Intramuscular lipoma of the tongue masquerading as angioedema

January 24, 2013
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Abstract

In most cases, the diagnostic evaluation of angioedema is challenging, as there are many possible etiologies. We report a case of an infiltrating lipoma of the tongue that masqueraded as angioedema. The patient, a 68-year-old man, presented with tongue swelling that had followed a waxing and waning course over a 6-month period. Physical examination showed a diffusely enlarged tongue with no discrete mass. A laboratory evaluation for angioedema was unremarkable. After the patient's condition did not respond to treatment with antihistamines and oral prednisone, a further workup was initiated. Magnetic resonance imaging of the neck and computed tomography of the oral cavity revealed only diffuse enlargement of the tongue. The patient underwent a tongue biopsy, which identified the cause of the swelling to be an infiltrating lipoma of the tongue. Clinicians should be aware that other causes of tongue swelling may mimic angioedema.


Introduction

Angioedema is a swelling of the soft tissues secondary to extravasation of fluid into the interstitial tissues. The most common manifestations are the typical symptoms and signs of soft-tissue edema, and they occur most often in the face and upper extremities.1 There are many causes of angioedema, and the specific etiology of a particular case often cannot be determined.1

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