Tongue Benign Tumour — MFDS Part 1 MCQ

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ModerateOral PathologyTongue Benign TumourMFDS Part 1

A 46-year-old woman has a solitary, painless, slowly enlarging, firm submucosal nodule on the dorsolateral tongue. Biopsy shows sheets of large polygonal cells with abundant eosinophilic granular cytoplasm. The overlying epithelium exhibits pseudoepitheliomatous hyperplasia. What is the most likely diagnosis?

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Correct answer: A — Granular cell tumour

The diagnosis is a granular cell tumour. This uncommon Schwann-cell neoplasm characteristically presents as a solitary, asymptomatic tongue nodule in an adult woman. Large polygonal cells containing abundant eosinophilic granular cytoplasm are diagnostic, and the associated pseudoepitheliomatous hyperplasia can mimic squamous cell carcinoma histologically. A haemangioma would show vascular channels and usually has a red-blue, compressible clinical appearance. An irritation fibroma is a reactive collagenous proliferation, generally associated with chronic trauma, rather than a true neoplasm. Neurofibroma comprises spindle cells with wavy nuclei in a delicate stromal background. Lipoma is formed from mature adipocytes and usually presents as a soft, sometimes yellowish, mobile lesion.

Reference: Lafuente Ibáñez de Mendoza I, et al. Oral granular cell tumour: A multicentric study of 56 cases and a systematic review. Oral Diseases. 2020;26:573–589. https://pubmed.ncbi.nlm.nih.gov/31898368/