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Wednesday, April 23, 2014
Dental and Oral Health (Adults)
Painful Marble-Sized Cyst Inside Tongue
For the past 2 days I have had this painful small marble sized cyst inside my tounge about 1/2 inch away from the tip. The firs day it was pea sized now it`s doubled in size. It hurts to talk and eat, or basically do anything that has to do with using my tounge. What could this be and should I be concerne? Years ago I used to use chew tobacco for about a year.
Have you had this evaluated by your primary care provider or dentist? If not, why not?
Without actually seeing the lesion and taking a complete history and doing a thorough exam, I can only hypothesize what is occurring. The tongue is highly vascularized, thus any form of trauma may cause bleeding and you may have a hematoma. There are also salivary glands in the tongue and likewise trauma to the body of the tongue could have affected the ductal system of the gland and thus a resultant swelling that is enlarging can also occur.
Another reported “fluctuant swelling of the tongue” is the “median lingual cyst” or “lingual choriastoma”. Generally, these lesions are very rare and usually occur in infants or neonates. The cause is believed to be congenital anomalies and are epithelial-lined masses that may be fluid filled. The origin of such lesion has been hypothesized to be caused from a developmental defect of the foregut during differentiation (embryological defect).
The question arises if this is a true developmental defect then why now and not as an infant? Because this is an uncommon lesion, a differential diagnosis would also include mucocele (salivary galnd rention cyst), dermoid cyst, epidermoid cyst, duplication cyst (foregut origin), and lingual bronchogenic cyst. (Thyroglossal cyst may be considered, but generally occurs more laterally).
The major problem with these expansive lesions is that they can affect chewing and swallowing, speech, and you can further traumatize them because they are on the dorsum of the tongue. Because of this, I highly recommend that you have it evaluated.
Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University