Progressively enlarging midline cystic mass of the floor of the mouth in an infant

Abstract

A 6-month-old infant arrived with parents for evaluation of an anterior floor of mouth swelling. The birth history was unremarkable, and the parents stated that the swelling had been present since birth. During the past few months, the oral swelling had enlarged progressively; however, the parents denied observing any difficulties with feeding or breathing. The parents noted no other medical abnormalities. On examination, a large, distensible mass was palpated at the anterior floor of the mouth. The overlying mucosa had a bluish tinge, and both submandibular duct orifices were present, patent, and laterally displaced by the lesion. There were no palpable neck masses. Magnetic resonance imaging of the face was performed 1 month before at an outside hospital and revealed a 1.5- × 1.7- × 1.8-cm, well-defined, predominantly cystic, lesion located within the root of the tongue (Figure 1). There was a small, enhancing, soft-tissue nodule ventrally. Dr. Trinh is a resident, Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY. Dr. Lee is a resident, Division of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, New York, NY. Dr. Eisig is the chairman, Division of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, New York, NY. Dr. Peters is an assistant professor, Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY.