Hemilingual Angioedema after Thrombolysis in a Patient on an Angiotensin II Receptor Blocker.

Orolingual angioedema (OLAE) is a rare adverse effect of alteplase. Previous studies have associated the occurrence of OLAE with thrombolysed patients maintained on angiotensin converting enzyme inhibitors. We report a case of a 60-year-old male presenting with hyperacute ischemic stroke developing hemilingual edema after thrombolysis. He was previously maintained on an angiotensin II receptor blocker (ARB), losartan. The swelling resolved over 2 days with immediate administration of intravenous steroids and antihistamine drugs. Our case is the third documented case of OLAE occurring in a thrombolysed patient concurrently taking an ARB. The presence of hemilingual edema in a post-thrombolysis patient maintained on losartan suggests a possible association between OLAE and ARBs.

Persistent untreated Riga-Fede disease for 6 years.

Riga-Fede disease is an uncommon, benign, ulcerative condition due to dental trauma that can occur at any age. A 9-year-old boy with a painful tongue is presented. Physicians need to recognize Riga-Fede disease and Riga-Fede-like disease to intervene early.

Platyhelminthes in tongue--a rare case and review.

Humans are the only known definitive host of the tapeworm Taenia solium and become a carrier by eating undercooked pork contaminated with "Cysticercus cellulosae" (cysticerci). Pigs act as an intermediate host and acquire cysticercosis by ingestion of eggs or proglottids from human feces, which develop into cysticerci within tissue, mostly without causing clinical symptoms in the host. Cysticercosis occurs in humans in a context of "fecal peril" by ingestion of egg-contaminated soil, water, vegetation, or auto-infestation. It has been reported in the published data that the separation of swine from humans, healthy cooking, and hygienic practices would lead to the eradication of the disease. However, cysticercosis is still a major public health problem in endemic regions, with more than 50 million infected people and is now a re-emerging disease in industrialized countries owing to human migration. It is the second most common cause of seizures in tropical countries. We report a case of oral cysticercosis in a 28-year-old woman who presented with a painless swelling in the ventral portion of the tongue. An excisional biopsy was performed, and histopathologic examination revealed a cystic cavity containing the tapeworm.

[Ectopic thyroid: a report of a case and review of the literature]. / Ectopie thyroïdienne: à propos d'un cas et revue de la littérature.

Ectopic thyroid is the presence of thyroid tissue outside its normal cervical seat. It results from abnormal embryological development. We report the case of an ectopic lingual thyroid found during maneuvers of intubation in a patient of 56 years old. The examination found a rhonchopathy with sleep apnea syndrome and sleep in a sitting position. Endoscopy showed a posterior lingual tumour. The cervical echography showed an absent thyroid in the normal place. Scintigraphy, computed tomography and magnetic resonance imaging confirmed the diagnosis of ectopic lingual thyroid position. The treatment consisted of surgical excision by cervical route after a safety tracheotomy.

[Application of endovascular methods in complex diagnostics and treatment of tongue angiodysplasias].

In article experience of diagnostics and treatment of 30 patients with angiodysplasia of the tongue was given. The surgical treatment was made to 21 patients with vascular malformation of the tongue, selective bilateral catheterization of lingual arteries and endovascular microembolization by PVA - 250-400 µ was successfully performed in 4 cases, transcutaneus sclerotherapy with solution aethoxyskleroli 0,5% in 3 cases was successfully provided. Advantages of endovascular diagnostics and treatment methods angiodysplasias of the tongue were shown.

Highly effective treatment with tacrolimus ointment in an adolescent with oral graft-versus-host disease.

CASE: We report a case of acute oral graft-versus-host disease in an adolescent, which was successfully treated with tacrolimus 0.1% ointment. CONCLUSION: Although tacrolimus ointment is not licensed for the indication of oral GvHD, this case report provides preliminary evidence for a potential effectiveness of using tacrolimus in case of failure when GvHD is resistant.

[Unilateral tongue atrophy and articulation difficulties]. / Einseitige Zungenatrophie und Artikulationsschwierigkeiten.

A 24-year-old female complained of difficulty articulating and chewing of 2 more than weeks' standing. She reported that her tongue felt "heavy and inert". Clinically, right-sided atrophy of the tongue and deflection of the tongue to the right were observed. Tone audiogram demonstrated normal hearing on both sides and tympanometry was also normal. On CT, a bone-destroying process was seen in the area of the right lateral skull base, which reached as far as the internal carotid artery. MRI demonstrated atrophy of the right tongue musculature with fatty degeneration, as well as an oval, smoothly edged lesion which showed marked contrast-medium uptake with a "salt and pepper" configuration in the region of the right jugular foramen. The diagnosis was hypoglossal paresis due to ipsilateral jugular paraganglioma (Fisch classification C1). Following embolization of the feeding vessels of the paraganglioma, the tumor was completely resected, including the hypoglossal nerve which ran through the tumor. Postoperative dysfunction of the vagus and facial nerves became unsymptomatic with time as a result of logopedic therapy.

Oral lichen planus in childhood: A rare case report.

Oral lichen planus is a cell-mediated immune condition and is infrequently encountered in children, with a prevalence of about 0.03 percent in childhood. Reports of oral lichen planus affecting children are scarce in the literature. The purpose of this article is to present a rare case of oral lichen planus affecting a seven-year-old child without concomitant cutaneous lesions. Intraoral lesions and associated mild discomfort treated with topical corticosteroid therapy and a plaque control regime resulted in a favorable result.

Vallecular cyst: a dangerous cause of failure to thrive in infants.

A 2-month-old full-term female infant with medical history of situs inversus totalis presented to the emergency department with congestion and abnormal breathing. She was discovered to have failure to thrive (FTT) and subsequently admitted. Investigations revealed a large vallecular mass at the base of her tongue which was noted to cause severe, intermittent airway obstruction. The mass underwent marsupialisation by otolaryngology (ENT) and pathology confirmed a diagnosis of vallecular cyst. The patient made a full recovery and is now growing and thriving. This case emphasises the need to consider anatomic airway abnormalities in the differential diagnosis of young infants with the constellation of respiratory symptoms and FTT. Such airway abnormalities can cause life-threatening airway obstruction if not discovered.

Neck-tongue syndrome.

Two patients with neck-tongue syndrome, a rare disorder of the upper cervical nerves that results in paroxysmal neck pain and paresthesia of the tongue, are described. Signs are the result of compression of the C2 root by disorders affecting the first two cervical vertebrae. Conservative management is effective in most cases if no masses are in the involved area. The disorder has been observed rarely in children. Clinical onset occurred at 6 and 11 years of age, respectively, in the reported patients.

A case of sarcoidosis involving the tongue.

Sarcoidosis is a systemic granulomatous disorder which commonly affects the skin. Involvement of the tongue is rare; a review of the previous literature over the last 30 years revealed only six cases of sarcoidosis affecting the tongue. We studied a case of sarcoidosis involving the tongue in a 32-year-old Japanese woman with characteristic clinical and pathological findings. She visited our department with a complaint of a tongue lesion of which she had been aware for a month. A diagnosis of sarcoidosis was made for the lesion by clinical and pathological examinations. Oral involvement by sarcoidosis is rare, however this disorder should be considered as a possible cause of intraoral granulomatous lesions.

Dual ectopic thyroid: report of a case.

Dual ectopic thyroid is very rare. We report a case of dual ectopic thyroid in the lingual and infrahyoid areas in a 20-year-old female patient with no thyroid gland in its normal anatomical location. On physical examination, there was a 7 x 5 cm anterior midline neck swelling just below the hyoid bone and a 2 x 2 cm mass in the base of the tongue. Triiodothyronine (T(3)), thyroxine (T(4)), and thyroid-stimulating hormone (TSH) levels were normal. A thyroid scan with technetium-99m sodium pertechnate confirmed dual ectopic thyroid with no iodine uptake in the normal anatomical location of the thyroid gland. The infrahyoid ectopic thyroid was surgically removed for cosmetic reasons, and the lingual thyroid, which was symptomatic, was left untouched. The importance of thyroid scanning in the evaluation of anterior midline neck swellings and treatment options are discussed.