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

Abstract

An otherwise healthy 8-year-old boy was consulted in July 2020 presenting with a 20-day history of a painless growth on the tongue which had been 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, located in the midline of the tongue dorsum (Figure 1A-B). Although the lesion was asymptomatic, the patient reported slight discomfort when swallowing. The patient's past medical and family histories were unremarkable and non-contributory to any systemic conditions or malignancy. Given the history of trauma, location, and clinical appearance, the main 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. (Figure 1C-D).