A 7-year-old healthy boy presented with progressive eruption on his tongue of 4 years’ duration. The condition was noticed by the parents when the child was 3 years old, and they did not report any other medical problems.
The most probable diagnosis of this case is:
(a) Lymphangioma circumscriptum
(b) Hereditary haemorrhagic telangiectasia
(c) Hereditary benign telangiectasia
(d) Capillary hemangioma
This patient may be at risk of developing:
(a) Gastrointestinal tract bleeding
(b) Squamous cell carcinoma
(c) Paroxysms of severe pain
(d) Autoimmune disorders
(e) None of the above
1: a; 2: b
Lymphangioma circumscriptum is a form of localized lymphatic malformation that manifests with translucent fluid-filled vesicles, but may vary in colour from red to blue-black when they contain blood. The most common symptom is recurrent oozing, usually of clear fluid. Complications include ulceration, bleeding and secondary infection. Squamous cell carcinoma is described arising within lymphangioma circumscriptum 1–3.
1. Mortimer PSBurns T, Breathnach S, Cox N, Griffiths C. Disorders of lymphatic vessels. Rook’s textbook of dermatology 2010; 38th ed..Oxford, UK: Blackwell Science;26–27.
2. Peachey RC, Lim CC, Whimster IM. Lymphangiomas of the skin. Br J Dermatol 1970; 83:519–527.
3. Wilson GR, Cox NH, McLean NR, Scott D. Squamous cell carcinoma arising within congenital lymphangioma circumscriptum. Br J Dermatol 1993; 129:337–339.