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A 50-year-old-male presented to the emergency department with a missing tongue for the past 2 weeks. Symptoms initially began a year ago with hemoptysis and tongue swelling. The patient was treated with a short course of antibiotics and steroids at that time, with some improvement. Since then the patient noticed that his tongue felt loose and he developed increasing jaw pain. His tongue subsequently detached and fell out 2 weeks prior to presentation. An outside hospital attempted to place a percutaneous endoscopic gastrostomy tube, which was unsuccessful. He then had a nasogastric tube (NG tube) placed and was discharged. He reports 100 lb weight loss over the past year. History was partially obtained from his brother at bedside, because of the patient’s difficulty speaking. On physical examination, the patient had moist mucous membranes, no teeth present, and an absent tongue. Healing wounds were …