Tongue Swelling and Red Oral Mucosa: Causes and Next Steps - Otolaryngology

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Hello, thank you for your detailed inquiry regarding the issues you are experiencing with your tongue and oral mucosa. Based on the symptoms you've described, including the presence of two raised lesions on your tongue, persistent redness in the oral mucosa, and a family history of lung adenocarcinoma, it's understandable that you are concerned about the underlying causes and potential next steps.

The presence of raised lesions on the tongue, especially if they have been there for an extended period and are not painful, could be indicative of several conditions. These may range from benign lesions such as fibromas or papillomas to more concerning conditions like leukoplakia or even early signs of malignancy. The fact that you have a family history of cancer adds an additional layer of concern, as genetic predispositions can play a significant role in the development of various cancers.

The persistent redness of the oral mucosa could suggest chronic irritation or inflammation, which might be due to several factors, including dietary habits, oral hygiene, or even systemic conditions affecting your immune response. Given that you have undergone various tests, including immunological and rheumatological evaluations, it is essential to consider that some systemic conditions can manifest as oral lesions or mucosal changes.

Regarding your question about whether to proceed with a biopsy, this is often a prudent step when there are persistent lesions that do not resolve over time, especially when there is a concern for malignancy. A biopsy can provide definitive information about the nature of the lesions and help rule out any serious conditions. It is advisable to consult with an oral surgeon or an otolaryngologist (ENT specialist) who can evaluate the lesions and determine if a biopsy is warranted.

As for testing for HPV (Human Papillomavirus), this is particularly relevant if there are concerns about oropharyngeal cancers, which can be associated with certain strains of HPV. Discussing this with your healthcare provider would be beneficial, as they can guide you on the appropriate tests based on your symptoms and medical history.

In terms of additional investigations, it may be worthwhile to consider imaging studies if there are any concerns about deeper structures in the oral cavity or surrounding areas. A CT scan or MRI could provide more insight into any underlying issues that may not be visible during a physical examination.

Lastly, managing stress and anxiety is crucial, especially when dealing with health concerns. Chronic stress can exacerbate physical symptoms and may contribute to a cycle of discomfort and worry. Engaging in stress-reducing activities, such as mindfulness, yoga, or counseling, can be beneficial.

In summary, it is essential to follow up with a specialist who can perform a thorough examination and consider a biopsy of the lesions. Additionally, discussing the possibility of HPV testing and further imaging studies may provide more clarity regarding your symptoms. Your health and peace of mind are paramount, and seeking comprehensive care is the best approach to address your concerns. Thank you for reaching out, and I wish you the best in your health journey.