History of the present illness
This is an 11-day-old baby who was presented by her parents to the Oral & Maxillofacial Surgery clinic at Children’s Hospital and Medical Center.  Their chief complaint was that the baby’s tongue was progressively increasing in size, making it difficult for the mother to continue breastfeeding.  The baby did not appear to be in any acute distress.  On examination, the tongue was elevated (Fig 1) and there was swelling in the submental space.  Palpation of the area revealed a firm mass in the floor of the mouth and posterior tongue.  The overlying mucosa was intact and there was no evidence of ulceration or purulent drainage.   

 

Figure 1. This is a clinical photograph as the patient first presented to the Children’s Hospital Dental Clinic.  Note the smooth tongue being pushed upward and outward.