Oral hemangioma treated with a sclerosing agent. Report of a case

Treatment of Facial Infantile Hemangioma: Comparative Study Between Propranolol and Ethanolamine Oleate

BACKGROUND

Infantile hemangiomas (IH) are the most common benign vascular tumors in childhood. Approximately 10% to 15% of these tumors require drug or surgical intervention. There are many options for IH treatment, of which propranolol is currently considered the gold standard. This study aims to compare the therapeutic results of 2 distinct drugs (ethanolamine oleate and propranolol), in order to increase the available therapeutic arsenal for the treatment of IH, thereby benefiting a larger group of patients.

METHODS

A retrospective observational study was conducted to assess 16 patients with facial IH, allocated into 2 groups (n = 8). All patients met the same inclusion and exclusion criteria. The resulting evolution assessment was based on photographic documentation produced in a professional setting, and was performed before, during, and after treatment. Two measurement scales, photographic-based assessment of infantile hemangioma characteristics, and outcomes were used for comparison between the 2 therapeutic methods.

RESULTS

Both assessment methods did not present any significant statistical difference (P > 0.05) at 1 year of follow-up.

CONCLUSION

Both therapeutic modalities are able to offer the patient similar and satisfactory final esthetic results.

Intramuscular hemangioma in lip treated with sclerotherapy and surgery

Intramuscular hemangioma is a relatively rare, benign tumor of vascular origin, accounting for less than 1% of all hemangiomas. This paper reports a case of a 48-year-old female patient with intramuscular hemangioma in the upper lip, treated with sclerotherapy and subsequent complementary surgery.

Prevalence of oral hemangioma, vascular malformation and varix in a Brazilian population

Hemangioma, vascular malformation and varix are benign vascular lesions, common in the head and neck regions. Studies about the prevalence of these lesions in the oral cavity are scarce. The aim of this study was to estimate the prevalence of and to obtain clinical data on oral hemangioma, vascular malformation and varix in a Brazilian population. Clinical data on those lesions were retrieved from the clinical forms from the files of the Oral Diagnosis Service, School of Dentistry, Federal University of Minas Gerais, Brazil, from 1992 to 2002. Descriptive analysis was performed. A total of 2,419 clinical forms in the 10-year period were evaluated, of which 154 (6.4%) cases were categorized as oral hemangioma, oral vascular malformation or oral varix. Oral varix was the most frequent lesion (65.6%). Females had more oral hemangioma and oral varix than males. Oral vascular malformation and oral varix were more prevalent in the 7th and 6th decades, respectively. Oral hemangioma and oral varix were more prevalent in the ventral surface of the tongue and oral vascular malformation, in the lips. Oral hemangioma was treated with sclerotherapy (54.5%), and vascular malformation was managed with sclerotherapy and surgery (19.4% each). The data of this study suggests that benign vascular lesions are unusual alterations on the oral mucosa and jaws.

Algorithm for using a long-pulsed Nd:YAG laser in the treatment of deep cutaneous vascular lesions

BACKGROUND

Conventional therapies for deep cutaneous vascular anomalies have demonstrated poor efficacy and many side effects. New laser systems offer greater potential to treat these difficult lesions, but the lack of specific treatment guidelines has restricted consistent success.

OBJECTIVE

To establish a rational, user-friendly algorithm that incorporates basic components of deep vascular lesions to define the correct laser settings required for safe, effective, and reproducible treatment.

METHODS

Within 18 months, 162 deep vascular lesions of various types and anatomic sites were evaluated for vessel size, depth, color, and pressure. An algorithm incorporating these characteristics was employed to determine laser parameter settings. Using a high-peak power, long-pulse 1064-nm Nd:YAG laser system, the vascular lesions were then treated.

RESULTS

Within 6 months of follow-up, 80% of treated areas demonstrated a 50% or greater resolution after a single treatment session, with complete clearance shown in 19%. Only minimal and transient side effects were observed. Of note, 74% of areas on the extremities and 83% within the oral cavity showed a 50% or greater resolution after one treatment.

CONCLUSION

Previously challenging deep cutaneous vascular anomalies may be safely reduced or cleared with the use of an appropriate laser system and this algorithm-directed technique. This represents a significant breakthrough in the management of vascular lesions.

Merits of intralesional fibrin glue injection in surgery for the cavernous sinus cavernous hemangiomas

✓ In planning surgical treatment for extraaxial cavernous hemangiomas, care should be taken to control severe tumor bleeding. The authors present a case of a large cavernous hemangioma of the cavernous sinus, which was completely removed with the aid of multiple intratumoral injections of fibrin glue. This novel method is very effective for preventing excessive blood loss during surgery for this type of lesion.

Intraosseous hemangioma of the mandible: a case report and review of the literature

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.

Treatment of oral vascular anomalies by transfixion technique

BACKGROUND

Vascular anomalies (hemangiomas and vascular malformations) are frequently located in the oral cavity. They can be treated by cool steel surgery, cryotherapy, laser therapy, embolization, and sclerosis. The choice of treatment should depend on the type of vascular anomaly, its site, the general condition of the patient, and the doctor's experience.

OBJECTIVE

The objective of this article is to assess the usefulness, indications, and advantages of transfixion technique in the treatment of oral vascular lesions.

METHODS

We present seven patients with various vascular anomalies in the oral cavity that were treated using transfixion technique. This procedure is performed with local infiltration anesthesia and it consists of interlacing a polyglycolic acid suture a number of times in an upward direction until the vascular anomaly becomes bloodless.

RESULTS

In all seven patients we completely eliminated the vascular lesion without significant long-term complications. We detected a transitory retractil scar in only one patient and edema in the postoperative period in another one.

CONCLUSIONS

Treatment of vascular anomalies of the oral cavity by transfixion technique is an effective, simple method that does not cause major complications and is low in cost.

Intralesional sclerotherapy in the management of hemangiomas of the glans penis

PURPOSE

We studied the role of sclerotherapy in the management of glans penis hemangiomas.

MATERIALS AND METHODS

Four patients with hemangiomas of the glans penis were treated on an outpatient basis with intralesional injections of 30% hypertonic saline.

RESULTS

In all 4 patients the lesions regressed and all were satisfied with the outcome.

CONCLUSIONS

Intralesional sclerotherapy is a cost-effective modality for the treatment of glans penis hemangiomas, especially in developing countries and at peripheral hospitals where expensive laser equipment may not be available.

Central hemangioma of the mandible

Central hemangioma of the mandible is a relatively rare condition; when it occurs, the clinical and radiographic presentation are often nonspecific. A proper diagnosis can be made with a high level of clinical suspicion, and imaging studies such as angiography can confirm the suspicion that a vascular lesion exists and can contribute valuable information to the preoperative data base. We report three cases of central hemangioma of the mandible demonstrating the variability of signs and symptoms and review the various treatment alternatives in the literature. We suggest that the treatment of choice for this entity is surgery, including reconstruction as necessary.