The culprit behind this woman’s tongue oedema had been hiding in plain sight in her medicine cabinet for over a decade.

The 84-year-old presented to a Japanese ED with progressive isolated swelling on the left side of her tongue that had developed over several days.

Her vital signs were unremarkable, and she denied dyspnoea, dysphagia, airway compromise or any recent changes in diet, medications, allergen exposure or infectious contacts.

The swelling was localised, non-tender and without signs of inflammation, and examination at an oral surgery clinic ruled out malignancy.