Riga-Fede disease: trauma due to teeth or tongue tie?

Riga-Fede disease: a mimicker of malignancy

Riga-Fede disease (RFD), also known as traumatic eosinophilic granuloma, is a benign inflammatory condition of the oral cavity that may mimic a malignant tumour. It's a rare condition mainly reported in infants. We present a unique case report of a 57-year-old man who presented to our outpatient department with foreign body sensation in the throat and swelling over the dorsum of the tongue for a period of 1 month. He gave no history of trauma, especially due to sharp teeth. Video laryngoscopy done revealed an ulceroproliferative growth on the midline of the dorsum of the tongue. With clinical suspicion of malignancy, the patient underwent wide local excision of the tongue lesion. Histopathological examination was suggestive of RFD. The postoperative follow-up was uneventful with good wound healing. The patient was followed up with no evidence of recurrence.

Riga-Fede disease in the upper jaw in an infant

Riga-Fede disease is a benign and uncommon mucosal disorder. This illness is an ulceration of the oral mucosa and arises from repetitive traumatic injuries. The disease is usually caused by the sharp edges of new erupted teeth. The aim of the present case report is to present Riga-Fede disease and its treatment. We reported a 11-month-old healthy female infant diagnosed as Riga-Fede disease based on clinical features. After the conservative treatment that focused on eliminating the source of trauma, total healing was observed. Riga-Fede disease is rare. This illness can be confused with malignancies. Therefore, the diagnosis and treatment of this disease are very important for physicians and patients.

[Riga-Fede disease]

INTRODUCTION

Riga-Fede disease is a benign affection of the oral mucosa which has been poorly described in the literature. This entity of unknown ethiopathogenicity is sometimes revealing of dysautonomic or neuropsychic disorders. We report a new case.

CASE REPORT

A 10-month-old girl was referred to us for a unique deep ulceration of the lower lingual apex, in a context of right basal pneumopathy. Samples were negative for bacteriological, virological and mycological analysis. After successful treatment of the pneumopathy, the ulceration was unchanged and we diagnosed Riga-Fede disease.

DISCUSSION

Our observation is representative of the Riga-Fede cases previously described in the literature, comparing the age of onset, the topography and the ulceration type. We did not diagnose any dysautonomic or neuropsychic disorder as reported in some cases. Suppression of the lingual trauma resulted in healing of the ulceration.

Traumatic lingual ulceration in a newborn: Riga-Fede disease

Riga Fede disease is a reactive mucosal disease as a result of repetitive trauma of the tongue by the anterior primary teeth during forward and backward movement. Although the aspect of the lesion might be impressive, its nature is relatively benign. The history and clinical features are most often so typical that there is seldom a need for addititonal histopathological examination. Riga Fede disease can most often be treated with conservative measures only.

Beside the presentation of a six-month-old boy with Riga Fede disease, the literature has been reviewed as well. From this review it can be concluded that Riga Fede disease is almost exclusively restricted to the tongue, occurs soon after birth when associated with (neo)natal teeth, has a male predilection, and is in one quarter of the cases associated with neurologic disorders. In the later case, Riga Fede disease develops after the age of 6 months.