A 19-year-old female was seen in the surgery clinics today with a complaint of a blue lesion on her tongue present for as long as she could remember. The lesion was asymptomatic and she did not think that it had increased in size. The patient's medical history was positive for epilepsy. The seizures began a few years ago, but had been decreasing in intensity progressively. She had been taking medication sporadically for her condition. At present she was off all medication on the advice of her doctor. Her concern was whether the blue lesion in her mouth had anything to do with her epileptic seizures.
Intraoral examination was insignificant except for a 12 x 10 mm purplish-blue lesion on anterior dorsal tongue. The lesion was slightly elevated and was relatively firm on palpation.
Based on the long-term history and clinical appearance, a diagnosis of hemangioma was made.
The patient was informed of this diagnosis. She was also told that the hemangioma and her epilepsy were two independent conditions. We offered to remove the hemangioma but the patient decided against it for the moment.
Hemangioma:
Hemangiomas are benign vascular tumors. They are most common in infancy. Females are more commonly affected than males. In infants, hemangiomas rapidly increase in size over a period of time. Following this drastic increase in size, most tumors begin to involute. By age 9, 90% of the lesions have resolved to some degree.
Initial lesions are usually red, older lesions tend to become darker in color. Some hemangiomas are flat and present only as color changes, while others form obvious masses of variable sizes. Bone involvement, although rare, can occur. The classic radiographic appearance of intraosseous hemangiomas is described as a multilocular defect with "honey-comb", or "soap bubble" appearances.
Histologically hemangiomas are classified into various types. Although these histological types usually don't have a significant effect on the prognosis of the lesion, they may effect the treatment plan.
For young children with hemangiomas, periodic observation may the best course of action. If the lesion fails to involute and results in significant esthetic concerns, surgical removal can be attempted. Since this lesion is vascular and there is a risk of significant bleeding, sclerotherapy should be attempted before intervention.
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| 19-year-old with a hemangioma on dorsal tongue |
Based on the long-term history and clinical appearance, a diagnosis of hemangioma was made.
The patient was informed of this diagnosis. She was also told that the hemangioma and her epilepsy were two independent conditions. We offered to remove the hemangioma but the patient decided against it for the moment.
Hemangioma:
Hemangiomas are benign vascular tumors. They are most common in infancy. Females are more commonly affected than males. In infants, hemangiomas rapidly increase in size over a period of time. Following this drastic increase in size, most tumors begin to involute. By age 9, 90% of the lesions have resolved to some degree.
Initial lesions are usually red, older lesions tend to become darker in color. Some hemangiomas are flat and present only as color changes, while others form obvious masses of variable sizes. Bone involvement, although rare, can occur. The classic radiographic appearance of intraosseous hemangiomas is described as a multilocular defect with "honey-comb", or "soap bubble" appearances.
Histologically hemangiomas are classified into various types. Although these histological types usually don't have a significant effect on the prognosis of the lesion, they may effect the treatment plan.
For young children with hemangiomas, periodic observation may the best course of action. If the lesion fails to involute and results in significant esthetic concerns, surgical removal can be attempted. Since this lesion is vascular and there is a risk of significant bleeding, sclerotherapy should be attempted before intervention.
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