Lingual Cavernous Hemangioma

Diagnosis: Lingual Cavernous Hemangioma

Blue-red spongy tumor mass of tissues filled with blood involving the tongue.

Clinical Presentation

Blue-red spongy tumor mass of tissues filled with blood involving the tongue.

Clinical History

Submitted by Alaa Saad. Originally posted October 20, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Vascular malformation • Kaposiform hemangioendothelioma • Tufted angioma • Pyogenic granuloma • Kaposi sarcoma • Neuroblastoma (metastatic) • Myofibroma

Key Learnings

• Infantile hemangioma: most common tumor of infancy — GLUT1 positive • Classic phases: proliferative (0-12 months) → plateau → involution (years) • Complete involution in ~50% by age 5, ~90% by age 9 • PHACES syndrome: large facial hemangiomas with posterior fossa, hemangioma, arterial, cardiac, eye, sternal defects • Alarming locations requiring treatment: periocular (amblyopia), airway (subglottic), ulcerated, large facial • Propranolol is the first-line treatment for problematic infantile hemangiomas — revolutionary since 2008 • Timolol 0.5% gel (topical) for small, superficial lesions

Tags: lingual, cavernous, hemangioma, alaa saad