy. Results and Conclusion: Early diagnosis and treatment, with pus drainage and systemic antibiotic therapy, are pivotal to avoid severe and life-threatening complications.

Actinomycosis of the tongue is rare. It may be difficult to differentiate this infection clinically and radiologically from other tongue pathology especially neoplasia. We report a substantial tongue lesion which mimicked malignancy at presentation. The patient was treated successfully with 4 weeks of oral antibiotic therapy. It is also important that clinicians are aware of the radiological differential diagnosis of lingual actinomycosis. Keywords: Actinomycosis, Tongue, Imaging

Hemangiopericytoma (HPC) is a mesenchymal tumour that is usually benign, but has definite malignant counterpart. 16-25 % cases of all reported HPC’s are observed involving Head and Neck region. We report a case of HPC on the left lateral border of tongue. The histopathology features revealed increased cellularity, vascularity with some staghorn pattern. Observed nuclear pleomorphism and vesicular as well as hyperchromatic nuclei suggest an intermediate grade characterized by unpredictable clinical behaviour. Therefore long follow up is essential. No local recurrence or distant metastasis was noticed in a 5 year follow-up period. Keywords: Hemangiopericytoma, Vascularity, Staghorn

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue neoplasm of intermediate biologic potential. Here, we describe an unusual presentation of IMT in the oral tongue of a pediatric patient. In contrast to other presentations in the literature suggestive of a malignant process, the presentation seen here appears benign. However, unlike the more common benign pediatric tongue lesions, IMT does have aggressive and even mortal potential. Though rare, it is important to keep in mind atypical presentations like the one described here and consider IMT on the differential diagnosis of a tongue lesion in a pediatric patient.

Self-induced lesions or factitious ulcer of the mouth can be manifestation of unusual or aggressive oral habits or an emotional disorder. Here, we report 2 rare cases of difficult management of factitious ulcer. The first was an 18-year-old male patient who was a former alcohol, tobacco, marijuana, and cocaine user referred to the stomatology service because of lateral tongue lesion because the lesion itched and burned. The second occurred in a 10-year-old male patient who was taken to service because of a lip injury. The patients had the lesions treated but presented recurrence; biopsy specimen revealed a chronic inflammatory process. Systemic and local alterations that justified the ulcerations were investigated but were not found. Low-level laser therapy was performed for the 2 patients. The clinical follow-up, clinical history, and histopathologic aspects for the lesions were of great importance, and diagnosis was chronic wound by self-inflicted thermal injury.

Surgery for the base of the tongue lesions can be challenging since this area is difficult to access and contains important neurovascular structures. External incision in the neck via an approach that varies from a transoral midline glossotomy approach to a lip-split mandibulotomy, which inevitably results in obvious scarring of the face and neck. Transoral robotic surgery can be considered for removal of these difficult neoplasms. But limitations of robotic surgery include the size and cost of the device, a learning curve, and safety concerns. Hence, alternative surgical approaches that allow for good exposure, complete tumour excision, low complication rates, low recurrence rates, and no postoperative neck scarring are preferred.

Abrikossoff 's tumor, also called granular cell tumor (GCT), is a rare benign neoplasm of the soft tissues. In almost 70% of the cases, it occurs in the head-and-neck region (especially in the tongue), even though it may present in every other part of the body. This neoplasm has a benign behavior usually, but there have been described a malignant transformation in 2%–3% of the cases. The characterization of this tumor depends on its clinical and histopathological findings. The purpose of our work is to report three uncommon cases of oral Abrikossoff 's tumor located on the tongue in young patients referred to our department of maxillofacial surgery of “University Magna Graecia” in Catanzaro, also reviewing of the literature.

Multiple primary oral squamous cell carcinomas (SCCs) are rare in clinical practice. A 62-year-old white male patient, a tobacco culture work farmer, was referred to our outpatient clinic for evaluation of a tongue lesion. A long-standing tobacco and alcohol consumption associated to daily occupational sun exposure was reported. The medical and family history was not contributory. Extraoral examination did not detect lymph nodes. The vermilion border of the lower lip had multiple crusted ulcerated lesions. Intraoral examination revealed an extensive endophytic ulcer with a yellowish surface affecting the right lateral border of the tongue with 4 months of evolution. Incisional biopsies were performed, and the histopathologic analyses confirmed the diagnosis of SCC for both lesions. The patient was referred for oncological therapy. This report shows the importance of the rigorous clinical examination performed by stomatologist for a complete diagnosis and adequate reference to treatment.

Introduction: A 7-year-old female presented with a tongue lesion that was causing dysphagia and difficulty breathing at night. Work-up revealed symptomatic lingual thyroid tissue. Transora...

Antimicrobial photodynamic therapy (PDT) is a noninvasive, painless, and safe procedure that can be used on a wide range of diseases in clinical practice. Dermatology for dogs and cats is emerging as one of the main areas of interest for the application of this therapeutic approach; however, despite being a promising technique to treat various dermatological diseases, researchers and clinicians have made little use of this powerful tool. The farm animals’ medicine has evolved over the past few years, and the growing demand of consumers looking for absence of residues in animal products becomes essential in the search for alternatives to conventional treatments. Although the bulk of researches on PDT in veterinary medicine are to treat domestic animals, there is a great appeal for its clinical application in exotic, zoo, and wildlife medicine. In this chapter, we describe potential applications of PDT in veterinary clinical practice.

Amyloidosis is the extracellular fibril deposition of a variety of proteins, many of which circulate as plasma ingredients. It is a disease difficult to identify due to its nonspecific symptoms and manifestations. Amyloidosis of the tongue, either isolated or part of the systemic disease, is rare and its features resemble those of a tumor. We report the case of a patient with amyloidosis who presented with a tongue lesion, weakness, nonspecific arthritis, and dyspnea on exertion that resulted in multiorgan system failure.

We present a case of endocarditis with embolic stroke and digital infarction due to the recently renamed Aggregatibacter aphrophilus. The isolation and identification of this organism can be problematic but was achieved in this case using both older phenotypic and newer genotypic methods. A benign tongue lesion is suggested as the likely portal of entry for this oropharyngeal organism. The patient made a good recovery with six weeks of intravenous ceftriaxone but will need cardiac valvular surgery at some point in the future.

Renal cell carcinoma (RCC) has the propensity to metastasize to any organ in the body. Tongue metastases from RCC is very rare with most of them being metachronous in nature. We present a rare case where patient presented with a tongue lesion leading to a diagnosis of RCC. Surgery is the preferred modality of treatment for tongue metastases.

A 66-year-old woman presented with acute onset of fever, chills, and productive cough associated with right-sided chest pain. During a recent hospitalization for dyspnea, she had been diagnosed with Coombs-positive autoimmune hemolytic anemia and had been taking a tapering dose of prednisone starting approximately 6 weeks prior to admission. In the interim, her dyspnea had resolved on treatment with steroids. At the time of presentation, her prednisone dose was 40 mg. Additional medical history included VTE, for which the patient was receiving anticoagulation therapy, and steroid-induced diabetes mellitus. Many years earlier, she had been treated for TB in her home country. The patient had immigrated to Queens, New York, from a Nepalese village 8 years prior. While still in Nepal, she had worked on a farm and had been in close proximity to cows. In Queens, she lived with her family in a house with a small garden but had no pets. Recent travel included a visit to Nepal 9 months ago and a trip to Syracuse, New York, one month prior to presentation. She was a never smoker and did not consume alcohol.

Idiopathic leukoplakia is a rare potentially malignant lesion, usually found on the tongue with an increased risk of malignant transformation as compared to the tobacco associated form. The risk of malignant transformation increases with age. Diagnosis poses a challenge to the clinician as it is diagnosed by exclusion of other possible causes leading to hyperkeratosis. We present one such rare case in an elderly male patient who was followed up for a year to record the course of the lesion and to report recurrences, if any.

Sarcoidosis is a systemic granulomatous disorder which commonly affects the skin. Involvement of the tongue is rare; a review of the previous literature over the last 30 years revealed only six cases of sarcoidosis affecting the tongue. We studied a case of sarcoidosis involving the tongue in a 32-year-old Japanese woman with characteristic clinical and pathological findings. She visited our department with a complaint of a tongue lesion of which she had been aware for a month. A diagnosis of sarcoidosis was made for the lesion by clinical and pathological examinations. Oral involvement by sarcoidosis is rare, however this disorder should be considered as a possible cause of intraoral granulomatous lesions.

Adenosquamous carcinoma is a rare tumour This tumour is characterised pathologically by the simultaneous presence of distinct areas of adenocarcinoma and squamous cell carcinoma. A 57-year-old woman, who had been treated with neoadjuvant chemotherapy and partial tongue resection for squamous cell carcinoma of the tongue 14 years earlier, presented with a new tongue lesion diagnosed as an adenosquamous carcinoma.

A Spanish-speaking farm worker with type 2 diabetes mellitus presented to our institution with an ulcerating tongue lesion. He was initially evaluated for possible squamous cell carcinoma; however, histologic examination revealed coccidioidomycosis. Coccidioidal titers were elevated and consistent with disseminated disease, although the patient had no systemic symptoms and clinical evaluation was negative. He was ultimately treated with intravenous and oral antifungal medication, which was followed by improvement of his tongue lesion.

A 47-year-old female, presented with 3-month history of rapidly expanding painful nodules on the tongue following trauma (Fig. 96.1). There was no history of drug intake

B S Renal cancers account for about 3% of all adult malignancies, with renal cell carcinoma (RCC) being the most common. RCC has many diverse manifestations often with non-urologic features and few warning signs. Metastatic lesions to the tongue are rare and have been the presenting feature in only 5 cases. We present a case of RCC diagnosed after initial presentation of a tongue lesion in a 72-year-old man. This case is the sixth case of RCC presenting as a tongue metastasis.

OBJECTIVE To present a rare, benign lesion of the oral tongue and its treatment. STUDY DESIGN Case presentation and literature review. METHODS Case report. RESULTS A 68 year old male presented with an asymptomatic lateral oral tongue lesion which had been present for several years. Fine needle aspiration was consistent with pleomorphic adenoma versus myoepithelioma. Pathology following complete surgical excision revealed schwannoma. He remains without recurrence following excision. CONCLUSIONS Oral tongue schwannoma is a rare lesion which is treated with complete surgical excision.

Sarcoidosis is a systemic granulomatous lesion of uncertain etiology. It occurs most frequently with bilateral hilar lymphadenopathy and skin or eye lesions. Oral sarcoidosis is rare, especially in the tongue. We report on a patient with tongue lesion diagnosed as sarcoidosis.

A 67-year-old woman presented with tongue pain, dysphagia, and dysarthria. On examination, an exophytic mass with a whitish surface and multiple papillary projections was seen, involving the right half of the tongue. The tongue showed limited mobility.

A full-term female infant weighing 3.1 kg was delivered by uncomplicated vaginal delivery and required no resuscitation. She was reviewed by the neonatal team soon after birth due to a swollen tongue (figure 1). Figure 1 Cystic tongue lesion. Image taken by the medical photography department at Derriford Hospital. On examination, her tongue was protruding and …