Tongue Granulomas: Are They Tumors and What to Expect?

Lingual granuloma

Hello, I previously discovered a raised lump on the side of my tongue, approximately one centimeter in size.
After a biopsy in the outpatient clinic, it was suspected to be something concerning.
Subsequently, I underwent laser excision, and upon follow-up, the doctor said it was a granuloma.
Is this a tumor? Is it benign or malignant? Why was there a discrepancy between the biopsy results and the final diagnosis? What could be the cause? Is there a possibility of recurrence? Thank you for your response.

Chen, 30~39 year old female. Ask Date: 2012/04/20

Dr. Zheng Jueyi reply Otolaryngology

Dear Chen,
Hello.
Granulomas are a type of benign tumor, often caused by repeated infections or friction, commonly resulting from dental abrasion.
If you frequently bite the same area or experience ulcers, it is advisable to have a dental examination to assess the condition of your teeth and prevent the recurrence of granulomas.
However, if the wound does not improve or if pain persists, a biopsy may be necessary for confirmation.
Wishing you peace and health.
Sincerely,
Dr.
Jue-Yi Cheng
Attending Physician, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2012/04/20

More Info

Granulomas are a type of inflammatory response that can occur in various tissues, including the tongue. They are not classified as tumors in the traditional sense, as tumors typically refer to abnormal growths of cells that can be benign (non-cancerous) or malignant (cancerous). Granulomas are generally considered benign lesions, and they arise as a result of the body’s immune response to various stimuli, such as infections, foreign substances, or autoimmune conditions.

In your case, the presence of a granuloma on the side of your tongue suggests that your body was reacting to some form of irritation or injury. Common causes of tongue granulomas include chronic irritation from dental appliances, trauma, infections, or even certain systemic diseases. The fact that your doctor performed a biopsy and the results indicated a granuloma means that the tissue was examined under a microscope, and the findings were consistent with this type of inflammatory response.

It is important to note that granulomas can sometimes be confused with neoplastic processes (tumors) because they can present as masses or lumps. However, the key difference lies in their nature: granulomas are not proliferative in the same way that tumors are. They do not exhibit the uncontrolled growth characteristic of cancerous cells.

Regarding the concern about the biopsy results being inconsistent, it is possible for initial clinical impressions to differ from histopathological findings. This can happen due to the complexity of tissue responses and the need for careful examination by a pathologist. In some cases, additional tests or a second opinion may be warranted if there is still uncertainty about the diagnosis.

As for the possibility of recurrence, granulomas can recur, especially if the underlying cause of irritation or inflammation persists. For example, if the granuloma was caused by chronic irritation from a dental appliance, it may return if the appliance is still in place. However, many granulomas resolve completely after appropriate treatment, such as surgical excision or laser removal, and do not come back.

In summary, tongue granulomas are benign inflammatory lesions rather than tumors. They arise from the body’s immune response to various stimuli and are not indicative of cancer. While there is a possibility of recurrence, especially if the underlying cause is not addressed, many patients experience resolution after treatment. If you have ongoing concerns or symptoms, it is advisable to maintain regular follow-ups with your healthcare provider to monitor your condition and address any new developments.

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