A photograph shows a soft, compressible, bluish-purple vascular dilation on the ventral surface of the tongue in a 72-year-old patient. What is the most likely diagnosis?

Correct answer: A. Varix (varicosity)

• A. A varix (oral varicosity) is a dilated, tortuous vein most commonly found on the ventral tongue and floor of mouth in older patients. It appears as a bluish-purple, soft, compressible lesion that blanches with pressure. Very common in the elderly. ✓
• B. A mucocele is a mucus-filled cyst from a damaged minor salivary gland, typically found on the lower lip. It appears bluish but is firm and fluctuant, not vascular.
• C. A ranula is a large mucocele of the floor of the mouth arising from the sublingual gland, presenting as a large dome-shaped swelling — not a focal vascular lesion on the ventral tongue.
• D. A hemangioma is a vascular proliferation/malformation present since childhood or early life, not typically appearing de novo in elderly patients.