[GLOSSALGIA SYNDROME AS SUPRAESOPHAGEAL MANIFESTATION OF GASTROESOPHAGEAL REFLUX DISEASE].

The case of clinical supervision of the patient having polimorbid pathology is presented. One of extraesophageal manifestations of a gastroesophageal reflux disease is the glossalgia. Glossalgia is the polyetiological disease. Treatment needs to be carried out taking into account the factors causing emergence of a glossalgia. In this regard normalization of functions of organs and systems of an organism is provided.

Glossodynia and coeliac disease.

Coeliac disease is an immune-mediated chronic inflammatory disorder of the small bowel caused by irritant gluten and, possibly, other environmental cofactors, in genetically prone people. Coeliac disease is characterized by no (or elusive or varied) symptoms. Oral clinical settings include aphthous stomatitis and dental enamel defects. Association with other signs in the oral mucosa (such as, for example, soreness, a burning sensation, erythema or atrophy) is much less common and, often, not considered by clinicians. We report on a 72-year-old woman with a four months history of oral burning sensation as a single clinical manifestation of coeliac disease. Clinical presentation and symptomatology are discussed in relation to the differential diagnosis of oral glossodynia. This case history highlights the importance of considering coeliac disease in managing cases of idiopathic glossodynia.

Unilateral glossodynia as a harbinger of an occult cerebellopontine angle tumour.

A woman in her late 80s with severe bronchomalacia was referred to a tertiary orofacial pain clinic for unexplained right unilateral glossodynia of progressive and continuous evolution for the past 8 months, spreading to the ipsilateral labiomental region, associated with ipsilateral hypoacusia. Local and general clinical examinations were unremarkable and routine blood work could not reveal any underlying systemic disease explaining the glossodynia and burning/pricking labiomental pain. Suspecting a painful trigeminal neuropathy secondary to a space-occupying lesion, a cerebral MRI was prescribed, revealing an ipsilateral cerebellopontine angle lesion, compatible with either a schwannoma or meningioma. This lesion invaded the root entry zones of cranial nerves V and VIII explaining the patient's oral pain and hypoacusia. Following a neurosurgical consultation where surgical treatment was rejected, her pain was successfully managed by topical pregabalin mouthwashes, to prevent any risk of respiratory depression related to her underlying severe bronchomalacia.

Metastatic gastric adenocarcinoma of the tongue with initial symptoms of glossodynia.

A 60-year-old woman presented to our department with severe tongue pain. On initial examination, the mucosal surface of the tongue was intact but a hard submucosal mass on the dorsum of the tongue was detected on palpation. Magnetic resonance imaging demonstrated an ill-defined tumor in the intrinsic tongue muscles. Sequential whole-body positron emission tomography/computed tomography revealed a tumor of the pancreas apart from the tongue lesion, and upper gastrointestinal endoscopy revealed gastric mucosa ulceration. On biopsy, the tongue lesion was confirmed to be metastatic gastric adenocarcinoma, and the gastric ulcer was simultaneously diagnosed as poorly differentiated gastric adenocarcinoma. The definitive diagnosis was thus gastric adenocarcinoma and synchronous pancreatic cancer, with gastric carcinoma metastases to the tongue. We administered FOLFIRINOX treatment for pancreatic cancer and FLTAX treatment for gastric cancer. Because of difficulty with oral intake due to the growth of the tongue lesion, we administered palliative radiation therapy at a dose of 30 Gy in 10 fractions following which the patient was able to resume oral intake and was satisfied with this outcome. She died 8 months after her first visit to our department.

Diseases of the oral mucosa in the aged patient.

A wide variety of diseases of the oral mucosa may occur in the aged patient. The majority arise primarily in the oral cavity. Some, however, are manifestations of generalized diseases. Based on his dental and medical education and with the help of several good atlases (Strassburg and Knolle, 1968; Pindborg, 1980) and textbooks of oral pathology (Shafer et al., 1974; Lucas, 1976) the dentist should be able to recognize most of the lesions warranting intervention.

Localized amyloid tumor of the tongue. A case report and review of the literature.

Amyloid is usually deposited in the tongue, as a part of generalized amyloidosis. Isolated localized amyloidosis of the tongue is relatively rare. We report such a case which presented with glossodynia and glossopyrosis and was thought clinically to represent median rhomboid glossitis. Histologically the amyloid stained positively with Congo-red giving green birefringence under polarized light, was not abolished after permanganate pretreatment and did not react immunohistochemically for amyloid A, beta 2 microglobulin and transthyretin.

[A contribution to the definition and differentiation of the concepts of prosthetic stomatitis, glossalgia and stomatodynia]. / Ein Beitrag zur Deutung und Differenzierung der Begriffe Stomatitis prothetica und Glossalgie bzw. Stomatodynie.

Due to differences in the aetiology, diagnosis, therapy, and prognosis, it is necessary to delimitate the clinic picture of stomatitis prothetica against the syndromes of glossalgia and stomatodynia.

[Changes of the lip salivary glands in glossodynia. Histologic and morphometric analysis (author's transl)]. / Veränderungen der Lippenspeicheldrüsen bei Glossodynie. Pathohistologische und morphometrische Analyse.

The minor salivary glands of the lower lips were analyzed histologically and morphometrically from biopsy specimens taken from 29 patients with glossodynia and 12 normal controls. The causes of glossodynia included Sjögrens syndrome [5], stomatological disorders such as diabetes mellitus, prosthesis allergy, etc. [5], psychiatric depressions [6], and idiopathic [13]. Using semi-thin tissue sections, the following results were obtained: 1. The control group had an average acinous area of 70.2%. This area was moderately reduced in the older patient. In patients with glossdynia, the acinous area was reduced to a mean value of 38.9%. Some severe cases showed values of 10% and less. 2. The area of duct structures was 9.3% in control tissues, and increased to 13.1% in patients with glossodynia. Values to 26% were rarely observed. 3. The interstitial tissue of the control group was inconspicuous and contained only few inflammatory cells. In glossodynia, the reduction of glandular acini could be positively correlated with the proliferation of the connective tissue and to stromal infiltration by lymphocytes and plasma cells. In diffuse lymphocytic sialadenitis, the mean value of the acinous area was 46%. An additional focal lymphocytic infiltration resulted in a further reduction to 27.3%. 4. The most severe cases of sialadenitis were found in glossodynia associated with Sjögren's syndrome. As such, the lip biopsy was found to be a useful method for diagnosis of the syndrome.