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An ulcerative nodule on the dorsal tongue in an 8-year-old boy

Published:February 11, 2023DOI:
      An otherwise healthy 8-year-old boy was consulted in July 2020, presenting with a 20-day history of a painless tongue growth associated with trauma. According to his parents, the lesion initially appeared as a “blood-filled blister” and had evolved into an ulcerated swelling. Intraoral examination revealed a reddish, sessile nodule with an ulcerated surface in the tongue dorsum's midline (Figures 1A and 1B). Although the lesion was asymptomatic, the patient reported slight discomfort when swallowing. The patient's medical and family histories were unremarkable and non-contributory to systemic conditions or malignancy. Given the history of trauma, location, and clinical appearance, the primary differential diagnoses were reactive lesions or benign mesenchymal tumors. An incisional biopsy was performed under local anesthesia to elucidate the diagnosis, and 3 weeks after the procedure, the lesion presented an accelerated growth, doubling its initial size, now appearing as an aggressive dome-shaped nodule. (Figures 1C and 1D).
      Fig 1
      Fig. 1Clinical features. (A, B) A firm and ulcerated broad-based nodule involving the dorsal tongue, 20 days after the initial trauma, at which time the incisional biopsy was performed. (C, D) Three weeks after the incisional biopsy, the tumor appeared aggressively as a large dome-shaped reddish nodule with superficial ulceration.
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