Oral Lymphangiomas Clinical Presentation

  • Author: Sean P Edwards, DDS, MD, FRCD(C); Chief Editor: William D James, MD   more...
 
Updated: Jan 18, 2012
 

History

  • Although most lesions appear in the individual's first 2 years of life, lesions occasionally appear in early adulthood.
  • Typical histories include annoying and repetitive surface bleeding, paroxysms of lesion expansion, usually in association with upper respiratory tract infections, intralesional hemorrhage, or repeated infections.
Next

Physical

  • Superficial lymphatic malformations have a pebbly surface and are clear or bluish. The bluish color may be caused by either a venous component or an intralesional hemorrhage. Superficial lymphatic malformation. Superficial lymphatic malformation. Superficial lymphatic malformation. Superficial lymphatic malformation.
  • Deeper lesions may have a superficial component. When a superficial component is absent, deeper lesions usually appear as soft, ill-defined masses that markedly distort the local anatomy. Marked lingual enlargement caused by lymphatic malMarked lingual enlargement caused by lymphatic malformation. Note the pebbly surface in areas not covered by materia alba. Also note the ecchymotic lesions protruding from the buccal mucosa in the mandibular vestibules. Note the significant left buccal and submandibularNote the significant left buccal and submandibular swelling. Profile view of a young adult with oral lymphangioProfile view of a young adult with oral lymphangioma (same patient as in Media File 2).
  • Macrocystic lesions may be fluctuant and readily transilluminating.
Previous
Next

Causes

  • Although no clear consensus on the mechanism for lesion development exists, the lesions likely develop as a result of aberrant sequestration of portions of these primitive embryonic anlagen. See Pathophysiology.
Previous
Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Sean P Edwards, DDS, MD, FRCD(C)  Assistant Professor, Chief of Pediatric Oral and Maxillofacial Surgery, Section of Oral and Maxillofacial Surgery, Department of Surgery, C S Mott Children's Hospital, University of Michigan Medical Center

Sean P Edwards, DDS, MD, FRCD(C) is a member of the following medical societies: Alpha Omega Alpha, American Association of Oral and Maxillofacial Surgeons, American Cleft Palate/Craniofacial Association, American Medical Association, International Association of Oral & Maxillofacial Surgeons, and Royal College of Dentists of Canada

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph Helman, DMD  Clinical Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Michigan

Joseph Helman, DMD is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Smeena Khan, MD  Private Practice, Adult and Pediatric Dermatology Associates

Smeena Khan, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS  Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. Mar 1982;69(3):412-22. [Medline].

  2. Padwa BL, Hayward PG, Ferraro NF, Mulliken JB. Cervicofacial lymphatic malformation: clinical course, surgical intervention, and pathogenesis of skeletal hypertrophy. Plast Reconstr Surg. May 1995;95(6):951-60. [Medline].

  3. Tempero RM, Hannibal M, Finn LS, Manning SC, Cunningham ML, Perkins JA. Lymphocytopenia in children with lymphatic malformation. Arch Otolaryngol Head Neck Surg. Jan 2006;132(1):93-7. [Medline].

  4. Alqahtani A, Nguyen LT, Flageole H, Shaw K, Laberge JM. 25 years' experience with lymphangiomas in children. J Pediatr Surg. Jul 1999;34(7):1164-8. [Medline].

  5. Yonetsu K, Nakayama E, Kawazu T, Kanda S, Ozeki S, Shinohara M. Value of contrast-enhanced magnetic resonance imaging in differentiation of hemangiomas from lymphangiomas in the oral and maxillofacial region. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Oct 1999;88(4):496-500. [Medline].

  6. Puricelli E, Ponzoni D, De Paris MF, de Abreu MC, Togni L. Surgical treatment of tongue lymphangioma in a pediatric patient: a case report. J Dent Child (Chic). Jul 2011;78(2):120-3. [Medline].

  7. Bonet-Coloma C, Minguez-Martínez I, Aloy-Prósper A, Rubio-Serrano M, Peñarrocha-Diago MA, Peñarrocha-Diago M. Clinical characteristics, treatment, and evolution in 14 cases of pediatric orofacial lymphangioma. J Oral Maxillofac Surg. Jun 2011;69(6):e96-9. [Medline].

  8. Raveh E, de Jong AL, Taylor GP, Forte V. Prognostic factors in the treatment of lymphatic malformations. Arch Otolaryngol Head Neck Surg. Oct 1997;123(10):1061-5. [Medline].

  9. Aciole GT, Aciole JM, Soares LG, Santos NR, Santos JN, Pinheiro AL. Surgical treatment of oral lymphangiomas with CO2 laser: report of two uncommon cases. Braz Dent J. 2010;21(4):365-9. [Medline].

  10. Bai Y, Jia J, Huang XX, Alsharif MJ, Zhao JH, Zhao YF. Sclerotherapy of microcystic lymphatic malformations in oral and facial regions. J Oral Maxillofac Surg. Feb 2009;67(2):251-6. [Medline].

  11. Burrows PE, Mitri RK, Alomari A, et al. Percutaneous sclerotherapy of lymphatic malformations with doxycycline. Lymphat Res Biol. 2008;6(3-4):209-16. [Medline].

  12. Greinwald JH, Burke DK, Sato Y, et al. Treatment of lymphangiomas in children: an update of Picibanil (OK-432) sclerotherapy. Otolaryngol Head Neck Surg. Oct 1999;121(4):381-7. [Medline].

  13. Edwards PD, Rahbar R, Ferraro NF, Burrows PE, Mulliken JB. Lymphatic malformation of the lingual base and oral floor. Plast Reconstr Surg. Jun 2005;115(7):1906-15. [Medline].

  14. Neville DD, Damm DD, Allen CM, Bouquot JE. Soft tissue tumors. In: Oral and Maxillofacial Pathology. ed. WB Saunders Co; 1995:711.

 
Previous
Next
 
Marked lingual enlargement caused by lymphatic malformation. Note the pebbly surface in areas not covered by materia alba. Also note the ecchymotic lesions protruding from the buccal mucosa in the mandibular vestibules.
Note the significant left buccal and submandibular swelling.
Profile view of a young adult with oral lymphangioma (same patient as in Media File 2).
Superficial lymphatic malformation.
Superficial lymphatic malformation.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.