Goodness, gracious, Great Ball Of Acid. Imagine having a spot on your tongue that just won’t go away for half a year, and when finally going to the doctor about it, it turns out to be a very rare disorder – this is what happened to a 72-year-old female patient in a new case report. The patient went into the clinic to evaluate what was going on with her tongue. For six months she'd had a whitish nodule (2 millimeters by 2 millimeters, or less than one-tenth of an inch) appear on the upper surface of the tongue, which was giving her pain when speaking and swallowing. During this time the spot had no changes in color or size. What she had was something called oral focal mucinosis (OFM). This causes a very rare soft-tissue lesion, which is characterized by excessive production of hyaluronic acid. Yes, the same acid that is often put into skincare products. In the body, this acid is often found in the fluids in the eyes and joints, and acts a cushion for other tissues. In people with OFM, hyaluronic acid is produced by the breakdown of connective tissues in the submucosa. The buildup of the fluid is what causes the lump to form. Out of the 100 cases reported in literature, most of the time OFM is found in the hard palate or gums, and it has only ever been documented in the tongue in seven cases. So, it is very rare case. We asked the authors if they have ever seen a case like this before. “No, I have not encountered this before. In fact, when we came across this case, we were unaware of its existence. Subsequently, we conducted a literature search and found some similar cases reported,” Dr. Rosa E. Gómez-Torres, co-author of the paper and dental surgeon at the Research Institute in Dentistry at the University of Guadalajara in Mexico, told IFLScience. This disorder does not have any specific features that can distinguish it from other oral lesions, so to diagnose it the doctors had to get a histology report. An excisional biopsy was performed on the patient, which removed the lesion under anesthetic. When analyzed, they found all the characteristics that led to an OFM diagnosis. Luckily for the patient, the lump had not come back at the 10-month checkup. So, what caused this disorder? The patient did have a previous trauma on the tongue and this may have been the cause, although this reason is controversial to some scientists. “The factors contributing to or associated with OFM remain poorly understood, mainly due to the limited number of reported cases in the literature (roughly 100 cases),” Dr Gómez-Torres told IFLScience. “However, based on the location of the traumatic sites and other molecular factors associated with mucin deposition, we, along with other authors, have speculated that traumatic incidents in the mouth may be related to the development of OFM. Further research is needed to better understand the exact etiology of this condition.” So, if you ever see a lump appearing on your body and you are ever concerned, please go see a doctor. The authors did give us a warning. “The presence of a spontaneous lump in any part of the body, including the mouth, is not normal. If you notice a lump in your mouth, it is advisable to seek consultation with a dermatologist or an odontologist for proper evaluation and diagnosis,” Dr Gómez-Torres told IFLScience. Source
