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Muraoka H, Kaneda T, Kondo T, Tokunaga S. Central vascular malformations of the mandible: Characteristic findings in computed tomography and magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00432-7. [PMID: 37202282 DOI: 10.1016/j.oooo.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 05/20/2023]
Abstract
Central vascular malformations (CVMs) of the mandible are rare and can have varied clinical and radiological characteristics, thus making differential diagnosis difficult. We retrospectively reviewed 5 patients with proven CVM who underwent computed tomography (CT) and magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) (and magnetic resonance angiography (MRA) for one patient), to assess the characteristic imaging findings of this lesion. CT revealed multilocularity in 3 lesions. All CVMs produced fine, irregular borders and low-to-intermediate density. Lesion continuity with the mandibular canal was discovered in 4 cases and enlarged feeding and outflow vessels in 3 lesions. Bone overgrowth was observed in 2 patients. CT values ranged from 30.84 to 52.87 Hounsfield units (HU). MRI exhibited low to intermediate signals on T1-weighted imaging (T1WI), signals ranging from low to intermediate-to-high on T2WI, and low to high signal intensity on short-tau inversion recovery (STIR) images, with flow voids in all patients and no inflammation in surrounding tissues. As calculated with DWI, the apparent diffusion coefficient (ADC) ranged from 0.69 to 1.74 × 10-3 mm2/s. MRA showed the presence of feeding vessels in 1 lesion. Interexaminer agreement on image interpretation ranged from moderate to excellent. These typical CVM imaging findings may aid in the differential diagnosis of this lesion.
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Affiliation(s)
- Hirotaka Muraoka
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.
| | - Takashi Kaneda
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan
| | - Takumi Kondo
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan
| | - Satoshi Tokunaga
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan
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Ommerborn MA, John G, Becker J, Preetz J, Gabris S. Forty-five-months follow-up of a minimally invasive, interdisciplinary treated hemangioma of the mandible with a high risk of severe bleeding - a case report. Head Face Med 2023; 19:1. [PMID: 36639813 PMCID: PMC9840336 DOI: 10.1186/s13005-022-00346-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hemangiomas are benign tumours, mostly seen in the soft tissues. The intraosseous appearance is rare, in particular in the jaws they represent a very seldom malformation. AIM To present a combined endodontic and surgical management report of a clinical case with a rare intraosseous hemangioma diagnosis in the mandible. CASE PRESENTATION This well-documented case report describes the interdisciplinary treatment approach of an intraosseous hemangioma in the left mandible of a 70-year-old male patient. This incidental finding was detected through a routine dental examination. The panoramic radiograph revealed an asymptomatic, apical translucency approximately 15 mm diameter with contact to the mesial root of the tooth 36. The clinical examinations showed no abnormalities. The multifaceted specialized treatments started with the endodontic treatment of the tooth prior to the surgical removal of the lesion and were followed by the histological assessment. As derived from the histologically verified diagnosis, this rare case included the risk of severe bleeding complications during therapy.
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Affiliation(s)
- Michelle Alicia Ommerborn
- grid.411327.20000 0001 2176 9917Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Gordon John
- grid.411327.20000 0001 2176 9917Department of Oral Surgery and Central Admittance, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Jürgen Becker
- grid.411327.20000 0001 2176 9917Department of Oral Surgery and Central Admittance, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julia Preetz
- grid.411327.20000 0001 2176 9917Department of Pathology, Faculty of Medicine, Heinrich-Heine-University and University Hospital, Düsseldorf, Germany
| | - Sondos Gabris
- grid.411327.20000 0001 2176 9917Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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Okura S, Igarashi C, Wakae-Morita S, Ichiko T, Ito H, Sugisaki M, Sato T, Kobayashi K. A case of venous malformation of the mandible. Oral Radiol 2018; 35:194-197. [PMID: 30484192 DOI: 10.1007/s11282-018-0335-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/24/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Vascular malformations occur more rarely in bones than in soft tissue, with 0.5-1.0% of all intraosseous tumors occurring in the mandible. We report a diagnostically challenging case of unilocular venous malformation of the mandible. CASE REPORT A 76-year-old man presented with a heterogeneous, unilocular, radiolucent lesion with a well-defined border. Panoramic radiography and computed tomography imaging revealed a continuous white line on the cortical bone at the inferior border of the left mandibular molar region. A spherical lesion with a well-defined border and a clear round region in the left mandible were revealed on magnetic resonance imaging. The lesion had the same signal intensity as muscles on T1-weighted imaging, a homogeneous high-intensity signal on short T1-inversion recovery imaging, and a well-defined low-signal intensity region surrounded by a high-intensity signal region on T2-weighted imaging. Pathological findings indicated that the lesion was a venous malformation. DISCUSSION Although many studies have reported that venous malformations have a multilocular appearance, few have described the occurrence of unilocular lesions. Future investigations using magnetic resonance imaging and computed tomography are needed to increase the diagnostic accuracy for unilocular central vascular malformations of the jaw bone.
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Affiliation(s)
- Shintaro Okura
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan.
| | - Chinami Igarashi
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Satsuki Wakae-Morita
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Takashi Ichiko
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Hirokazu Ito
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Masashi Sugisaki
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Toru Sato
- Department of Oral Medicine and Stomatology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
| | - Kaoru Kobayashi
- Department of Oral and Maxillofacial Radiology and Diagnosis, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi Ward, Yokohama, Kanagawa, 230-8501, Japan
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Chandra SR, Chen E, Cousin T, Oda D. A case series of intraosseous hemangioma of the jaws: Various presentations of a rare entity. J Clin Exp Dent 2018; 9:e1366-e1370. [PMID: 29302291 PMCID: PMC5741852 DOI: 10.4317/jced.54285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/09/2017] [Indexed: 11/05/2022] Open
Abstract
Background Hemangiomas of the soft tissue are common in the head and neck area, especially in the tongue and in children under ten years of age. Intraosseous hemangiomas of the mandible and maxilla (IHM), on the other hand, are exceedingly rare and are not well characterized. This study presents six IHM cases focusing on the clinical, radiographic, and histologic characteristics. Material and Methods Six cases of IHM were retrieved from the archives of the Biopsy Services at the University of Washington. Clinical, radiologic, and histologic findings are described. Results A total of six cases of IHM were reviewed. The patient age range was 16 to 65; the group comprised three females and three males. All six cases presented as swellings, two caused tooth resorption, and one was associated with pain and numbness. Three of the six IHM were present in the body of the mandible, two in the area of the extracted right mandibular third molar, and one in the anterior maxilla between the right canine and lateral incisor. Radiographically, five were radiolucent and one was radiopaque. Of the five radiolucent, two were unilocular and three multilocular. The one radiopaque case was exophytic, simulating a large osteoma. Histologic features ranged from cavernous to a mix of venous and arterial types. Follow-up is available for all six cases ranging between one to seven years; only one case recurred within the first year post-surgery. Conclusions IHM are exceedingly rare; IHM do not present in a consistent manner both clinically and radiographically. It is therefore important to recognize the wide spectrum of IHM's clinical, radiographic, and histological presentations. Key words:Hemangioma, Vascular Malformation, mandible, maxilla.
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Affiliation(s)
- Srinivasa R Chandra
- MD, DDS, Clinical Assistant Professor, 1959 NE Pacific St, Department of Oral & Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington 98195-7133, USA
| | - Eleanor Chen
- MD, PhD, Assistant Professor, Department of Pathology, University of Washington Medical Center , 1959 NE Pacific St Box 357705
| | - Timothee Cousin
- DDS, Candidate, Class of 2017, 1959 NE Pacific St, Room D322, University of Washington School of Dentistry, Seattle, Washington 98195, USA
| | - Dolphine Oda
- BDS MSc, Professor, 1959 NE Pacific St, Department of Oral & Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington 98195-7133, USA
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Dhiman NK, Jaiswara C, Kumar N, Patne SCU, Pandey A, Verma V. Central cavernous hemangioma of mandible: Case report and review of literature. Natl J Maxillofac Surg 2016; 6:209-13. [PMID: 27390499 PMCID: PMC4922235 DOI: 10.4103/0975-5950.183866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Intraosseous hemangiomas are one of the rarest lesion of jaw bones (0.5-1%) occurring most commonly in vertebral column, skull bone, and rarely in mandible. Mainly occurs in the second decade of life with female: male predilection (2:1). Origin of hemangiomas is still debatable. World Health Organization considers it as a true benign neoplasm of vascular origin, and many authors believe it to be a hamartoma. It is very difficult to diagnose due to variable clinical and radiological features. A biopsy is not done on a routine basis due to a higher risk of hemorrhage. Management is very difficult because of massive vascular network in that region. Here, we are presenting a case report of a 14-year-old boy with intraosseous hemangioma of right body of mandible, which was treated with en bloc surgical resection of mandible and followed by reconstruction.
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Affiliation(s)
- Neeraj Kumar Dhiman
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Chandresh Jaiswara
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Naresh Kumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shashikant C U Patne
- Department of Pathology, Faculty of Modern Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arun Pandey
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vishal Verma
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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6
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Frizzera F, Beccalli I, Maia RMLC, Tonetto MR, Zanetti LSDS, de Barros LPA. Conservative treatment of intraosseous hemangiomas in the mandible: case report with a 17-year follow-up period. J Contemp Dent Pract 2014; 15:376-80. [PMID: 25307825 DOI: 10.5005/jp-journals-10024-1547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Intraosseous hemangiomas in the jaws are rare lesions and may lead to several complications. The authors present a case of a 12-year-old girl with a radiolucent periapical lesion between tooth 35 and 36 where nocturnal exsanguinating bleeding started to occur from periodontal sulcus during orthodontic treatment. Diagnosis of an intraosseous hemangioma in the mandible was based on positive needle aspiration for blood, computed tomography and arteriography. At first the family chose to only follow-up the lesion but episodes of nocturnal hemorrhage were becoming more frequent and a treatment was requested. Embolization and dental extraction were performed in order to treat the lesion. After a follow-up period of 17 years no more cases of hemorrhage occurred and lesion regressed.
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Affiliation(s)
- Fausto Frizzera
- Full Professor, Department of Dentistry, Integrated College Espírito Santense FAESA, Vitória, ES, Brazil
| | - Ivette Beccalli
- Adjunct Professor, Department of Clinical Odontology, Health Sciences Center, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Rosa Maria Lourenço Carlos Maia
- Adjunct Professor, Department of Clinical Odontology, Health Sciences Center, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | - Liliane Scheidegger da Silva Zanetti
- Professor, Full Professor, Department of Dentistry, Integrated College Espírito Santense FAESA, Vitória, ES, Brazil, e-mail: lilianabarros@ hotmail.com
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7
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Kondylidou-Sidira A, Dietrich EM, Koloutsos G, Sakkas L, Antoniades K. Intraosseous vascular malformation of the mandibular condyle: presentation of a case and differential diagnosis. Oral Radiol 2012. [DOI: 10.1007/s11282-012-0090-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Naikmasur VG, Sattur AP, Burde K, Nandimath KR, Thakur AR. Central hemangioma of the mandible: role of imaging in evaluation. Oral Radiol 2010. [DOI: 10.1007/s11282-010-0035-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Oliveira AC, de Moraes Ramos FM, Jeunon FA, Silva EC, Manzi FR. Central haemangioma of the mandible in a 7-year old child. Int J Paediatr Dent 2009; 19:216-8. [PMID: 18489573 DOI: 10.1111/j.1365-263x.2008.00925.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Behnia H, Ghodoosi I, Motamedi MHK, Khojasteh A, Masjedi A. Treatment of arteriovenous malformations: assessment of 2 techniques--transmandibular curettage versus resection and immediate replantation. J Oral Maxillofac Surg 2008; 66:2557-65. [PMID: 19022136 DOI: 10.1016/j.joms.2008.06.056] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 03/07/2008] [Accepted: 06/17/2008] [Indexed: 11/18/2022]
Abstract
PURPOSE This study evaluates 2 surgical methods used at our center for the treatment of mandibular arteriovenous malformations (AVMs): resection with immediate replantation and curettage via proximal transmandibular osteotomy. PATIENTS AND METHODS Patients with AVMs of the mandible who were treated during a 17-year period between 1992 and 2008 at our department were assessed. Two surgical techniques were used for treatment: 1) resection of the segment, curettage of the intrabony lesion, extraction of involved teeth, and immediate replantation and 2) proximal osteotomy curettage of the lesion within the bone and extraction of involved teeth. In the replantation group the resected segment of the mandible was replanted after the contents were scraped out and the involved teeth removed. In contrast, in the proximal osteotomy group this was done without removal of the bone segment. In both techniques the cortical bone of the mandible was maintained. However, in the transmandibular curettage group the periosteum was not entirely stripped off because curettage was done via proximal osteotomy without removal of the segment. The entire intrabony lesion and a margin of cancellous bone related to the lesion were excised in both groups. The bone was fixed with titanium plates in all cases. All patients were followed up annually for a period of 1 to 17 years (mean, 9.5 years). RESULTS We treated 12 patients with mandibular AVMs (2 male and 10 female patients). Their ages ranged from 7 to 17 years. Preoperative angiography showed high-flow central vascular lesions in all patients. Of the lesions, 7 (58%) were treated via resection with immediate replantation and 5 (42%) were treated via transmandibular curettage. Embolization was performed in 4 cases 48 hours before surgery. However, blood loss was not significantly decreased by embolization. The lesions were categorized as multilocular (58.3%) or unicystic (41.7%) based on the radiographic findings and were located in the mandibular body (66.7%) or ramus (33.3%). Blood loss averaged 1.60 L in the group undergoing resection and immediate replantation and 1.30 L in the transmandibular curettage group. During the follow-up period, no recurrences were encountered in either group via clinical, radiographic, or computed tomography scan assessment, and none of the patients had facial deformities develop. CONCLUSIONS The results suggest that transmandibular curettage via proximal osteotomy without complete resection is an effective less invasive method with which to treat AVMs of the mandible provided that the lesion is small, is confined within the bone, and has not invaded the soft tissues. Less blood loss, preservation of the bone, more favorable postoperative esthetics, and better function are among the advantages of this technique. In more extensive cases and those involving both hard and soft tissues, resection with immediate replantation is recommended. Both techniques obviated the need for bone graft reconstruction. This technique is better than resection and discarding of the segment.
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Affiliation(s)
- Hossein Behnia
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alves S, Junqueira JLC, de Oliveira EM, Pieri SS, de Magalhães MHCG, Dos Santos Pinto D, Mantesso A. Condylar hemangioma: report of a case and review of the literature. ACTA ACUST UNITED AC 2006; 102:e23-7. [PMID: 17052619 DOI: 10.1016/j.tripleo.2006.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 03/23/2006] [Accepted: 04/07/2006] [Indexed: 11/28/2022]
Abstract
According to the World Health Organization, hemangiomas are benign vasoformative neoplasms or developmental conditions of endothelial origin. The body region is the most commonly affected part of the mandible, and only 4 cases of condylar tumors have been reported in the literature to date. The differential diagnosis between high and low flow vascular lesions is crucial for successful treatment, decreasing the occurrence of serious intraoperative hemorrhage. The clinical, radiographic, and pathological features of an intraosseous vascular lesion in the mandibular condyle in a 22-year-old male are presented, and the differential diagnostic aspects between hemangioma, vascular malformation, and high or low flow lesions are discussed.
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Affiliation(s)
- Sérgio Alves
- Department of Oral Pathology, University of São Paulo School of Dentistry, São Paulo, SP, Brazil
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13
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Liu DG, Ma XC, Zhao FY, Zhang JG. A preliminary study of angiographic classification and its correlation to treatment of central arteriovenous malformation in the jaw. ACTA ACUST UNITED AC 2006; 100:473-80. [PMID: 16182169 DOI: 10.1016/j.tripleo.2005.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2004] [Revised: 01/06/2005] [Accepted: 01/06/2005] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To elaborate on the classification of central arteriovenous malformations (AVMs) in the jaw based on angioarchitecture and to evaluate the correlation of this classification with treatment options. STUDY DESIGN X-ray films and digital subtraction angiograms (DSA) of 25 cases with AVMs in the jaw were retrospectively reviewed to evaluate the appearance of bone resorption, feeding arteries, nidus of the malformations, and draining veins. Based on the findings a classification of angioarchitecture was recommended. Furthermore, the treatment results of these cases were reviewed to assess the correlation of this classification system with treatment options. RESULTS The angiographic pictures of 25 cases with central AVMs could be divided into 5 types: Type I (n = 5) had diffused microarteriovenous fistulas (AVFs); type II (n = 8) had 1 large venous pouch with all the feeding arteries draining into it; type III (n = 7) had a large venous pouch as well as diffused microAVFs (I+II); type IV (n = 2) had multiple venous pouches; and type V (n = 3) had multiple venous pouches and diffused microAVFs (I + IV). The angioarchitecture corresponded well to the x-ray appearance in all cases except 1 (96%). With respect to the treatment outcomes, type II, III, and IV AVMs gained clinical cure in 100% of the cases, whereas type I and type V AVMs obtained clinical cure only in 60% and 33.3% of the cases, respectively. CONCLUSIONS Central AVMs in the jaw contained variant patterns of angioarchitecture and could be divided into 5 types. This angiographic classification was helpful for decision making about appropriate therapy.
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Affiliation(s)
- Deng-gao Liu
- Department of Oral Radiology, Peking University School of Stomatology, Beijing, China.
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14
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Zlotogorski A, Buchner A, Kaffe I, Schwartz-Arad D. Radiological features of central haemangioma of the jaws. Dentomaxillofac Radiol 2005; 34:292-6. [PMID: 16120879 DOI: 10.1259/dmfr/37705042] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the radiological and clinical features of central haemangioma of the jaws. METHODS A total of 86 cases (84 from the English-language literature and two new cases) were studied and critically evaluated with emphasis on the radiological features. RESULTS Age at time of initial diagnosis ranged from 0 to 74 years (mean 23 years, median 17 years). There was approximately equal distribution between females and males. The ratio between the mandible and maxilla was 3.3:1. Of the lesions, 69% were located in the posterior region of the jaws. Lesions were radiolucent in 96% of cases. Of the lesions, 66% were multilocular, 33% unilocular, and 1% not loculated. Borders were described in 41 cases, as well defined in 32% and diffuse in 68%. Tooth resorption was described in 23% of the lesions and tooth displacement in 16%, both more common in the mandible. The inferior alveolar nerve canal was involved in 15% of the mandibular lesions and the sinus in 35% of the maxillary lesions. CONCLUSIONS Central haemangioma has a marked variability in its radiological appearance and should be considered in the differential diagnosis of many unilocular or multilocular radiolucent lesions of the jaws, especially in the mandible. Some radiographic patterns, such as the spoke-like and sunray appearance frequently described in the literature, are actually extremely rare.
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Affiliation(s)
- A Zlotogorski
- Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel; E-mail:
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15
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Kocer U, Ozdemir R, Tiftikcioglu YO, Karaaslan O. Soft tissue hemangioma formation within a previously excised intraosseous hemangioma site. J Craniofac Surg 2004; 15:82-3. [PMID: 14704569 DOI: 10.1097/00001665-200401000-00023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intraosseous hemangiomas are rare benign lesions, occurring often in verbrata and skull. These lesions can present in the head and neck region being the next most common site with a predominance of the mandible. Herein we report a patient who experienced a soft tissue hemangioma occurring at the previous surgical site three years after the first operation.
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Affiliation(s)
- Ugur Kocer
- Ankara Training and Research Hospital, Plastic and Reconstructive Surgery Clinic, Ankara, Turkey
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16
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Cansiz H, Yener M, Kalekoglu N, Dalkiliç O. Arteriovenous Malformation of the Maxillary Sinus and Mandible: A Case Report. EAR, NOSE & THROAT JOURNAL 2003. [DOI: 10.1177/014556130308200816] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Vascular tumors are rarely encountered in the paranasal sinuses. When they do arise there, they can be life-threatening because of the risk of bleeding. Embolization alone and in combination with surgical resection has been the mainstay of treatment. We report the case of a prepubertal girl who experienced two recurrences of arteriovenous malformation, one in the maxillary sinus and the other in the mandible. To our knowledge, this is the first report in the literature of recurrences arising in these two locations.
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Affiliation(s)
- Harun Cansiz
- Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Murat Yener
- Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Nuran Kalekoglu
- Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Osman Dalkiliç
- Department of Radiology and Neuroradiology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
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17
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Ozdemir R, Alagoz S, Uysal AC, Unlu RE, Ortak T, Sensoz O. Intraosseous hemangioma of the mandible: a case report and review of the literature. J Craniofac Surg 2002; 13:38-43. [PMID: 11886990 DOI: 10.1097/00001665-200201000-00007] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intraosseous hemangiomas are benign lesions, occurring often in vertebra and skull. These lesions can present in the head and neck region being the next most common site with a predominance of mandible. There are approximately seventy intraosseous hemangiomas of mandible in literature reported to date. We present an intraosseous hemangioma of the symphysis mandible. We performed a block resection of the mass preserving the mandibular integrity with no complications. There were no recurrences in the follow-up period of 24 months.
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Affiliation(s)
- Ragip Ozdemir
- Department of Plastic and Reconstructive Surgery, Ankara Numune Hospital, Ankara, Turkey.
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18
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Zachariades N, Rallis G, Papademetriou G, Papakosta V, Spanomichos G, Souelem M. Embolization for the treatment of pseudoaneurysm and transection of facial vessels. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 92:491-4. [PMID: 11709682 DOI: 10.1067/moe.2001.117453] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Transection of the facial and the internal maxillary arteries while routine operations were performed was the cause of uncontrolled bleeding and a pseudoaneurysm. We present a study of the mechanisms that create and the means that control hemorrhage and pseudoaneurysms in the maxillofacial region.
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Affiliation(s)
- N Zachariades
- Department of Oral and Maxillofacial Surgery, K.A.T. General District Hospital of Attica, Kifissia, Athens, Greece.
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19
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Kaneko R, Tohnai I, Ueda M, Negoro M, Yoshida J, Yamada Y. Curative treatment of central hemangioma in the mandible by direct puncture and embolisation with n-butyl-cyanoacrylate (NBCA). Oral Oncol 2001; 37:605-8. [PMID: 11564583 DOI: 10.1016/s1368-8375(00)00119-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Management of central hemangioma in the mandible is difficult because of the abundant vascular network in this region. One of the most common signs of these patients, especially in the mixed dentition period, is hypermobility of the teeth with spontaneous hemorrhage from the surrounding gingival sulcus. Various therapeutic modalities have been considered, but surgery is the most frequently used. In cases of a large extensive lesion, however, intralesional injections of sclerosing agents have often been successful. A case of central hemangioma of the mandible with arteriovenous malformations in a 10-year-old girl is reported. She was treated with direct injection of an embolic material, n-butyl-cyanoacrylate, which brought satisfactory results. Preoperative embolisation of feeder vessels with Gelfoam and Avitene soaked in thrombin together with this direct injection is a safe treatment modality that is as effective as surgery.
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Affiliation(s)
- R Kaneko
- Department of Oral and Maxillofacial Surgery, Nagoya University Postgraduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
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20
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Corsten L, Bashir Q, Thornton J, Aletich V. Treatment of a giant mandibular arteriovenous malformation with percutaneous embolization using histoacrylic glue: a case report. J Oral Maxillofac Surg 2001; 59:828-32. [PMID: 11429753 DOI: 10.1053/joms.2001.24311] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Corsten
- Department of Neurosurgery, University of Illinois at Chicago Hospital, Chicago, IL 60612-7329, USA
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21
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Orsini G, Fioroni M, Rubini C, Piattelli A. Hemangioma of the mandible presenting as a periapical radiolucency. J Endod 2000; 26:621-2. [PMID: 11199807 DOI: 10.1097/00004770-200010000-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A case of an hemangioma of the mandible in a 53-yr-old female patient is presented. The lesion was removed, and no atypia or mitotic cells were found. The excision was curative, and the overall prognosis was excellent. A differential diagnosis of radiolucent periapical lesions of the mandibular symphysis is presented.
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Affiliation(s)
- G Orsini
- Dental School, University of Chieti, Chieti, Italy
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