January 2003

Case submitted by Youn W. Park, MD, and Y. T. Wu, MD

		CASE: A 55-year-old man complains of masses on his tongue. A review of the patient's history reveals that the lesions have been present and basically asymptomatic for years, but have recently enlarged. In addition to the red-blue masses on the tongue, a small vascular lesion is visible on the lower lip. WHAT IS YOUR DIAGNOSIS?
		This patient has cavernous hemangiomas of the tongue and lip. Common tumors in infancy and childhood, hemangiomas are probably developmental abnormalities rather than true neoplasms. Pathologic classification divides them into capillary, cavernous, and mixed types. The cavernous hemangioma usually appears as a red-blue, soft, spongy mass that, while sharply defined, is not encapsulated. Some hemangiomas of the tongue have a lymphangiomatous component, in which case they are called hemangiolymphangiomas. Although small hemangiomas usually remain asymptomatic, possible complaints include recurrent bleeding, pain or other discomfort, and difficulty in chewing, speaking, and swallowing, if they are large enough. Small lesions can be excised, preventing recurrence, but larger ones may require laser procedures utilizing argon, Nd:YAG, or both to avoid functional disability due to significant tissue loss.

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Dr. Park is a clinical professor of otolaryngology at Northeastern Ohio Universities College of Medicine and an attending physician in the section of otolaryngology at Akron General Medical Center in Akron, Ohio. Dr. Wu is an attending physician in the department of family practice at Akron General Medical Center.