Diagnostic and Therapeutic Challenges of a Large Tongue Lymphangioma in a Child: A Case Report.

Lymphangiomas are rare, painless, benign tumors in infancy or early childhood resulting from a congenital malformation of the lymphatic vessels with variable clinical appearance. We report the case of a six-year-old male child who presented with a micronodular surface of the tongue, a burning sensation, difficulties during swallowing and mastication, as well as speech disturbances. Histological examination of the excised tongue specimen showed an angiomatous lesion of the lamina propria that comprised many wide thin-walled spaces. MRI examination revealed an area of disparate T2 signal maximum diameter of 2-3 cm with cystic texture in the middle and frontal left part of the tongue. The lesion was diagnosed as a lymphangioma and was managed through pre-operative embolization and surgery. Tongue lymphangiomas may lead to aesthetic problems, functional issues (like dysphagia, airway obstruction, and speech difficulties), psychological disturbances, poor oral hygiene, and occasional bleeding associated with oral trauma. A major fraction of patients also experience infections, often leading to a significant increase in lesion size. A combination of preoperative embolization and surgical excision could be chosen considering its large size and the age of the patient, and to further eliminate the possibility of recurrence. Early diagnosis and radical treatment are critical in its management.

Intraductal papilloma of the sublingual gland imitating a ranula.

Ductal papillomas are rare benign lesions of the salivary glands with two distinctive types, intraductal and inverted. The rarest anatomical location where intraductal papillomas occur is the major salivary glands. In the present study, we report an intraductal papilloma of the left sublingual gland with the relevant clinical, imaging, and histopathological findings and postoperative follow-up. To our knowledge, this is the fourth case of an intraductal papilloma of a sublingual gland to be reported in the international literature. We present this rare case because of its clinical and radiological imitation of a ranula.