Rare vascular proliferations of the oral mucosa

Spindle Cell Hemangioma of Lower Lip: The Fourth Case Report with Review of Literature

Background

Spindle cell hemangioma previously known as spindle cell hemangioendothelioma is a benign vascular tumour with rare presentation in head and neck. Presentation in lip is even rarer with three cases reported previously.

Method

This report describes a case of spindle cell hemangioma presented as an asymptomatic growth on lower lip of a 32-year-old male. Clinicopathological characterization of this case along with previously reported 15 cases of spindle cell hemangioma of head and neck were conducted.

Result

Microscopic evaluation shows a well-circumscribed vascular neoplasm of spindled and epithelioid endothelial cells. Large ectatic thin-walled vascular spaces were seen engorged with RBCs. The neoplasm was CD31 positive. Slight predilection for female gender and young age were observed. Minimal possibility of recurrence was also observed.

Conclusion

Spindle cell hemangioma needs to be considered in the differential diagnosis of vascular tumours of head and neck to avoid misdiagnosis of aggressive vascular neoplasms.

Rare case of spindle cell haemangioma of oral cavity

Spindle cell haemangioma (SCH) is a slow growing, benign vascular lesion with a preference for the distal extremities. Its occurrence in the oral cavity is rare. Clinically, it presents as solitary or multiple subcutaneous nodules, therefore, it could be considered in the differential diagnosis of benign soft tissue tumours. Microscopically it mimics some malignant vascular tumours and it is necessary to differentiate it from other malignant vascular lesions. We report a case of SCH in anterior mandibular region of a young male in his 20s. Although it is a benign lesion, the reported case displayed extensive areas of muscle infiltration and necrosis. After studying the radiographic findings and considering the absence of cellular atypia, a final diagnosis of SCH was made. Literature survey suggests that this is the eleventh case of SCH reported in oral cavity.

Spindle Cell Hemangioma in the Mucosa of the Upper Lip: A Case Report and Review of the Literature

Spindle cell hemangioma (SCH) is a unique benign vascular lesion. We present a case of SCH in the upper lip of a 41-year-old woman. A submucosal nodular mass 30 × 20 mm in size was observed in the left upper lip. The mass developed 5 years earlier and enlarged after repeated ethanol injections. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. Under the clinical diagnosis of hemangioma, surgical excision was performed under local anesthesia. Microscopically, the lesion was composed of irregular cavernous spaces and multiple solid cellular areas. Cavernous spaces were filled with a mix of erythrocytes and organizing thrombi. The solid areas showed proliferation of spindle-shaped cells arranged haphazardly or in short interlacing fascicles. Immunohistochemically, most cells strongly reacted with vimentin. CD31, CD34, factor VIII, smooth muscle actin, and Wilms tumor-1 reacted with endothelial cells lining the cavernous spaces. The cells within solid areas consisted of mixed cell population with variable reaction for the markers except for factor VIII. From these findings, the diagnosis of SCH was made. Two years after surgery, no recurrence was noted. A review of SCH in the head and neck region is made.

Oral encapsulated vascular malformation: An undescribed presentation in the mouth

Vascular lesions have been classified in two broad categories, hemangiomas and malformations. Encapsulated vascular lesions have not been reported in the oral cavity, but they were described in other sites, mainly in the orbit. Herein, we present a case of an oral encapsulated vascular lesion located in the right buccal mucosa of a 69-year-old male, including histological and immunohistochemical description and a literature review.

Key words:Buccal mucosa, hemangioma, vascular malformation, oral cavity.

Intravascular papillary endothelial hyperplasia: report of 2 cases and immunohistochemical study

Intravascular papillary endothelial hyperplasia (IPEH) is a benign, nonneoplastic, vascular lesion. The main significance of the lesion lies in the fact that it may be mistaken for angiosarcoma. Oral lesions are uncommon and the present paper reports 2 cases of oral IPEH, in different sites. Histologically, the tissue was characterized by papillary fronds lined by proliferating endothelium. Immunohistochemically (IHC), the lesion was positive for CD34, smooth muscle actin (SMA), type I and IV collagen, vimentin, and laminin, but it was negative for CD105. Local excision was the treatment of choice. No recurrence was observed during a 1-year and 6-month follow-up period, respectively. The clinical, histological, and immunohistochemical characteristics are discussed.

Extravascular papillary endothelial hyperplasia of the palm masquerading as an angiosarcoma

Cutaneous extravascular papillary endothelial hyperplasia (PEH) is a rare lesion presenting as a cutaneous mass and histologically mimicking angiosarcoma. Herein, we describe a patient who presented with a palm tumor that had developed after trauma. Histologically, the lesion was ulcerated and showed proliferation of atypical epithelioid cells with nuclear enlargement and mitosis. Vascular proliferation was evident, and these were positive for CD31 and CD34, with approximately 20% positivity for MIB-1. We diagnosed this case as an extravascular papillary endothelial hyperplasia because there was no evidence of invasion into the surrounding tissue and elastica staining proved it did not have a vascular structure. To our knowledge, cutaneous extravascular PEH has not yet been reported in the published work.

Spindle cell hemangioma (hemangioendothelioma) of the head and neck: case report of an unusual (or underdiagnosed) tumor

Spindle cell hemangioma (SCH), also known as spindle cell hemangioendothelioma, is a unique vascular tumor with combined microscopic features of both a cavernous hemangioma and Kaposi sarcoma. It almost exclusively affects the dermis and subcutis of the distal extremities. A review of the literature disclosed only 5 cases of SCH reported in detail in the soft tissues of the head and neck. An additional case of SCH manifesting as a submucosal nodule in the upper lip of a 29-year-old woman is presented. Because this is the second case reported from the same institution, it is suggested that SCH is an underdiagnosed lesion.

Spindle cell hemangioma: report of a case presenting in the oral cavity

BACKGROUND

Spindle cell hemangioma, formerly termed spindle cell hemangioendothelioma, is an uncommon benign vascular tumor. Presentation in the oral cavity is rare with only two previously reported cases.

METHODS

We report a case of spindle cell hemangioma that presented as an asymptomatic mass of the buccal mucosa in a 44-year-old man.

RESULTS

The tumor was a well-circumscribed vascular proliferation of spindled to epithelioid endothelial cells. Tumor cells with intracytoplasmic vascular lumens were present in several areas. Larger, ectatic, thin-walled vessels lined by a single layer of flattened endothelial cells were evident at the periphery and focally in more cellular areas. The tumor was positive for CD31 and CD34.

CONCLUSIONS

Spindle cell hemangioma rarely presents in the oral cavity and needs to be considered in the differential diagnosis of oral cavity vascular tumors to avoid misdiagnosis as a more aggressive vascular tumor.

Spinal spindle cell haemangioma: an atypical location

We present a case of the 31-year-old male patient who complained of weakness in both legs and progressed slowly. Neuroimagine of the thoracic spine showed an intraspinal, extradural mass lesion, measuring 5.3 x 1.2 cm at the Th1-Th3 level. Histologically the lesion was a spindle cell haemangioma composed of dilated vascular spaces and a proliferation of bland appearing interspersed spindle cells. Immunohistochemical analysis was diffusely positive for VIM, SMA and focally for CD34. This lesion is uncommon and shows a predilection for distal extremities. Spindle cell haemangioma within the spine has not been previously reported in the literature.