Oral Lymphangioma in a Paediatric Patient- A Case Report

Introduction:
Lymphangioma is a rare benign tumour, caused by congenital malformation of the lymphatic system. It commonly occurs in infants and children. It mainly presents in the head and neck region but is uncommon in the oral cavity. Here we present a case of intraoral lymphangioma in a paediatric patient.

Case report:
An 8-year-old boy was seen in the joint Oral Medicine and Paediatric Dentistry clinic following a referral from his General Practitioner regarding a painful ulcerated mouth and haemorrhagic lesions on the dorsum of the tongue. The child was then referred to the Oral and Maxillofacial Surgery department. Clinical examination showed a two cm multilocular purple lesion on the dorsum of the tongue, slightly hard but not indurated. An MRI scan failed to show any deep tissue involvement within the oral cavity or pharynx. Subsequently, the child had an incisional biopsy which identified several thin-walled dilated vessels expanding the epidermis. Several vessels were also seen in the deeper lamina propria in between skeletal muscle fibres. The vessels were diffusely positive for D240 and negative WT1 and Glut1 stains. These findings confirmed the diagnosis of Lymphangioma. Conservative management was chosen, and the child remained asymptomatic during the follow up periods with no changes in clinical appearance.

Conclusion/ Clinical relevance:
Whilst Lymphangioma is a rare lesion affected mainly infants and children, diagnosis is based on history and clinical examination. Biopsy is very useful in confirming the diagnosis and imaging is required for determining depth of the lesion. Surgical management is not always necessary for small and non-destructive cases.