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Case Reports
. 2024 Sep 19;16(9):e69759.
doi: 10.7759/cureus.69759. eCollection 2024 Sep.

Cavernous Hemangioma of the Tongue Base: A Rare Case

Fathmath Shana Mohamed  1 , Bee-See Goh  1
Affiliations
Case Reports

Cavernous Hemangioma of the Tongue Base: A Rare Case

Fathmath Shana Mohamed et al. Cureus. .

Abstract

Vascular anomalies encompass a range of conditions affecting blood vessel development, categorized as tumors or malformations. Hemangiomas, the most common vascular tumors, involve abnormal endothelial cell proliferation, particularly in hemangiomas, which are prevalent benign tumors arising from mesenchymal tissue in the head and neck. They manifest as capillary, cavernous, or mixed types, affecting areas like the tongue and lips. Hemangiomas of the tongue base are notably rare, emphasizing the complexity of diagnosis and management due to their uncommon occurrence and potential for complications like bleeding. This report highlights a case of cavernous hemangioma of the tongue base, underscoring diagnostic challenges and management considerations. A Malay man in his late 30s, a nonsmoker and nondrinker, presented with a year-long history of intermittent globus sensation without associated symptoms like odynophagia, dysphagia, intraoral bleeding, or neck swelling. Flexible nasopharyngolaryngoscopy revealed a lobulated bluish mass at the right base of the tongue, prompting a provisional diagnosis of hemangioma. Contrast-enhanced CT suggested an irregular lesion with calcification, leading to MRI confirmation of a well-defined, non-muscle-invasive lesion that favored venolymphatic malformation rather than hemangioma. However, it was confirmed histologically as cavernous hemangioma after excision, where intraoperative findings aligned with initial preoperative clinical assessments.

Keywords: base of the tongue; cavernous hemangioma; head and neck neoplasms; hemangioma; vascular anomalies.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Axial CECT neck showing irregular exophytic enhancing lesion at the right base of the tongue (white arrow). There is hyperdensity at the right base of the tongue to suggest calcification. It abuts the epiglottis.
CECT: contrast-enhanced computed tomography
Figure 2
Figure 2. (A) T1-weighted axial MRI neck, (B) T2-weighted axial MRI neck, and (C) T1-weighted axial MRI neck (post-contrast)
(A, B, C): A well-defined lesion is observed at the right base of the tongue, appearing homogeneously isointense on T1 and hyperintense on T2. It does not involve the extrinsic muscles of the tongue but abuts the vallecula. Post-contrast images show incomplete enhancement of the lesion at the right tongue base, with no arterial supply to the lesion. MRI: magnetic resonance imaging
Figure 3
Figure 3. (D) A broad-based vascular tumor located at the base of the tongue, not involving the vallecula or the lingual surface of the epiglottis. (E) Excision of the vascular tumor was performed using suction diathermy and microscissors
See this image and copyright information in PMC

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