A 44-year-old woman presented to the emergency department status post incidental discovery of a large lingual mass identified during workup of a known intracranial neoplasm. The patient presented with a 4-month history of progressive altered mental status, somnolence, aphasia, and dysphagia; symptomology was attributed to the suprasellar tumor. Metastatic disease to the oral cavity was the primary differential diagnosis. Imaging demonstrated a 5.5 × 5.5 cm posterior tongue mass with near complete pharynx obstruction. Prompt debulking and pathology workup occurred. On postoperative day 1, the patient experienced complete resolution of all symptoms. Given rapid improvement, neurological decline was ultimately attributed not to the suprasellar mass but instead as being secondary to profound obstructive sleep apnea and ensuing sleep deprivation caused by the lingual tumor. This case describes the rare finding of a massive lingual superficial angiomyxoma with a synchronous cerebral neoplasm in which the latter functioned as a diagnostic distraction.
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