FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
A 35-YEAR-OLD MAN presented to a community otolaryngologist with a 1-year history of a painless mass on the dorsum of his tongue. He denied dysphagia, odynophagia, otalgia, fatigue, and weight loss. He had a medical history that was significant only for hypertension that was well controlled with lisinopril. He had a 15-year smoking history of 1½ packs of cigarettes per day but denied any alcohol use. There was no family history of lymphoma or head and neck cancer.
On physical examination, there was a 1.1 × 1.2-cm raised, nontender, firm, erythematous lesion on the dorsum of the tongue in the midline, just anterior to the circumvallate papillae (Figure 1). The lesion was surrounded by an area of leukoplakia. The patient had a normal voice and healthy dentition. His tongue displayed normal mobility. The results of the rest of his head and neck examination were unremarkable.
Simons JP, Hunt JL, Johnson JT. Pathology Quiz Case. Arch Otolaryngol Head Neck Surg. 2003;129(1):127. doi:10.1001/archotol.129.1.127