Tuberculosis is still one of the most prevalent infectious diseases in developing countries like Bhutan. As per the world health organization (WHO) the estimated incidence of TB cases in Bhutan in 2019 was 1,300 cases. Caused by Mycobacterium tuberculosis, it affects the pulmonary system which can be fatal if not treated on time. Although tuberculosis can affect almost every organ in our body, lungs are the most commonly affected organ. A rare site getting affected, ulcers in the oral cavity are generally not worked up to rule out tuberculosis often causing missed diagnosis and treatment delay.

We present a case of a middle-aged woman who complained of a non-healing ulcer at lateral border of tongue for 6 months’ duration. Its treatment failed to show improvement and, therefore, reconsidering its diagnosis was warranted. Histopathological findings revealed presence of langhans giant cells that confirmed tuberculosis. The clinical presentations, differential diagnosis and management of such oral manifestations are discussed subsequently.

Keywords: Oral tuberculosis; Tongue; Ulcer