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String like bump under tounge. Would cancer have shown up in the CBC ?

I have this very weird string like red bump under my tounge. I say bump because I thought it was a bump and then through messing with it relized it was more like a string. It s weird because I have a tooth on the same side of the bump that has a burning/tingling sensation, and my ear on that side has pressure in it and pain. The bump is under my tounge, but it s actually on the bottom of my tounge not the floor of my mouth. It has been there for probably almost 5 months and has not gotten smaller. I am a smoker, I have been one for 10 years. I just filled a percription for chantix though, and I am planning on quitting. I also am a recovering heroin addict and didn t brush my teeth for months at a time due to being homeless. Could this be mouth cancer? I just got braces and the dentist didn t say anything about it and neither did I because I thought it would go away but it hasn t. I also had a CBC done recently because I switched my primary care physician and the only thing that showed up was that I had a slightly high monocyte count. Would cancer have shown up in the CBC ? The string bump makes my tounge feel swollen and it burns a little. Please help and thank you.
Asked On : Tue, 24 May 2011
Answers:  2 Views:  1460
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Dermatologist 's  Response
u need not to worry as cbc report is near normal.monocyte has no relation with cancer
u must keep ur oral hygiene clean
it may be cyst due to minor trauma during eating or etc
u must consult oral surgeon for this
generally its harmless but better to remove it
give up smoking and heroin
drink ore water
Answered: Tue, 24 May 2011
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ENT Specialist Dr. Sumit Bhatti's  Response
1. There is no substitute for direct examination and biopsy. Going by your description, this could be one of the following:

a) The red raised stringy patch under your tongue may be a patch of Erythroplakia which is most probably related to tobacco use.

b) It may also be an inflamed Wharton's Duct (sub mandibular salivary gland duct). There may also be a stone or debris in the duct. You should take an x-ray to rule out a stone. A sialogram is also possible after the inflammation subsides. Antibiotics which are excreted in saliva, such as clindamycin are best suited in such situations.

c) A localized inflammation of a normal structure, or a dental abscess could also cause referred pain to the tooth and ear.

3. Leukoplakia or Erythroplakia is considered benign but a potential precancerous lesion with a risk of turning cancerous in 5 to 15% persons.

4. Stopping the irritative factor, such as tobacco in your case, lowers the risk. It is good to hear that you have quit. Usually, the Erythroplakia stabilizes or reduces after the original irritation that caused it has been stopped.There are some other causes besides tobacco which can lead to other types of Leukoplakia / Erythroplakia.

5. One option for you is a brush biopsy with Oral CDX which you can easily arrange for.The other is a full biopsy followed by histopathological examination. Long term follow up is needed.

6.If may help if you could e-mail an image of your floor of mouth to with 'Attn: Dr. Sumit Bhatti' as the subject line.

7. Congratulations on quitting heroin and your monocyte count should not be of any significance.
Answered: Tue, 24 May 2011
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