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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Saturday, March 20, 2010
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Saturday, March 20, 2010
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Mouth Diseases |
Tongue biopsy04/04/2005 |
The underside of my tongue on both sides hurt and had a burning feeling when I moved it. The oral surgeon did a tongue biopsy with a local anesthetic. The diagnosis was oral lichen planus. The doctor said that lichen planus can become malignant so it will need to be watched. I am now afraid of needing another tongue biopsy at some time. It was a very painfull and stressfull procedure to me. If I need it done again, could I be asleep? I hate to be a wimp but I don`t know if I could be awake for that again.
In addressing the concern about oral lichen planus and malignancy, it must be stated at the beginning that this is a murky and controversial area. The only paper that directly looked at this issue by examining the DNA of biopsy samples from patients with lichen planus and oral cancer did NOT find any evidence supporting a link between these two conditions. But other papers with more indirect evidence still claim that lichen planus can become malignant over time.
In my own experience, the risk for cancer arising in lichen planus patients seems very small. But the problem is more basic. Oral cancer and precancerous changes can look identical to the oral lesions of lichen planus. Allergy-type reactions (lichenoid reactions) to a variety of things including drugs, amalgam (silver fillings) and flavoring agents can cause these types of changes in the mouth as well. These conditions can even mimic one another in a biopsy specimen. Therefore, I recommend review of such biopsies by an oral and maxillofacial pathologist whenever possible to take advantage of their specialized training with oral lesions.
Close follow-up with your oral surgeon is important to be sure that the tissue changes are not becoming worse. If they worsen despite proper treatment, then biopsy is always a good idea. Catching oral cancer or precancer early is always the best step towards a cure.
Good luck!
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John R. Kalmar, DMD, PhD Professor and Graduate Program Director Dental Faculty Practice Section of Oral and Maxillofacial Pathology College of Dentistry The Ohio State University |
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