Figure 1.    This is a clinical photograph as the patient first presented to the Children’s Hospital Dental Clinic.  Note the dome-shaped smooth surfaced exophytic grayish nodule on the ventral tongue

 

History of the present illness
This is a healthy four-year-old girl whose mother was the first to notice a single, smooth-surfaced, well-demarcated and grayish-pink nodule on the right side of the ventral surface of tongue about 4 X 4 mm in size.  It was asymptomatic and enlarged progressively over a period of six to eight weeks to about 1 cm in its greatest dimensions.  At early presentation, the mass was described as superficial and fluctuant, although it eventually became firmer.  The overlying mucosa was stretched and smooth with no evidence of ulceration.