88-year-old woman presents with a nodular lesion on the dorsum of the tongue. A tentative diagnosis of focal epithelial hyperplasia (FEH) was suggested by the referring dentist. Patient history The patient was not aware of the lesion herself. Medical history revealed thyroiditis, hypertension, bradycardia, angina pectoris and pain from the neck. Medications: levothyroxine, hydrochlorothiazide, acetylsalicylic acid, felodipine and paracetamol. No allergies, non-smoker.
Clinical examination A broad-based nodular lesion on the dorsum of the tongue of approximately 1 cm in diameter (image 1) was evident. The surface was smooth and no inflammatory reaction could be seen in the adjacent tissue. The lesion was solid on palpation and appeared to extend down to the underlying muscle. The clinical appearance was therefore not consistent with a common fibro-epithelial hyperplasia or FEH. The…
