Tongue lesion with sensation of fullness in the mouth.

Volume 83, Number 7 www.aafp.org/afp American Family Physician 839 A 73-year-old man with type 2 diabetes mellitus presented with a sensation of fullness in his mouth that began two months prior. The patient described the sensation as a “funny feeling in the back of my mouth.” He had no other notable symptoms, such as fever, nausea, weight loss, or night sweats, and his vital signs were normal. The patient was a 30 pack-year smoker, occasionally drank alcohol, and drank coffee daily. He did not use illicit drugs. Physical examination revealed a brown, hairy-appearing lesion at the midline, covering the posterior two-thirds of his tongue (see accompanying figure). The lesion was approximately 3 × 1 cm, was nontender to palpation, and could not be removed with a tongue blade. The patient had moist oral mucosa; however, dental caries and several missing teeth were noted. He did not have overt halitosis.