cases

One  yeay old infant presented by recurrant red&bluish eruptions  on  the dorsal surface of  the tongue with drooling of saliva for past 2 dayes 7 restrected movment of the tongue the eruption 2mm=2mm  dark red  with bluish discolouration in the cente mild oozing  on oxifilution for 10 minites   (figA)

) she was treated with oral propranolol  &contenued with  this medication for one yearr after one year follow up  the lesion subside completely (figB)

Whate is the diagnosis/?

The Correct Answer is

Tongue hemangioma. Hemangiomas are vascular malformations or hamartoma that may rise from capillary or vein or the artery.Hemangiomas are occurring in as many as 2.6 percent of neonates and 12 percent of children aged 1 year. {1} The prevalence of tongue hemangioma is found to be 11 percent. Approximately 89.6 percent hemangiomas in infants are located in the periorbital mainly in the upper or lower eyelid area and 70.6 percent of patients are girls. {2} The lesion is characterized by its bright red color, raised texture and lobular appearance. {3} Most hemangiomas require no treatment. Though they are typically benign, some of them may progress to produce complications such as fissure formation, ulceration, bleeding and compression of airway mainly in the rapid proliferative phase. Potential complications also include Kasabach-Merritt syndrome. Medical treatment of tongue hemangioma includes the administration of oral propranolol and intralesional injection of corticosteroids. Second-line pharmacologic agents include vincristine or interferon alfa-2b. In addition to medical treatment, radiotherapy, cryotherapy, laser therapy, injection of sclerosing substances and the selective embolization of the lingual artery are also seem to have some efficacy.  {References 1. Stal S, Hamilton S, Spira M. Hemangiomas, lymphangiomas, and vascular malformations of the head and neck. Otolaryngol Clin North Am.1986`19:769-96 2. Xu S, Jia R, Ge S, Lin M, Fan X. Treatment of periorbital infantile hemangiomas: A systematic literature review on propranolol or steroid. J Paediatr Child Health. 2014`50, 271–279 3. Waner M, Suen JY, Dinehart S. Treatment of hemangiomas of the head and neck. Laryngoscope. 1992`102:1123-1132 4}