Cavernous Hemangioma of the Tongue Base: A Rare Case

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.