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Large mass on base of tongue

J Fam Pract. 2014 October;63(10):603-605
By
Jeremy T. Reed, MD, MPH & TM
Colin M. Grant, DO
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Our patient’s tongue mass hadn’t bothered her until she became pregnant; that’s when it got larger and caused problems swallowing and breathing. A simple test confirmed our suspicions.
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A 26-year-old nonsmoking obese woman presented to our primary care clinic for treatment of a mass at the back of her tongue that was causing intermittent dysphagia and nocturnal choking when she was lying down. She had first noticed the mass 3 years ago; it had been asymptomatic until her recent pregnancy, when its size increased significantly. She denied hemoptysis and dyspnea.

On examination, we noted a purplish, 3 × 3 cm, midline posterior tongue mass with marked superficial vasculature (FIGURE 1). The mass was firm, nontender, and non-friable on palpation. Nasopharyngoscopy revealed a patent airway. There were no other lesions.

WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?

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