I have those exact bumps on my tongue - a really large one on the right. Starting to get really worried! What happened with the ENT?

quote:

Originally posted by Dr Vinod K Joshi:
Hello Nicole

You are right about the circumvallate papilla being more towards the middle that what the photo shows. It could be a lingual tonsil which are an aggregation of lymphoid tissue that tends to appear at the lateral border (side) in the posterior part of the tongue.

What was the diagnosis?

Best wishes
Vinod

It was a lingual tonsil that was inflamed. I have noticed something new, and it's not the "tongue", but underneath (like the part of the mouth the tongue is attached to). It's below where that growth was, and it's a bump there. It looks a little red. It's not an open sore, but I don't have a "lump/bump" like this on the other site. It doens't hurt, but I'm still worried.

Does mouth cancer usually present like this? What could this be? I'm not asking for a diagnosis, but I am asking for the types of things this could be. Thanks!

It is likely that you are describing the sublingual caruncle, an eminence on either side of the frenulum of the tongue, on which the major sublingual duct and the submandibular duct open. In the anterior portion of the floor of the mouth, under the tongue, on each side are the sublingual plicae or carunculae, slightly raised, cylindrical structures running from the midline to each side and housing openings of the sublingual glands. At the most anterior portion of each is a more raised nodule with an opening to the submandibular gland (Wharton duct).


You may find the descriptions of the normal appearances in the mouth in the article Examination Technique with Normal Findings and Structures Mistaken for Disease helpful. See Figure 1.49.

No, when I say under the tongue, I don't mean under my tongue where the frenum is. I mean at the BACK of the tongue. Whatever the tongue attaches to at the very back of the mouth - that's where this lump is. It's flesh colored. It's like a little lump underneath the skin there. I can feel it, and can see it protruding a little, but there is no open sore or anything. I clearly don't have this on the other side. I'm going to call my ENT and make an appt in the morning.

Could this be an area he stuck a needle into? It's at the back of my mouth where he removed the swollen lingual tonsil, but it's further down, and not on my tongue, per se, but on that thing that attaches the tongue to the mouth (if that makes sense). I'm hoping that maybe it's scar tissue or something from a possible injection of anesthetic? I'm grasping at straws, probably. Just wish I didn't have this thing in my mouth.

quote:

Originally posted by Dr Vinod K Joshi:
It is likely that you are describing the sublingual caruncle, an eminence on either side of the frenulum of the tongue, on which the major sublingual duct and the submandibular duct open. In the anterior portion of the floor of the mouth, under the tongue, on each side are the sublingual plicae or carunculae, slightly raised, cylindrical structures running from the midline to each side and housing openings of the sublingual glands. At the most anterior portion of each is a more raised nodule with an opening to the submandibular gland (Wharton duct).


You may find the descriptions of the normal appearances in the mouth in the article Examination Technique with Normal Findings and Structures Mistaken for Disease helpful. See Figure 1.49.

Here are some pics:


By ssttuu at 2009-12-13


By ssttuu at 2009-12-13


By ssttuu at 2009-12-13

It's weird b/c when I push up under it, it looks different. It's feels kind of firm, but not "solid". I THINK it moves in there, which I THINK is a good sign? I don't know. I'm wondering if this has anything to do with my swollen lingual tonsil? Obviously, I worry about the big C.

So tired of these darn bumps in my mouth!

Hello Nicole

I suspect something very innocent like a minor salivary gland mucous retention cyst. Let us know what your specialist says.

Best wishes
Vinod

So I went to the doc on 12/15. He was caught up in surgery, so I saw a PA. This guy freaked me out. He seemed to be new to what he was doing too. Anyway, he didn't know what it was. Finally my ENT came in. He looked at it for 5 seconds and said, "It's nothing." When I asked him what it was, he reapeated that it was "nothing". I know it's SOMETHING, whether it's good or bad, but I couldn't get an answer. He seemed very unconcerned, but I'm not the type of patient to just take "nothing" for an answer. I want to believe it's nothing, but I need more info than that. If it's some structure in my tongue, I want to know what it is. Whatever it is, it has a name.

I have an appt for a 2nd opinion tomorrow morning. I'm so worried about this. I have no confidence in my other ENT at all. First off, when I went to have the swollen lingual tonsil tissue removed, he removed two circumvallate papillae INSTEAD of the thing he was SUPPOSED to remove. So then I had to go back two days later to get THAT removed. He did biopsy it, and it was fine. But it made me lose confidence, which I think is understandable.

The lump hasn't gotten any larger, but it feels kind of firm, and it's worrying me. I was going to wait til after Xmas to go to the doc b/c I was afraid of getting bad news before Xmas, but I'll just worry myself anyway. Please say a prayer for me.

Oh, Dr. Joshi, when I asked the PA if it could be a salivary gland muscous retention cyst, he said no. He said something like that would only appear on my tongue. I didn't even get a chance to ask my ENT about it.

So, if it is a cyst like you suspect, what do you do to get rid of it? And how can it be diagnosed?

Hi Nicole

Sorry that you're not getting the answers that you need. It might seem like jumping the gun, would it be possible for your doctors to get you a referral to a head & neck cancer specialist? Or perhaps to an ENT at a teaching hospital?

Please don't go to tomorrow's appointment alone.

Julia

quote:

Originally posted by Julia:
Hi Nicole

Sorry that you're not getting the answers that you need. It might seem like jumping the gun, would it be possible for your doctors to get you a referral to a head & neck cancer specialist? Or perhaps to an ENT at a teaching hospital?

Please don't go to tomorrow's appointment alone.

Julia

Thanks for the response, Julia. To be honest, making an appt with a cancer doc freaks me out. I want to find out what it is before I do that. If I don't get an answer tomorrow, or at least get on the road to an answer (i.e., appt for some sort of test or biopsy), I will look into it.

Do you guys recommend seeing an ENT for this, or an oral surgeon? I'm reading conflicting things on the internet about which doc would be best. I already have an appt with an ENT tomorrow, but would an oral surgeon be the better choice?

Hi Nicole

Sorry. I didn't mean to freak you out with my suggestion.

With the exception of a nurse practitioner, the only doctors I've seen have been ENT's. My main doc is also a h&n specialist, and I've had nothing but good luck with him. I've never been to an oral surgeon, so I can't say which is better for this situation.

Let us know how things turn out.

Julia

quote:

Oh, Dr. Joshi, when I asked the PA if it could be a salivary gland muscous retention cyst, he said no. He said something like that would only appear on my tongue. I didn't even get a chance to ask my ENT about it.

So, if it is a cyst like you suspect, what do you do to get rid of it? And how can it be diagnosed?

The oral mucosa is full of minor salivary glands and your lesion's clinical appearance shows it to be filled with fluid, hence my suggestion of 'a mucous retention cyst'. The only way to confirm a diagnosis is by biopsy. It probably is 'nothing'(to be worried about) but just difficult for your ENT to be specific about.