International Journal of Science and Research (IJSR) ISSN: 2319-7064 SJIF (2022): 7.942 Volume 12 Issue 9, September 2023 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Management of Tongue Hemangioma with Sclerosing Agent - A Case Report Dr. Asif Imtiyaz Molla Consultant Maxillofacial Surgeon, Bengal Cancer Foundation, Burdwan, West Bengal, India Abstract: Hemangiomas are one of the most prevalent birth abnormalities in humans, which are formed from vascular tissues. 60% of instances involve the head and neck, which is the most common site. Numerous therapy options are tested, some of which are effective and others are somewhat disappointing. Among the treatment options considered are irradiation, sclerosing agents, surgical excision, cauterization, CO2 freezing, steroid medication, and watchful waiting. Hemangiomas must be treated carefully, taking into account factors including size, location, patient age, and the effectiveness of the intended approach. This case report presents the efficacy of intralesional injection of sodium tetradecyl sulphate for the management of haemangiomas Keywords: Tongue hemangioma, Sodium Tetradecyl Sulfate, Vascular malformation, sclerotherapy 1. Introduction Hemangiomas are generally present at birth, however they can occasionally get worse with age. They typically occur alone and present as a flat or elevated reddish blue lesion. Hemangiomas invariably involute, but at least 10–20% of cases require active treatment due to their propensity to bleed and develop ulcers 1 . Although head & neck region only makes up 14% of the body's surface area, but it is where 65% of hemangiomas develop. Despite the prevalence of these tumors, the exact cause of their development remains unknown. Clinically, lesions with cavernous hemangiomas are discolored. The are ill defined soft, and blanch easily under compression 2 . Depending on the size, location, depth, and involvement of nearby structures, a variety of treatment techniques including surgical excision, laser therapy, cryotherapy, cauterization, radiotherapy, silver nitrate, and sclerosing solution have been utilized 3 .The use of sclerosing solution is the most convenient, effective and inexpensive treatment modalities especially in oral and peri-oral hemangioma lesions. I hereby present a case report of hemangioma of tonguetreated successfully with 3% sodium tetradecyl sulfate injection. 2. Case Report A 75 years old male patient reported to my Advanced Dental & Facial Surgery Centre, Guskara, West Bengal with a complaint of swellings on the dorsal surface of tongue and swallowing difficulty. The patient gave history of swelling of tongue which increase suddenly on biting and regress after few days. No history of rupture or any drainage. Patient visited to multiple specialists where he wasgiven medication but did not get relieved. Local examination revealed a single swelling near to the tip of the dorsal surface of the tongue on the left side. Color of the swelling was bluish with pin point erythematous areas on the surface measuring 24mmx16mm. (Fig1) On palpation, swelling was pulsatile, non-tender, non- fluctuant and no blood or pus discharge. Based upon clinical examination, provisional diagnosis of Hemangioma of tongue, was given. The patient was advised for color doppler ultrasound of tongue in which internal vascular malformation was observed that was discretely heterogenous confirming the diagnosis of Hemangioma. Patient was planned for treatment of the lesion using a sclerosing agent sodium tetradecyl sulfate. Surface anesthesia was given by 15% lidocaine spray. 3% sodium tetradecyl sulphate was injected intralesionally, first at the periphery and then into the centre of the lesion with insulin syringe. 1 ml ofsodium tetradecylsulphate was injected in one sitting. Manual compression was applied to the lesion to ensure stasis wherever it was possible. Patient complained of pain and mild local inflammatory reaction. Sclerosing agent caused tissue necrosis after 72 hrs of injection (Fig:2). For pain and necrosis patient was prescribed analgesics, anti inflammatory and antibiotic tablet for 7 days. The lesion had entirely regressed when the patient was called back for follow-up after 28 days (Fig: 3). Figure 1: Photograph showing swelling of the tongue Figure 2: Necrosis of the tongue after 72 hours of sclerotherapy Paper ID: SR23924211221 DOI: 10.21275/SR23924211221 1908