Masson tumor of the lingual tongue: a case report

Abstract

<h3>Background</h3> Intravascular papillary endothelial hyperplasia, or Masson tumor, is a benign lesion of the head and neck region. The etiology of the lesion arises within a blood vessel and is thought to be reactive and associated with vascular injury. Masson tumors comprise approximately 2% of all vascular tumors of skin and subcutaneous tissues; however, this is rarely seen intraorally. It is important to consider at the time of differential diagnosis to distinguish from malignancy and avoid aggressive surgery or unnecessary treatment. <h3>Case Summary</h3> We describe a case of a patient who presented to the Erie County Medical Center Department of Oral Oncology for evaluation of a soft, nontender, mobile mass in the right side of the ventral tongue. The patient first presented in June 2019 with an approximately 5-mm round mobile mass on the right side of the ventral tongue of 6 days' duration. The patient opted for no treatment in June 2019 and returned in December 2019 after the mass had grown in size and had begun to affect his everyday activities. Treatment options included excisional biopsy under general anesthesia or under local anesthesia. The patient opted for excision under local anesthesia. The vascular component was identified and tied off, and the tumor was removed in total. The tumor was a bluish lesion with a thick intact capsule. The final pathology revealed a thrombosed blood vessel with papillary endothelial hyperplasia consistent with Masson tumor. Immunostains for CD31 and D2-40 supported this diagnosis. The patient has some residual tethering of the right side of the tongue resulting from establishing primary closure. <h3>Conclusions</h3> The majority of tumors with this diagnosis have an excellent prognosis with complete excision. Malignant transformation and metastasis have not been reported.