10 years old, medically fit patent presented to the clinic with the following: CC: 'swelling on my tongue" MH: NRMH HoCC: Started about 4 months ago and has been increasing in size ever since then Clinical examination revealed no tenderness and the patient is not complaining of any pain Can you give differential diagnosis and what would you request to aid in reaching a definitive diagnosis How would you manage this case?

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Hi doctor .. Very interesting case ! .. Well my management will be taking an incisional biopsy and send it to histopathology.. I would not choose excisional because I would want to make sure that the tissue is nothing of importance .. Then my differential diagnosis would come like this: Fibroma, lymphoma The definitive diagnosis will become easier after the histopathology report

Fibroma .......biopsy
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D/D Pyogenic granuloma / Fibroma / Ectopic lingual thyroid

DDx: - Pyogenic Granuloma - Giant Cell Fibroma - Peripheral Giant Cell Granuloma I would go for an excisional biopsy to reach the definitive diagnosis. Thanks for sharing.

Capillary haemangioma, ( red coloured swelling) Benign vascular lesion Ectomesenchymal chondromyxoid tumor  Granular cell tumor Aspiration cytology with a wide bore needle can be tried before Incisional or Excisional Biopsy. H/p evaluation will be the key to unlock the treatment

Hemangioma is the most probable diagnosis Excision with oral propranolol is the treatment other unlikely D/D are lingual dermoid, lingual thyroid etc

It could be fibroma .. you have to do a biopsy .. keep us updated, thanks for sharing dr. Ahmad

Capillary Hemangioma

Give patient history such as any trauma, irritation, habbit, oral hygiene, burning sensation, at All etc.???

Unfortunately, neither the patient nor his parents were able to recount history of trauma. The child didn't complain of any pain or abnormal sensation in relation to the swelling.
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Very good case thank you for sharing

Fibroma Lymphoma

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