Clinicopathologic Conference| Volume 127, ISSUE 2, P92-96, February 2019

Download started.


An ulcer on the ventral tip of tongue

Published:February 09, 2018DOI:
      A 55-year-old male patient was referred to our department with the chief complaint of a painful and nonhealing ulcer of 1-month duration in the ventral tip of the tongue. He also complained of difficulty chewing and swallowing. The patient smoked 20 cigarettes per day for 15 years. The patient reported unintentional weight loss of 4 lb during the last 2 months and presented an unproductive cough lasting for 5 years, considered a complication of his smoking habit. Additional past medical and surgical histories were unremarkable. Extraoral examination revealed a localized, fixed, cervical lymphadenopathy on the right side, involving the submental and submandibular areas. The intraoral examination revealed a horseshoe-shaped gray-white ulcer with an erythematous thickened posterior border on the ventral tip of the tongue. The lesion measured 2 × 4 cm and was of a firm consistency (Figure 1A). The remaining part of the tongue was normal in texture and color. The mobility of the tongue was normal.
      Fig. 1
      Fig. 1The clinical aspects of the patient's tongue before and after treatment. A, Pretreatment lesion showing a gray-white ulcerated lesion with irregular margins and whitish patch on the ventral tip of the tongue. B, Post-treatment image showing healing of the lesion.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Fang Q.G.
        • Shi S.
        • Li Z.N.
        • et al.
        Squamous cell carcinoma of the buccal mucosa: analysis of clinical presentation, outcome and prognostic factors.
        Mol Clin Oncol. 2013; 1: 531-534
        • Dos Santos Costa S.F.
        • Brennan P.A.
        • Gomez R.S.
        • et al.
        Molecular basis of oral squamous cell carcinoma in young patients: is it any different from older patients?.
        J Oral Pathol Med. 2017; ([Epub ahead of print])
        • Pontes F.S.
        • Carneiro Jr, J.T.
        • Fonseca F.P.
        • et al.
        Squamous cell carcinoma of the tongue and floor of the mouth: analysis of survival rate and independent prognostic factors in the Amazon region.
        J Craniofac Surg. 2011; 22: 925-930
        • Thiagarajan S.
        • Nair S.
        • Nair D.
        • et al.
        Predictors of prognosis for squamous cell carcinoma of oral tongue.
        J Surg Oncol. 2014; 109: 639-644
        • Strieder L.R.
        • León J.E.
        • Carvalho Y.R.
        • Kaminagakura E.
        Oral syphilis: report of three cases and characterization of the inflammatory cells.
        Ann Diagn Pathol. 2015; 19: 76-80
        • Leuci S.
        • Martina S.
        • Adamo D.
        • et al.
        Oral syphilis: a retrospective analysis of 12 cases and a review of the literature.
        Oral Dis. 2013; 19: 738-746
        • de Paulo L.F.
        • Servato J.P.
        • Oliveira M.T.
        • Durighetto Jr, A.F.
        • Zanetta-Barbosa D.
        Oral manifestations of secondary syphilis.
        Int J Infect Dis. 2015; 35: 40-42
        • Singhaniya S.B.
        • Barpande S.R.
        • Bhavthankar J.D.
        Oral TB in an asymptomatic pulmonary tuberculosis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111: e8-e10
        • Chiesa Estomba C.M.
        • Betances Reinoso F.A.
        • Rivera Schmitz T.
        • et al.
        Head and neck tuberculosis: 6-year retrospective study.
        Acta Otorrinolaringol. 2016; 67: 9-14
        • Krawiecka E.
        • Szponar E.
        Tuberculosis of the oral cavity: an uncommon but still a live issue.
        Postepy Dermatol Alergol. 2015; 32: 302
        • Pedreira Rdo P.
        • Guimarães E.P.
        • de Carli M.L.
        • et al.
        Paracoccidioidomycosis mimicking squamous cell carcinoma on the dorsum of the tongue and review of published literature.
        Mycopathologia. 2014; 177: 325-329
        • Trindade A.H.
        • Meira H.C.
        • Pereira I.F.
        • et al.
        Oral paracoccidioidomycosis: retrospective analysis of 55 Brazilian patients.
        Mycoses. 2017; 60: 521-525
        • Wang W.C.
        • Chen J.Y.
        • Chen Y.K.
        • Lin L.M.
        Tuberculosis of the head and neck: a review of 20 cases.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 381-386
        • Khateeb D.
        • Kang M.
        • Capitle E.
        • Feurdean M.
        Oral TB: a rare manifestation of disseminated disease in a patient with dermatomyositis on chronic corticosteroids.
        Case Rep Med. 2016; 2016: 8193178
        • Kumar S.
        • Sen R.
        • Rawal A.
        • et al.
        Primary lingual tuberculosis in an immunocompetent patient: a case report.
        Head Neck Pathol. 2010; 4: 178-180
        • Ganesan V.
        • Mandal J.
        Primary oral TB in a patient with lepromatous leprosy: diagnostic dilemma.
        Int J Mycobacteriol. 2016; 5: 102-105
        • Bhatia R.
        • Mahajan R.
        • Arava S.
        • Singh S.
        • Kandasamy D.
        A non-healing oral ulcer as a manifestation of systemic tuberculosis in an immunocompetent man.
        Indian J Dermatol Venereol Leprol. 2017; 83: 238-241
        • Khuzwayo Z.B.
        • Naidu T.K.
        Head and neck tuberculosis in KwaZulu-Natal South Africa.
        J Laryngol Otol. 2014; 128: 86-90
        • De Souza B.C.
        • De Lemos V.M.A.
        • Munerato M.C.
        Oral manifestation of tuberculosis: a case-report.
        Braz J Infect Dis. 2016; 20: 210-213
        • Lambor S.D.
        • Lambor D.V.
        • Nayak S.S.R.
        • Naik A.D.
        Primary oropharyngeal tuberculosis—a differential diagnosis to malignancy.
        Int J Otolaryngol Head and Neck Surg. 2014; 3: 128
        • Yashveer J.K.
        • Kirti Y.K.
        Presentations and challenges in tuberculosis of head and neck region.
        Indian J Otolaryngol Head Neck Surg. 2016; 68: 270-274
        • Jain P.
        • Jain I.
        Oral manifestations of tuberculosis: step towards early diagnosis.
        J Clin Diagn Res. 2014; 8 (ZE18-ZE12)
        • Parajuli R.
        • Maharjan S.
        Tubercular ulcer of tongue in an elderly patient masquerading as a traumatic ulcer.
        Case Rep Otolaryngol. 2017; 2017: 8416963
        • McIlleron H.
        • Wash P.
        • Burger A.
        • et al.
        Determinants of rifampin, isoniazid, pyrazinamide, and ethambutol pharmacokinetics in a cohort of tuberculosis patients.
        Antimicrob Agents Chemother. 2006; 50: 1170-1177