Vogel et al classified the causes for true macroglossia. The authors are from the University of North Carolina at Chapel Hill and Harvard Medical School.
True macroglossia may be either:
(1) congenital (which includes macroglossia secondary to a genetic disorder, malformation, or tissue heterotopia; may or may not be clinically evident at birth)
(2) acquired
Causes of true macroglossia:
(1) vascular malformation (affecting lymphatics, veins or capillaries)
(1a) capillary hemangioma
(1b) lymphangioma
(1c) lymphangiohemangioma
(1d) venous malformations
(2) muscular hypertrophy and/or hyperplasia
(2a) hemihypertrophy
(2b) Beckwith-Wiedermann syndrome (with exophthalmos and gigantism)
(3) infiltration secondary to a inherited metabolic disorder
(3a) mucopolysaccharidosis
(4) acquired systemic disorder
(4a) amyloidosis
(4b) acromegaly (gigantism) with generalized hypertrophy of intrinsic elements
(4c) hematoma secondary to a systemic bleeding disorder
(4d) infection (syphilitic gumma, abscess, tuberculoma)
(5) local reactive change (usually transient)
(5a) edema
(5b) vascular congestion
(5c) thermal or chemical burn
(5d) traumatic
(5e) allergic/hypersensitivity response
(5f) perioperative (congestion due to position, trauma from intra-oral tubing)
(6) cysts and benign tumors
(6a) dermoid cyst
(6c) lingual cyst
(6c) rhabdomyoma
(7) malignant tumors
(7a) squamous cell carcinoma
(7b) malignant lymphoma
