Twenty years ago, this 82 year-old patient developed a painless, slowly-growing, raised, bluish tongue hemangioma..
Although hemangiomas are common in infancy and childhood, they are probably developmental abnormalities rather than true neoplasms. Pathologists distinguish three classes: capillary, cavernous, and mixed types. Cavernous hemangiomas are blue, soft, spongy masses that are not encapsulated. Some hemangiomas of the tongue have a lymphangiomatous component, hence the name hemangiolymphangiomas.
Although most hemangiomas of the tongue are asymptomatic, they could sometimes cause significant bleeding, pain or difficulty in chewing, speaking, and even swallowing, if they are large enough. Small lesions can be excised with impunity. Large lesions, if excised, could result in significant functional disability. This is why several modalities of less invasive treatment have recently been advocated (Argon laser, Nd:YAG laser, or both to avoid functional disability caused by tissue loss). Also, there have been reports of treatment with superselective embolization using polyvinyl alcohol foam (Ivalon) and absorbable gelatin sponge (Gelfoam) particulates.