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Have black spots on tongue. What could be causing this? Could it be cancer?

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I have a black spot about the size of a pencil lead on the side of my tongue. There are also striations (pinkish red, the same color as the tongue) that look like little valleys that run part of the length of the tongue. The spot is among these. What could cause this? I don't remember biting my tongue, and I scrape my tongue regularly and didn't notice it until tonight. I think it must be of recent onset. Could this be cancer? What else could cause it?
I had an oral cancer screening at my checkup about a year ago and it was negative. There were two forms of screening -- one with a solution in my mouth and a blue light; the other was a tongue scrape and sent off somewhere, if I remember correctly. I could be wrong about the second one. I have a checkup scheduled for Dec. 4. Should I go sooner?
Posted Wed, 5 Dec 2012 in Cancer
Answered by Dr. Bibhu Dutt Nanda 2 hours later
Thanks for writing to us and uploading the picture. I have taken a good look at it.

I would like to inform you that the black spot if associated with redness, swelling or even ulceration, then it needs to be examined carefully by the dentist.

In your case, the black spot does not seem to be ulcerated; therefore, you need not worry, but do keep a check on the black spot for change in size, shape or color.

I appreciate that you have already been screened for oral cancer and the reports are normal.

To be on a safer side, I recommend you to see an oral pathologist at the earliest as he/she might prescribe oral multivitamins, antioxidants if needed. You can go ahead with your appointment on Dec 4, it is not necessary to prepone it.

I hope this answer was helpful.
If you have any further questions, feel free to post them here.
I wish you good health.
Take care.
Above answer was peer-reviewed by
Follow-up: Have black spots on tongue. What could be causing this? Could it be cancer? 7 hours later
My cancer screening was a year ago. Could a melanoma develop relatively slowly under the skin and then "pop up" (become visible) rather suddenly? Also, what do you think is causing this? A mouth sore of some sort? A hemangioma? I suppose I could have missed seeing it for awhile since it is on the side of my tongue, but I am especially concerned since it appeared (what seems to me) relatively quickly. Thank you for your help on this; I appreciate it. I have a history of cancers of numerous sorts in my family -- this is why I am so concerned. My mother had esophogeal and tracheal cancer; my paternal grandfather had cancer of the larynx. Both of them were smokers. I smoked when I was young, but quit 1/1/1984, and hence have not smoked for almost 29 years. My total years smoking was about 17, and I was a heavy smoker (3 packs/day). Does this information change your opinion of the spot? (I don't know why my mind was blank last night when I found the spot -- I should have said something about the family history and my prior smoking. Sorry about that! Chalk it up to excess worry.) Thank you again.
Answered by Dr. Bibhu Dutt Nanda 2 hours later
Thanks for writing back.

I am glad you mentioned about your family history for cancer.

As you quit smoking a long back, therefore this cannot be the reason for the black spot. The black spot on your tongue is a kind of hyperpigmentation (oral fibroma); it has a genetic base and is usually painless.

If you experience pain or burning associated with it, then I shall advise cancer screening test for you.

I advise you to keep a check on it for changes in its colour, margins and size.

Rarely, black spots may progress into a melanoma, therefore you need not worry.

These spots usually take time to disappear on their own.

If it is bothering you much, then you may see an oral pathologist or even a dermatologist for its surgical removal with the lasers.

I hope this answer was useful. Feel free to post any further questions for me.

I wish you good health.
Take care.
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