A rare cause of spontaneous bleeding per oral in an elderly.

What is the possible diagnosis? A. Carcinoma of the tongue base B. Lingual thyroid C. Tongue hemangioma D. Teratoma E. Sarcoma of the palate Oral examination revealed a signifi cant midline mass, located at the base of the tongue (Fig. 1). There was evidence of recent bleed from the surface. Rigid laryngoscopic fi ndings revealed the mass had a smooth surface, pushing the soft palate upward and obstructing the view of laryngeal inlet. MRI of the neck showed the presence of a well delineated midline soft tissue mass at the base of the tongue accurately measuring 4.96 cm x 5.80 cm x 4.35 cm (AP X W X CC) (Fig. 2). Images of the lower neck revealed an absence of the normal thyroid tissue in its expected location. Her thyroid function tests were normal. The diagnosis of lingual thyroid was established. Thyroid hormone suppression therapy (THST) with L-Thyroxine 100 mcg daily was initiated. After 5 days, the bleeding stopped and reassessment after one month showed the lingual thyroid had shrunk in size.