Multiple lymphangiomas of the alveolar ridge in a neonate: case study.

A case report of bilateral lymphangiomas of the mandibular alveolar ridge in the neonate is presented. This case is of interest in that it constitutes the first report of multiple lymphangiomas occurring within a single dental quadrant. Lymphangiomas generally are regarded as hamartomas and as such represent a developmental malformation of lymphatic vessels. The most common intraoral site of lymphangiomas is the tongue, which when so affected may be enlarged and referred to as macroglossia. ~,2 Lymphangiomas are classified as simple, cavernous, cellular, diffuse systemic, and cystic lymphangiomas or hygroma. 2 Lymphangioma histologically consists of numerous enlarged lymphatic vessels lined with endothelium. These channels usually are fitted with protein-rich fluid with only a few blood cells. ~ Lymphangiomas of the alveolar ridges in neonates were first described by Levin et al. in 1976.3 In their study of 2092 infants, it was noted that only 55 (3.7%) manifested lymphangiomas of the alveolar ridges. The lesions were observed to occur only in blacks with a definite predilection for males. The lymphangiomas were limited anatomically to the posterior aspects of the maxillary ridge and to the posterior lingual surface of the mandibular ridge. The authors indicated that a majority of affected infants had multiple lesions, with the most common distribution being bilateral on the mandibular alveolar mucosa. In a similar series of cases, Jorgenson et al. 4 noted that 4% of black neonates had alveolar lymphangiomas ranging in size from 1 to 9 mm in diameter. No cases were noted in white infants and there was a 2:1 male-to-female distribution. Most of the neonates had 1 or 2 lesions, the latter being more common. Interestingly, no cases have been described in any series in which there were multiple lesions confined to any single quadrant. The present report is, to the authors’ knowledge, the first in which multiple lesions in a single quadrant of the mandibular alveolar ridge are observed. This also represents the first report in the dental scientific literature of lymphangioma of the alveolar ridge of a neonate.