American Medical Association Family Medical Guide - American Medical Association [483]
Tumors of the Mouth or Tongue
Tumors of the mouth or tongue are rare, usually slow-growing, single lumps that may be either benign (noncancerous) or malignant (cancerous; see page 126). A tumor can grow undetected for months and, in rare cases, years. Cancerous tumors of the mouth are rare in people under age 40, except for people who smoke. Oral cancer is most common in people over 60, especially those who smoke cigarettes, pipes, or cigars or who use smokeless tobacco, or who drink alcohol excessively. The risk increases even more when a person both uses tobacco and drinks alcohol excessively.
Symptoms
Both noncancerous and cancerous tumors of the mouth usually start as small, pale, painless lumps. Depending on their size and location, tumors of the mouth may rupture easily and bleed extensively, distort the face, cause fitting problems with dentures and other dental appliances, and make eating, swallowing, and speaking difficult. At first, cancerous tumors of the tongue can make the tongue muscles stiff and difficult to move. A cancerous tumor usually turns into a sore with a hard, raised rim and a fragile center that bleeds easily. The tumor grows and erodes the surrounding area. If a tumor gets very large or is in an awkward location, it can cause pain. See your doctor about any sore or swelling in your mouth that recurs or that doesn’t heal within 2 weeks.
Diagnosis
If you have symptoms of a tumor of the mouth or tongue, your doctor will recommend a biopsy (in which samples of cells taken from the tumor are examined under a microscope) to determine if the tumor is cancerous.
Treatment
The treatment of a tumor in the mouth depends on its cause and location. A noncancerous tumor that is not disfiguring or causing problems is usually not treated, although your doctor will check it every 6 months or at least once a year. Any growth or change in a tumor may indicate cancer.
Successful treatment of cancerous tumors depends on the stage of the cancer. Cases that are diagnosed and treated in an early stage are usually cured. If the tumor is in an early stage and the cancer has not spread, a surgeon can remove it. If the tumor is large or has spread, your doctor will order radiation therapy (see page 23), with or without surgery, in combination with chemotherapy (see page 23).
Early diagnosis is more likely to result in treatment that is less disfiguring and less likely to cause speech or swallowing problems. A surgeon can remove disfiguring tumors. If the tumor is on the lips, he or she can reconstruct them. If the tumor is on the gums, special dentures can restore the gums’ natural appearance.
Glossitis and Geographic Tongue
Glossitis refers to general inflammation of the tongue. Geographic tongue is a specific inflammatory disorder of the tongue in which the papillae (tiny hairlike projections known as taste buds) are deformed and cover only part of the tongue. Glossitis can result from an infection, an injury, a vitamin deficiency (especially a vitamin B12 deficiency), or an allergic reaction. The cause of geographic tongue is unknown.
Symptoms
In both glossitis and geographic tongue, the tongue is dark red, smooth (a healthy tongue is pink and bumpy) and sore (especially after eating spicy food). Geographic tongue produces a maplike appearance on the tongue, and the pattern changes from day to day. Geographic tongue usually affects smaller areas of the tongue than glossitis, and the symptoms come and go.
Diagnosis and Treatment
A doctor can diagnose geographic tongue by its appearance, but there is no known treatment for the condition. Treating the underlying cause of glossitis, such as an infection or vitamin deficiency, may clear it up. To help relieve soreness, avoid eating hot or spicy food, drinking alcohol, smoking cigarettes, or chewing tobacco.
Geographic tongue
In geographic