Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6247-6253
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6247
Foreign body granuloma in the tongue differentiated from tongue cancer: A case report
Zhen-Hua Jiang, Ran Xv, Li Xia
Zhen-Hua Jiang, Ran Xv, Li Xia, Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Author contributions: Xu R was the patient’s doctor in charge, reviewed the literature and contributed to manuscript drafting; Jiang ZH operated on the patient and contributed to manuscript drafting; Xia L reviewed the literature and was responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported by the Research Start-up Grant for Talent of Mianyang Central Hospital of China, No. 2021YJRC-001; and the Applied Technique Research and Development Program of Mianyang City of China, No. 2019YFZJ022.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompany images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Li Xia, MD, Chief Doctor, Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Mianyang 621000, Sichuan Province, China.
Received: December 7, 2021
Peer-review started: December 7, 2021
First decision: January 25, 2022
Revised: February 12, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: June 26, 2022

Embedded foreign bodies in the tongue are rarely seen in clinical settings. An untreated foreign body can cause a granuloma which often presents as an enlarged tongue mass. However, if foreign body ingestion status is unknown, physical examination and magnetic resonance imaging (MRI) tend to lead to suspicion of tongue cancer, especially in older patients. Thus, differential diagnosis of an enlarged tongue mass is important, especially because it is closely related to the choice of treatment method.


A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 mo. She had no previous medical history. MRI revealed abnormal signal intensities that were indicative of a neoplasm. Thus, the oral surgeon and radiologist arrived at a primary diagnosis of tongue cancer. The patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the tongue. The ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body (bone) in the tongue, even though the patient denied any history of foreign body ingestion. Complete surgical enucleation of the lesion was conducted. The mass which included a fish bone was completely removed. The post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers, macrophages and chronic inflammatory cells. The patient recovered without complications over a 2 mo follow-up period.


We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue cancer. The MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the tongue. The granuloma, which contained a fish bone, was completely removed via surgery and confirmed via biopsy. Differential diagnosis of the enlarged tongue mass was critical to the selection of treatment method.

Keywords: Tongue, Foreign body, Granuloma, Cancer, Differential diagnosis, Case report

Core Tip: This case report concerns an older adult referred to our Ear Nose and Throat Department with an enlarged tongue mass and a primary diagnosis of tongue cancer after magnetic resonance imaging (MRI). A review of the MRI data and oral ultrasound examination diagnosed a foreign body granuloma, confirmed by surgery and postoperative pathological examination. Oral ultrasound and/or computed tomography are critical in terms of differential diagnosis; certain MRI features may provide clues guiding diagnosis of a foreign body granuloma.