Bilateral idiopathic aneurysms of the lingual artery identified by three-dimensional computed tomography angiography

Aneurysms of the external carotid artery and its branches are rare, and usually occur in the more superficial branches. Lingual artery (LA) aneurysms are particularly rare, and pseudoaneurysms are associated with trauma, infection, and surgical intervention. Only a few cases of idiopathic LA aneurysms have been reported in the English literature. LA aneurysms can be fatal if they are not recognized and treated. Here, we report a case of bilateral idiopathic aneurysms of the LA identified by three-dimensional (3D) computed tomography angiography (CTA). An 80-year-old man with right tongue cancer (T2N0M0) and left tongue leukoplakia was referred to our department for treatment. He had no previous history of trauma, infection, surgery, or aneurysm in the oral and maxillofacial region. CTA with 3D reconstruction showed right and left aneurysms of the LA, with sizes of 2.4 x 2.3 x 2.1 mm and 3.4 x 3.2 x 2.5 mm, respectively. The patient underwent bilateral partial glossectomy under general anesthesia without intervention for the aneurysms, and the post-operative course was uneventful. A radiological follow-up has been performed regularly for the small unruptured aneurysms.