An otherwise healthy 13-month-old male was scheduled to undergo excisional biopsy of a left anterior tongue submucosal intramuscular mass (Figure 1). This firm-to-palpation mass was noted at birth and remained proportional in size with the child’s somatic growth, measuring approximately 1 cm in diameter on presentation. Preoperative magnetic resonance imaging (MRI) documented the mass to be uniformly solid and well circumscribed without cystic components or flow voids, hypointense on T2, and hyperintense with homogeneous contrast enhancement on T1. His head, neck, and general examination findings were otherwise normal with no cervical lymphadenopathy or additional masses.
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Neonatal tongue lesions have a broad differential diagnosis, including cystic, solid, and mixed composite lesions.1 Differentiation of cystic from solid lesions is important, as each warrants a unique differential diagnosis. Ultrasonography, computed tomography, and MRI are modalities that can be used to make this differentiation. If sedation is required, MRI with contrast is preferable given the excellent soft tissue detail without risk of radiation.
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Corresponding Author: Kenneth L. Kennedy, MD, Boston Children’s Hospital, 300 Longwood Ave (Mailstop: BCH3129), Boston, MA 02115 (email@example.com).
Published Online: September 21, 2023. doi:10.1001/jamaoto.2023.2911
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient’s parent for granting permission to publish this information.
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