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#1278 06-03-2003 01:40 PM
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I haven't posted since last August. At that time I had a growth on the base of the tongue that after biopsy turned out to be benign tonsil tissue (havent had tonsils since I was 7 and dont know how it got on my tongue) but was happy for result. Beginning in Jan, my tongue started burning, then got red areas with white borders on the tip mostly. Very uncomfortable, Went back to ENT said was geographic tongue. Went numerous times because left side of tongue became inflamed and had one area that was really raw. He treated with topical steriods, topical antibiotic and even prednisone..the prednisone helped the tip of tongue but not the sides. He said he thought I needed a guard for my teeth to keep my tongue from the irritation. I got 2 little outcroppings finally in the very back left side and a little circular white area a little further up. He still said inflamation and not to worry. Went to the dentist for the night guard and he was very abrupt and rude. He refused the guard and said "this looks bad"...."it isnt your teeth...you should have had biopsies"...long story short went to the ENT in tears. He ordered the biopsies although he said the dentist was out of line but since this had been going on for 6 months biopsy probably would be the prudent thing. He calle today and said it was not cancer...biopsy showed "chronic inflammation". Here are my questions....has anyone on here heard of this...? Its on the same side as the base of tongue growth....is it possible that that biopsy could have missed cancer and it is spreading inside my tongue but isnt showing up on these outside areas of inflammation? If it had been cancer from last August would I have other symptoms by now? Should I just quit worrying after 2 biopsies (actually this last one he biopsied 4 areas on the side of my tongue.)That area just feels inflammed all the time...bigger than the other side and not really a pain but a sensation. Can anyone relate? Sorry for the long post.

#1279 06-04-2003 10:25 AM
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First let me say the geographic tongue is not a cancer. And IF this particular diagnosis is correct, geographic tongue has not been shown to be a precancer. The tongue is covered on its dorsum (top side) with papilla, thousands of them. The tip of each individual papilla is cornified or hardened. When a person develops this condition, the hard tips are desqamified, or lost. But this does not happen to all the papilla uniformly on the tongue. The areas of focal, massive erythema where this is occurring contrast with the adjacent papilla which are not participating in the process (are normal), forming patterns on the tongue. Hence the name geographic tongue since it is rather map like when you look at it. The contrast between the two areas is intensified because a whitish or white yellow boarder develops around the edges of the process. As time passes, the papilla which have been effected regenerate the their tips, but at the same time other areas become affected, so the pattern is constantly changing. Some people call these wandering lesions or plaques.

The duration of the condition cannot be predicted. It can last for weeks, months, years, and then resolve suddenly, and possibly reoccur again. The causes of this condition (its etiology) are unknown, and none of the suggested causes (such as psychologic, neurohumoral or genetic) have clear-cut proof that they are the cause. There is no cure or treatment for this condition, except to treat the discomfort that is associated with it. Individuals who have geographic tongue need to remember that it is (while uncomfortable) a harmless condition and should not over treated with various medications that will offer no cure. Increased self-observations can lead to cancerphobia.

Obviously it is important that this diagnosis be made by a clinical oral pathologist least a more serious condition go undiagnosed. They need to be sure that it is not other things such as various forms of leukoplakias, and trophoneurologial changes to the surface of the tongue.

If this is indeed the correct diagnosis, the dentist who stressed everyone out regarding biopsy, has obviously had a limited exposure to this condition, though it is relatively common. On the other hand biopsy of something that has persisted for any length of time is prudent and hurts nothing. A biopsy of geographic tongue would probably show


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
#1280 06-04-2003 03:13 PM
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Thanks for the information. I just have read so many posts regarding doctors missing a diagnosis and even with biopsies missing it that I think I do have oral cancerphobia already. That base of the tongue growth started this paranoia and I cant seem to get past it due to these constant new bumps and ulcers that keep coming up. I'll try to quit worrying. Just one more question..has anyone heard of cancer being so deep inside the tongue that biopsies dont show it?

#1281 06-04-2003 05:12 PM
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Don't just quit worrying, that is not what I suggested. You are making the assumption that the first doctor was 100% correct, and you have stated that the issue of misdiagnosis weighs on you. If you want piece of mind, go to an oral pathologist, an EXPERT, to be sure what's what. The answer to your new question is yes, cancers can start within the muscle mass, but that is not their usual MO. Part of a proper oral cancer screening involves feeling the tongue, particularly the edges of it, for hardened areas. These sometimes can be mailignancies. Now don't just run your fingers over your tongue and decide that you do, or do not have a hard spot... it takes trained fingers with experience behind them to know what they are feeling!!! Let an expert give you a diagnosis you can live with. Call for an appointment and be sure.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.

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