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Dutra MJ, Anbinder AL, Pereira CM, Chiliti BA, Rocha AC, Kaminagakura E. Report of intraosseous intravascular papillary endothelial hyperplasia associated with an odontogenic cyst in the maxilla and literature review. Diagn Pathol 2024; 19:80. [PMID: 38867285 PMCID: PMC11167849 DOI: 10.1186/s13000-024-01505-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024] Open
Abstract
Intravascular papillary endothelial hyperplasia (IPEH) represents an uncommon reactive endothelial hyperplastic proliferation. A 46-year-old man experienced increased volume in the right maxilla, elevation of the nasal ala, and swelling of the hard palate with a reddish hue for 3 months. Computed tomography revealed an expansive hypodense region and cortical bone destruction associated with an impacted supernumerary tooth and an endodontically treated tooth. Under the differential diagnoses of a radicular cyst, dentigerous cyst, and ameloblastoma, an exploratory aspiration and incisional biopsy were performed. This revealed the formation of blood vessels of various diameters lined by endothelium, forming intravascular papillae positive for CD-34. The definitive diagnosis was IPEH, and the patient was treated by embolization and surgery. Histological analysis confirmed the presence of IPEH associated with an odontogenic cyst. After 12 months of follow-up, no recurrence was observed. Also, we reviewed case reports of IPEH affecting the maxilla and mandible. Fourteen intraosseous cases were reported in the maxilla and mandible, with a preference for males and affecting a wide age range. Complete surgical excision was the treatment of choice, and recurrences were not reported. The pathogenesis of IPEH is controversial and may originate from trauma or inflammatory processes. To the best of our knowledge, this is the first report of an association of IPEH with an odontogenic cyst. The importance of IPEH in the differential diagnosis of intraosseous lesions in the jaws is emphasized, and preoperative semiotic maneuvers are needed to prevent surgical complications.
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Affiliation(s)
- Mateus José Dutra
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São Paulo State University (UNESP), São José dos Campos Av. Engenheiro Francisco José Longo Avenue, 777/778, Jardim São Dimas, São José dos Campos, SP, 12245000, Brazil
| | - Ana Lia Anbinder
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São Paulo State University (UNESP), São José dos Campos Av. Engenheiro Francisco José Longo Avenue, 777/778, Jardim São Dimas, São José dos Campos, SP, 12245000, Brazil
| | - Christyan Moretti Pereira
- Oral and Maxillofacial Surgery and Traumatology Service, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil
| | - Beatriz Afonso Chiliti
- Oral and Maxillofacial Surgery and Traumatology Service, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil
| | - André Caroli Rocha
- Oral and Maxillofacial Surgery and Traumatology Service, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil
| | - Estela Kaminagakura
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São Paulo State University (UNESP), São José dos Campos Av. Engenheiro Francisco José Longo Avenue, 777/778, Jardim São Dimas, São José dos Campos, SP, 12245000, Brazil.
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Atherton K, Hinen H. Vascular Anomalies. Dermatol Clin 2022; 40:401-423. [DOI: 10.1016/j.det.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Intravascular Papillary Endothelial Hyperplasia of the Mandible: A Rare Entity. J Craniofac Surg 2021; 33:e431-e433. [PMID: 34759253 DOI: 10.1097/scs.0000000000008372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Intravascular papillary endothelial hyperplasia (IPEH) is a lesion characterized by the proliferation of endothelial cells within the lumen of the vessel, it was first described by Masson in 1923.The pathogenesis of Masson's tumor is still unknown, currently the most accredited hypothesis is the reactive 1. Clinically and symptomatologically it can have different presentations, it is, therefore, of fundamental importance to make a correct differential diagnosis. Diagnosis is mainly based on histological criteria. Intravascular papillary endothelial hyperplasia usually occurs in the skin and subcutaneous tissues, less commonly in the skeleton. The present is the fifth case of intravascular papillary endothelial hyperplasia of the mandible.
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Eguchi T, Nakaoka K, Basugi A, Arai G, Hamada Y. Intravascular papillary endothelial hyperplasia in the mandible: a case report. J Int Med Res 2021; 48:300060520972900. [PMID: 33233959 PMCID: PMC7705293 DOI: 10.1177/0300060520972900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intravascular papillary endothelial hyperplasia (IPEH) is histopathologically characterized by papillary proliferation of vascular endothelial cells. IPEH in the mandible is very rare, such that only four affected patients have been described in the English-language medical literature. Thus, there is a poor understanding of the pathogenesis and clinical features of IPEH in the mandible. This case report describes a patient with IPEH in the mandible who had a history of repeated trauma involving the mandible due to boxing-related and baseball-related injuries. Imaging examinations had diagnostic limitations, in that they showed a multilocular radiolucency suggestive of a simple bone cyst of the mandible, whereas intraoperative findings revealed a fluid-free unicystic cavity lined by a thin red membrane. Thus, histopathologic examinations were necessary for definitive diagnosis. The specimen demonstrated a spongy structure consisting of many small papillary fibrous tissues, lined by a typical monolayer endothelium that expressed CD34, but did not express D2-40 or AE1/AE3. Moreover, the Ki-67 labeling index was <1%. Thus, the lesion was identified as intraosseous IPEH in the mandible. Although the pathogenesis of IPEH has been controversial, our findings in this case suggest that pathogenesis of IPEH may be related to a history of trauma.
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Affiliation(s)
- Takanori Eguchi
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 13123Tsurumi University, Yokohama, Japan
| | - Kazutoshi Nakaoka
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 13123Tsurumi University, Yokohama, Japan
| | - Akihiko Basugi
- Department of Oral and Maxillofacial Surgery, 38281Toshiba Rinkan Hospital, Sagamihara, Japan
| | - Go Arai
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 13123Tsurumi University, Yokohama, Japan
| | - Yoshiki Hamada
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 13123Tsurumi University, Yokohama, Japan
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Vieira CC, Gomes APN, Galdino Dos Santos L, de Almeida DS, Hildebrand LC, Flores IL, Dos Santos JN, Schuch LF, Vasconcelos ACU. Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review. J Oral Pathol Med 2020; 50:103-113. [PMID: 33188642 DOI: 10.1111/jop.13127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion. METHODS Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases. RESULTS Of the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables. CONCLUSION Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.
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Affiliation(s)
- Carolina Clasen Vieira
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ana Paula Neutzling Gomes
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Laylla Galdino Dos Santos
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Douglas Silva de Almeida
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Laura Campos Hildebrand
- Department of Conservative Dentistry, Oral Pathology area, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isadora Luana Flores
- Department of Conservative Dentistry, Oral Pathology area, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jean Nunes Dos Santos
- Department of Pathology, Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
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Mirmohammadsadeghi H, Mashhadiabbas F, Latifi F. Huge central intravascular papillary endothelial hyperplasia of the mandible: a case report and review of the literature. J Korean Assoc Oral Maxillofac Surg 2019; 45:180-185. [PMID: 31508349 PMCID: PMC6728626 DOI: 10.5125/jkaoms.2019.45.4.180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/27/2018] [Accepted: 12/20/2018] [Indexed: 01/23/2023] Open
Abstract
Masson's tumor or intravascular papillary endothelial hyperplasia is an inflammatory soft tissue lesion that rarely occurs in the maxillofacial region and skeletal system. Precise clinical and para-clinical investigation is necessary for the accurate diagnosis and correct treatment of this lesion. This paper presents a massive intravascular papillary endothelial hyperplasia lesion in the bony tissue of the mandible. Histopathology features, clinical appearance, and suitable management are discussed, with a complete review of the literature. The patient underwent composite resection of the lesion as well as reconstruction. No recurrence was observed during 6 years of follow-up. To the best of our knowledge, this is the fourth case of Masson's tumor in mandibular skeletal tissue, which has unique and distinctive features due to its size and location. A rare occurrence in skeletal tissue, complex clinical presentations, and complicated histopathologic findings present diagnostic challenges for treatment of this lesion.
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Affiliation(s)
- Hassan Mirmohammadsadeghi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mashhadiabbas
- Department of Oral and Maxillofacial Pathology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Latifi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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