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Discussion in 'Spot Diagnosis' started by bb100, Apr 18, 2013.

  1. bb100

    bb100 Bronze Member

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    What is your medical diagnosis?

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  2. neo_star

    neo_star Moderator

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    huge fleshy mass on tongue....can't be just plain macroglossia or hypthyroidism. Looks more like a tumor.

    Differentials

    1) lymphangioma
    2) rhabdomyosarcoma
    3) fibromatosis

    Xtra edge

    Congenital rhabdomyosarcoma of the tongue is exceedingly rare. Fibromatosis of the tongue is also rare, and very difficult to distinguish from the spindle cell variant of rhabdomyosarcoma. Both appear histologically as spindle neoplasms replacing normal striated musculature of the tongue. The treatment protocol for the former has been developed by the Intergroup Rhabdomyosarcoma Studies (IRS) I–IV and requires surgery, radiation, and chemotherapy. For fibromatosis, complete surgical excision is usually adequate without additional therapy, although some cases of aggressive fibromatosis also require chemotherapy. With significant differences in appropriate treatment and prognosis, each entity must not be mistaken for the other. We review the differences in radiologic, histologic, and immunohistochemical (IHC) features of both entities.

    ref - http://www.sciencedirect.com/science/article/pii/S0165587610001722
     

    Last edited: Apr 19, 2013
  3. Hasan

    Hasan Bronze Member

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    Rhabdomyosarcoma most likely
     

  4. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    I think so, imponate to rhabdomyosarcoma.
     

  5. bb100

    bb100 Bronze Member

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    Correct diagnosis :
    Enlarged protruding tongue- This may be associated with a tumor such as a teratoma or may occur as part of an organomegaly syndrome (Beckwith—Wiedemann). Beckwith—Wiedemann syndrome is associated with omphalocele, macroglossia gigantism, pancreatic hyperplasia . There is an increased incidence of Wilms’ tumors and hepatoblastomas.
     

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