A 40-year-old white woman presented with a fluctuant and bleeding mass of the tongue. Clinical examination revealed a small, firm, submucosal nodule located in the right paramedian region of the dorsum of the tongue, 15 mm from the tip of the tongue. The patient refused a biopsy and no treatment was performed at that time. At the next visit, 5 months later, she again presented with a firm, irregular, rather deep mass, measuring approximately 7 × 3 mm (Figure 1, arrowheads). There was also an area of bleeding, and the lesion was painful to palpation. The patient was otherwise in good general health. An excisional biopsy specimen was examined with standard microscopy (Figure 2) and polarized light (Figure 3).
Lysitsa S, Najm SA, Samson J, Lombardi T. Submucosal Nodule of the Tongue—Quiz Case. Arch Dermatol. 2006;142(3):385-390. doi:10.1001/archderm.142.3.385-a