Page 100 - FINAL COMPENDIUM 2020-2021 27.2.2022

A REPORT OF LYMPHANGIOMA OF TONGUE

Abdullah N, Raja Shahardin RZ, Sockalingam G

Introduction: Lymphangiohaemangiomas are rare developmental anomaly. Clinically they
will behave as lymphangioma but will show on histological examination as both vascular
and lymphatic elements. Conservative management is usually recommended, with
intervention only if symptomatic commonly because of their location. Case report: A 4-
year-old girl was referred from General Paediatric for irregular bluish/reddish swelling
measuring about 1 cm x 1 cm at the right lateral border of tongue. She was under annual
review in Paediatric Dental-Radiology combine clinic since lesion was asymptomatic. At
the age of ten, she started to have bleeding from the tongue lesion. Upper and lower soft
splint were fabricated and issued. Subsequently, she had undergone two sclerotherapy
under general anaesthesia. Ensuing from discussion with an Interventional Radiologist,
surgical excision of lesion at right lateral border of tongue was performed under general
anaesthesia. Histological specimens showed presence of variable sizes of endothelial-
lined vessels containing red blood cells and lymph fluid. Dilated vascular channels
highlighted with CD31 immunostain extending between underlying muscle bundles with
occasional lympho-plasmacytic infiltration were observed, consistent with
lymphangiohaemangioma. After three months follow up, patient has excellent cosmetic
and functional outcome with no recurrence detected. Discussion: Unlike other reported
lesions, our case showed an atypical clinical presentation of lymphangioma. The lesion
was neither near water density nor did it show contrast enhancement following
intravenous medium administration, thus no definitive evidence of haemangioma was
concluded. Lesions over the tongue are frequently subject to trauma, hence symptomatic
intervention is often indicated. Conclusion: In the literature, there have been several
treatment modalities proposed for vascular anomalies and in the present case,
sclerotherapy with surgical excision has shown excellent result.

Virtual presentation at the MAPD 2021 Virtual Scientific Conference & AGM on 8March 2021

Dr Nurmimie Abdullah
Dr Raja Zarina Raja Shahardin
Dr Ganasalingam A/L Sockalingam
Department of Paediatric Dentistry
Hospital Tunku Azizah
Kuala Lumpur

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