Mysterious Tongue Lump: Unraveling the Enigma of Rare Oral Focal Mucinosis
A peculiar lump that gradually grew on a woman’s tongue over six months has left medical experts puzzled, as it resulted from an unusual accumulation of goo in the mouth with an unknown cause, according to her doctors’ report.
Published in The American Journal of Dermatopathology, the case report narrates the woman’s experience with oral focal mucinosis (OFM), an uncommon connective tissue disorder that typically leads to the formation of masses on the gums or hard palate. The occurrence of OFM on the tongue is even rarer, making this case unique.
In OFM, specific areas of the mouth experience a breakdown of normal connective tissue, replaced by a gelatinous, mucus-like substance—hyaluronic acid. This overproduction of hyaluronic acid results in a buildup, giving rise to a lump.
In this particular case, a 72-year-old woman from Mexico sought medical attention after enduring a lump on the top of her tongue for half a year.
The lump caused discomfort and pain while speaking and swallowing. The doctors easily identified the small, white lump, measuring approximately 0.8 by 0.8 inches (2 by 2 millimeters).
The typical treatment for OFM involves surgical removal of the lump followed by monitoring to ensure it does not recur. Thankfully, the condition is benign and poses no risk of cancer.
In this woman’s case, doctors successfully removed the tongue lump under local anesthesia, and it did not return after 10 months of observation.
While OFM has been described in medical literature since 1974, only around 100 cases have been formally documented. Among these, only seven have affected the tongue.
Scientists have postulated that the production of hyaluronic acid could be triggered as a response to some form of physical trauma. This theory is supported by the fact that mucins, including hyaluronic acid, can be produced in response to inflammatory molecules called cytokines, which are released after tissue injury.
Moreover, mucins possess anti-inflammatory properties that may aid in tissue repair by mitigating inflammation.
Interestingly, the woman in this case had reported a prior tongue injury before the formation of the troubling lump. However, the notion that OFM may be linked to trauma on the gums, hard palate, or tongue remains a subject of controversy.
Despite extensive research, understanding the development of OFM remains elusive. Nonetheless, the potential role of mucin in inflammatory signaling is captivating and warrants further investigation.