HealthDay News — Fungal lesions can mimic neoplastic growths on the tongue, according to a case report published online April 5 in Pediatrics.

James Naples, MD, from the University of Connecticut Health Center in Farmington, and colleagues presented the case of a 22-month-old, nonsyndromic girl with reports of a rapidly growing tongue lesion. On examination, a 2-cm firm, circular lesion was identified on the dorsal surface of the left tongue with overlying fibrinous exudates. She was prescribed antibiotics, but returned after three days reporting increasing size of the tongue mass.

The researchers note that the family elected to have excisional biopsy. The lesion was completely excised with primary closure and did not appear to be infiltrative to surrounding tissues. Normal squamous mucosa was seen on histology, with ulceration and mixed inflammatory infiltrates on pathologic examination. Negative stains were obtained for Langerhans cell histiocytosis, sarcoma, lymphoma, and granular cell tumors. The lesion was demonstrated to be colonized with Candida lusitaniae fungal culture. The patient had no new growths 6 months postoperatively, with excellent tongue mobility. 

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“This case reinforces the role of tissue culture when histology fails to demonstrate a diagnosis and emphasizes the need for efficient communication between the pediatrician, otolaryngologist, and pathologist for timely excision,” the authors write.

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