Oral haemangioma

Examination of oral hemangiomas by intraoral ultrasonography

OBJECTIVES

Oral hemangioma is a benign vascular tumor characterized by the presence of numerous blood vessels. We aimed to examine the clinical and ultrasonographic findings of patients diagnosed with oral hemangioma in our ultrasonography (USG) archive, retrospectively.

METHODS

This study was conducted by examining 20 patients diagnosed with oral hemangioma and underwent USG examination in the Department of Oral and Maxillofacial Radiology of Atatürk University Faculty of Dentistry from 2016 to 2020. All patients had intraoral and radiographic examinations. Patients pre-diagnosed clinically oral hemangioma were evaluated as intraoral with USG. The intraoral USG examinations were performed using both the B-mode and the color Doppler mode.

RESULTS

The mean age of the patients was 42.4 ± 19.14 years; 16 patients were female and four were male. The lesions were mostly observed on the alveolar mucosa (30%), followed by the buccal mucosa (25%), the lower lip (15%), the mouth floor (15%), the tongue (15%). In intraoral USG examinations of all oral hemangiomas, we detected submucosal located, well-defined, lobulated, non-capsule, hypo-isoechoic, heterogeneous lesion areas. Additionally, while we detected only peripheral blood flow in 6 (30%) of 20 patients, we detected both internal and peripheral blood flow in 14 (70%).

CONCLUSIONS

In our study, the examination of the oral hemangiomas with the intraoral probe and the color Doppler mode was very helpful in the differential diagnosis. Although histopathology has an important place in definitive diagnosis, particularly intraoral USG can provide sufficient information for the diagnosis of oral hemangiomas.

Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review

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.

Capillary haemangioma on the palate: a diagnostic conundrum

Haemangiomas are benign tumours of blood vessel origin and are classified as capillary, cavernous or central. They appear as flat or raised reddish-blue lesions and are generally solitary, affecting women in younger age groups. The tumour may be slowly progressive, involving extensive portions of the superficial and deep blood vessels, and affect function, depending on location. They are common in the head and neck region but rarely in the oral cavity. Oral lesions generally appear on the lips, buccal mucosa and tongue, but rarely on the palate. As the lesion can be confused with pyogenic granuloma, histopathological examination is important for a final diagnosis. The case presented here signifies a rare location of a capillary haemangioma on the palate in a middle aged man. The lesion was diagnosed by histopathology after surgical excision.

PHACES syndrome: Diode laser photocoagulation of intraoral hemangiomas in six young patients

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This study well defines the oral clinical aspects of PHACES oral hemangiomas, poorly noticed in current English literature, and their laser therapy.

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Diode laser photocoagulation techniques have been proved to be very effective and minimally invasive surgical treatment for IH in syndromic patient considering the presence of numerous lesions and the necessity of several interventions.

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This study shows the two main laser technique used for the treatment of oral hemangiomas highlighting the differences between these ones and their main recommendations.

Introduction

The acronym PHACES describes the association of posterior fossa malformations, facial hemangiomas, arterial anomalies (cardiovascular or cerebrovascular), coarctation of the aorta and cardiac defects, eye abnormalities, and sternal or ventral defects. In this study we report on 6 patients affected by the PHACES syndrome and showing 34 intraoral hemangiomas (IH), treated by diode laser photocoagulation (DLP).

Case presentation

IH appeared as red-bluish soft masses, smooth or lobulated, from a few millimetre to several centimetres in size, covered by intact mucosa and blanching on pressure. IHs were treated by DLP with 320 μm fibres at a wavelength of 800 ± 10 nm. The diode laser techniques applied were: Transmucosal DLP (DLTP), a no-contact technique in which laser energy is delivered by a flexible optic quartz fiber, which is kept 2–3 mm apart from the lesion, and Intralesional DLP (DLIP), in which the fibre is introduced into the lesion through a transmucosal access. DLTP was used for 20 flat, superficial IHs and, after a variable number of laser sessions (average = 3) depending on the size of the lesion, 65% completely regressed, while in the remaining 35% shrinkage of the lesion was achieved with minor and few complications.

The remaining 14 deep/multi-lobulated IHs were treated by DLIP, resulting in complete regression of 79% of them.

Conclusions

DLP techniques are an effective and minimally invasive procedure for IH in patients with PHACES, in consideration of the multiple lesions to treat, of the necessity of multiple interventions and the higher compliance of the patients.

Pedunculated haemangioma of the palate

Haemangiomas are the most common tumours of vascular origin of the head and neck region and can appear anywhere in the oral cavity. They are benign, appear in early childhood and usually involute as the child grows older. The dental surgeon should manage them appropriately if they are symptomatic. This report presents a rare case of a pedunculated haemangioma in a 4-year-old child.

Treatment of lip hemangioma using forced dehydration with induced photocoagulation via diode laser: report of three cases

Several vascular lesions are related to the lip area. There is no universally accepted protocol for the treatment of hemangiomas and vascular malformations. In the oral cavity, high-power lasers represent an excellent therapeutic option for this type of lesion. Their coagulative properties allow for the performance of procedures without the risk of bleeding, which promotes a better healing pattern and a differentiated postoperative appearance. This study describes three cases of lip hemangioma treated with forced dehydration with induced photocoagulation (FDIP) via diode laser. All the reported cases were followed up until complete healing of the operated area had total remission of lesions, with no complications or adverse effects. The findings of the present study suggest that FDIP is effective and useful in the treatment of hemangiomas in the oral cavity. Laser treatment of these lesions prevents their recurrence and is well tolerated by patients.

Cavernous hemangioma of the tongue

Hemangioma is a benign tumor of dilated blood vessels. It is most commonly seen in the head and neck region and rarely in the oral cavity. Hemangiomas in the oral cavity are always of clinical importance and require appropriate treatment. We report here a case of a 34-year-old female patient with a swelling on the lateral surface of tongue which did not respond to the sclerosing agent and was finally confirmed as cavernous hemangioma on histological evaluation.