Lip cavernous hemangioma in a young child

Three Cases of Parotid Hemangiomas in Adults

Hemangiomas account for only 0.4% to 0.6% of all parotid tumors, making them extremely rare in adults. Unlike pediatric parotid hemangiomas, those in adults typically present as asymptomatic swellings of the parotid, have no skin discoloration, and usually do not regress spontaneously. Therefore, an accurate diagnosis of parotid hemangiomas in adults before surgical excision is generally challenging. Herein, we present 3 cases of adult parotid hemangiomas. The patients all received parotidectomies with tumor resection. Histopathological analysis of the resected specimens revealed numerous dilated, thin- or thick-walled (small, large, or variably sized) vessels lined with flattened endothelial cells. A diagnosis of cavernous hemangioma of the parotid gland was established only after the histopathological analysis. Parotid cavernous hemangiomas in adults are rare and often misdiagnosed before surgical resection. Clinical presentation and imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and angiography may support an accurate preoperative diagnosis. Surgical resection proved a suitable treatment approach for our 3 cases.

Transoral surgery with Thunderbeat© for hemangioma of the tongue base: A novel procedure. Case report

INTRODUCTION

Hemangiomas are the most common benign tumors of the head-neck region in children and mainly affect the face, oral mucosa, lips, and tongue. The base of tongue is an extremely rare site of involvement. The incidence is higher in women and occur more frequently in infants and childhood.

PRESENTATION OF CASE

We present a rare case of cavernous hemangioma of the base of tongue in a 70-year-old male patient surgically removed by Transoral Ultrasonic Surgery (TOUSS). 1-year follow up didn't show sign of recurrence.

DISCUSSION

Hemangiomas are benign proliferations of endothelial cells common in the head and neck. The etiology is uncertain: an imbalance in angiogenesis related to substances such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) with uncontrolled proliferation of vascular elements is proposed. It can be asymptomatic or, when affecting the tongue, lead to difficulty swallowing, pain, bleeding and dyspnea.

CONCLUSION

This case report aims to stress that hemangioma should be considered in differential diagnosis in case of richly vascularized tongue base lesion, also in adult population. It would like to highlight the role of transoral ultrasonic surgery (TOUSS), which is able to achieve the same advantages as TORS with lower costs and shorter learning curve.

Acquired arteriovenous hemangioma on the nose of a middle-aged man: A case report

Arteriovenous hemangioma is a rare, benign vascular lesion that presents with an asymptomatic red or violaceous papule which is frequently asymptomatic but pruritus, pain and enlargement may be seen in some patients. In histology it is composed of thick-walled and thin-walled blood vessels distributed in superficial and mid dermis. The treatment of choice in such cases is complete excision and recurrence is rare. In this article we describe an acquired form of arteriovenous hemangioma on the nose of a middle-aged man.

Infantile Hemangioma of the Upper Lip: Report of a Rare Case With a Brief Review of Literature

Hamartomas are tumor-like abnormalities typified by the presence of cellular proliferation indigenous to the native site. However, hamartomas maintain growth cessation without the potential for further growth or malignant transformation. Hamartomas are commonly seen in the lungs, kidney, liver, and spleen and rarely occur in the orofacial region. Various hamartomatous oral lesions include hemangiomas, lymphangiomas, tori, exostosis, dens invaginatus, dens evaginatus, odontomas, nevi, and cherubism. Infantile hemangiomas are benign vascular tumors that emerge soon after birth and experience rapid growth within the first year. Oral hemangiomas affect up to 6.4% of infants and are more common on the ventral surface of the tongue, as opposed to oral vascular malformations, which are more prevalent on the lips. It also has a 3:1 female-to-male predominance. Afterward, their growth usually stabilizes and enters a prolonged, incomplete involution phase. Uncomplicated hemangiomas generally exhibit spontaneous resolution, whereas few can leave behind scars and telangiectasias on the external surface of the skin on which it occurs. Thus, lesions located in anatomically sensitive regions necessitate vigilant surveillance and treatment. This paper deals with an asymptomatic swelling of the upper lip in a four-year-old female child but with problems in aesthetics, speech, and feeding. A thorough history, clinical examination, positive diascopy, ultrasonography, and histopathology confirmed the diagnosis of infantile hemangioma.

Rare localization of tongue vascular lesion detected by multi-parametric magnetic resonance imaging

Hemangiomas are developmental vascular abnormalities that are common in the head and neck (60%), rare in the oral cavity, and uncommon in the tongue. A patient performed a multi-parametric MRI, which characterized the lesion of his tongue, providing relevant information for diagnostic, therapeutic orientation, and realization of slight aggressive surgery with consequent excellent recovery.

A cavernous hemangioma of the tongue base presenting as an ectopic thyroid: A case report

Introduction

Hemangioma is a common benign tumor of blood vessels, that rarely develops in the oropharynx. Cavernous hemangioma is characterized by thin-walled dilated blood vessels lined with endothelial cells.

Case report

We report a case of a 46 years-old woman who was admitted to our department with a complaint of chronic dysphonia and dysphagia. Clinical examination, radiological investigations and thyroid scintigraphy found a mass of the tongue base, compatible with a lingual thyroid. Treatment consisted of surgical excision through a cervical approach. The histopathological examination found a cavernous hemangioma.

Conclusion

Though hemangioma is very rare in the base of tongue, it should be a part of the differential diagnosis while investigating a lesion in the oral cavity and the oropharynx, alongside the other possibilities.

Recurrent Intramuscular Hemangioma (Infiltrating Angiolipoma) of the Lower Lip: A Case Report and Review of the Literature

OBJECTIVE

To report a case of a recurrent intramuscular hemangioma (IMH) of the lower lip of a 68-year-old female and review the published literature to provide an overview of the presentation, diagnostic strategy, pathological classification, and management of these lesions within the oral cavity.

METHODS

A case report was conducted by reviewing the documentation at a single institution. A systematic literature review on OVID MEDLINE and PubMed was performed using the MESH terms "intramuscular hemangioma" and "oral cavity," "tongue," "cheek," "buccal," "gingiva," and "lip."

RESULTS

A 62-year-old female presented to our institution with a 2 × 2 × 1 cm IMH of the lower lip involving the surrounding orbicularis oris muscle. She underwent a submucosal resection and did well postoperatively. Six and a half years later, she represented to our institution with a new lower lip lesion in the area of her previous resection. Preoperative magnetic resonance imaging showed a new 10 × 11 mm lesion with a well circumscribed central component surrounded by ill-defined tissue. Preoperative angiography showed that the lesion was supplied by vessels branching off the left facial artery, which were embolized. She underwent wide-local excision (WLE) with bilateral advancement flaps and at her 2-month postoperative visit has not had recurrence.

CONCLUSION

Only 39 cases of IMH in the oral cavity have been reported, with only 3 others occurring in the lower lip. Here we add the first case of an IMH of the oral cavity that recurred after primary WLE. The patient was successfully retreated with WLE. At a 3-month follow-up visit, she noted some incompetence with oral secretions and occasional tingling along the incision site but no evidence of recurrence.

Effects of sclerosing agents on head and neck hemangiomas: A systematic review

Background

The aim of this study was to systematically review the literature for studies that investigated the effects of sclerosing agents on head and neck hemangiomas.

Material and Methods

Clinical trials, cohort studies, and descriptive studies were considered eligible and selected in a two-phase process. Six main electronic databases, in addition to three grey literature databases, were searched. Risk of bias (RoB) was assessed using the “Meta-Analysis of Statistics Assessment and Review Instrument” checklist. From fifty-six considered eligible, five were finally included.

Results

One article were judged at low, one at moderate, and three at high RoB. The sclerosing agents investigated were sodium tetradecyl sulphate (n=2), ethanolamine oleate (n=1), pingyangmycin (n=1) and bleomycin (n=1). Overall, good results were achieved on the treatment of head and neck hemangiomas with intralesional sclerotherapy. Most commonly reported adverse effects included pain, swelling, fever, necrosis, transient facial palsy, and anorexia.

Conclusions

Considering the limited number of included studies, intralesional sclerotherapy on the management of HN hemangiomas presented overall good results with minor adverse reactions, especially in regards to smaller lesions.

Key words:Sclerotherapy, sclerosing solutions, vascular neoplasms, hemangioma.

Intralesional injection of triamcinolone acetonide for cavernous hemangiomas: A case report

RATIONALE

Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial.

PATIENT CONCERNS

A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation.

DIAGNOSES

Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination.

INTERVENTIONS

We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times.

OUTCOMES

She was cured and had no recurrence during the 3-month follow-up.

LESSONS

This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.

Hemangiomas of the tongue and the oral cavity in a myotonic dystrophy type 1 patient: A case report

RATIONALE

Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease caused by a cytosine, guanine, thymine (CTG) trinucleotide repeat expansion in the non-coding region of dystrophia myotonica protein kinase gene, causing a multisystem involvement. To date, few studies have been performed to evaluate skin features in DM1 patients, but none reported on the possible association between the disease and tongue hemangiomas.

PATIENTS CONCERNS

We report a case of a 63-year-old woman affected by DM1 and presenting, at the intraoral examination, several swelling and buish lesions occurring on buccal and palatal mucosa, and in the anterior two-thirds and margins of the tongue.

DIAGNOSIS

Multiple tongue hemangiomas in DM1 patient.

INTERVENTIONS

Color Doppler ultrasound revealed hypoechoic lesions with intermittent color picking suggestive of vascular lesion. Surgical excision was performed under general anesthesia. Histopathological examination was compatible with the diagnosis of cavernous hemangiomas.

OUTCOMES

At 6 months follow-up, a part from the cosmetic deformity, patient's hemangiomas did not bleed, but caused functional problems with speaking, mastication, and deglutition, in addition to the same symptoms induced by DM1.

LESSONS

This case may add new details to better characterize the DM1 phenotype, suggesting that even tongue hemangiomas may be part of the DM1 multisystem involvement.

Selected presentations of lip enlargement: clinical manifestation and differentiation

Lip enlargement may be an important symptom of either systemic or local diseases. On the basis of selected age-matched clinical cases we present the possible causes of lip swelling. We describe the most representative symptoms and recommend treatment of these pathologies. We differentiate lip swelling in Miescher syndrome, monosymptomatic form of Melkersson-Rosenthal syndrome, lip swelling in erythema multiforme and Stevens-Johnson syndrome and lip hemangioma and mucous extravasation cyst. We compare different causes of lip edema and indicate the most helpful diagnostic and treatment methods.

Venous malformations management by Er,Cr:YSGG laser: An Alternative approach

BACKGROUND AND AIM

Venous malformations (VMs) are slow-flow vascular anomalies composed of ectatic venous channels. Its management with Er,Cr:YSGG laser has been proven effective. In the present case a teenage patient reported with a bluish lesion, soft inconsistency on the dorsal aspect of tongue. The lesion was removed with Er, Cr: YSGG laser (2780 nm) with minimal anaesthetic infiltration.

RESULTS

Patient reported no postoperative pain. Clinical follow up after three months showed excellent results and uneventful healing.

CONCLUSION

Er,Cr:YSGG laser showed high clinical safety. Its advantages resulted in excellent healing of lesion and better acceptance by patient.

Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child

Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.

Resection of Giant Hemangioma of the Tongue Utilizing a Miniature Tourniquet Technique

With the progress of multidisciplinary vascular anomaly treatment, the use of radiotherapy, cryotherapy, laser therapy and medical treatments, the corticosteroid, sclerotherapy, and many more, the role of surgery has been refined. Surgical treatment has historically been the mainstay of treatment and will maintain.A miniature tourniquet technique applied to the tongue was successfully utilized in reducing bleeding to a minimum during surgical resection of a massive cavernous hemangioma involving the tongue and lower lip without any postoperative complications.Comprehensions of the neurovascular anatomy of the tongue, vasculature, innervations, and muscles physiological functions are very important for selecting the right surgical approach.A 9-year-old girl presented with giant hemangioma resulting in severe protrusions of the anterior and lateral two-thirds of the tongue with an extensive anterior open bite jaw deformity and oral physiological dysfunctions as speech, mastication, and deglutition. Such a presentation is a unique surgical challenge due to the high risk of bleeding, tongue swelling, and airway compromise.Postsurgical results showed oral physiological function improvement and the elimination of interaction effects on anterior open bite.

An unusually large cavernous hemangioma of retropharyngeal space: a rare case

Hemangiomas rarely occur in the retropharyngeal space with only several cases reported in the current literature. This article reports the hemangiomas of retropharyngeal space. A 55-year-old woman was referred to our institution for dysphagia. Computed tomography and magnetic resonance imaging of the neck and spine revealed a large, well-circumscribed, dense mass that extended from the retropharyngeal space to the sides of the neck. Patient underwent direct excision of the lesion. Complete regression of symptoms was observed after surgery, with no lesions found on routine 24-month follow-up. Although hemangiomas are relatively common in the head and neck, those that originate in the retropharyngeal space are very rarely observed. These benign tumors have the potential to compress adjacent tissues or organs and thereby produce associated symptoms like dysphagia and dyspnea. We present the reported case of larger hemangiomas of the retropharyngeal space and detail their management.

Cavernous hemangioma of tongue: management of two cases

Hemangiomas are benign tumours of infancy and childhood, most commonly located in the head and neck region and occur more frequently in the lips, tongue and palate. The treatment depends upon lesion location, size and evolution stage and the patient's age. This paper describes the management of cavernous hemangioma in a 2 -year -old child and 14 -year -old child using different approaches.

Cavernous hemangioma of the tongue: A rare case report

Hemangiomas are developmental vascular abnormalities and more than 50% of these lesions occur in the head and neck region, with the lips, tongue, buccal mucosa, and palate most commonly involved. They are considered as hamartomas rather than true neoplasms. Here we report a case of hemangioma of the body of the tongue, discussing the diagnostic aspects and treatment modalities of such lesion and emphasizing the role of the color Doppler ultrasonography, especially in the diagnosis and treatment. Factors such as patient's age, size and site of lesion and the proximity of lesion to vital structure are paramount in the determination of the therapeutic approach and surgical excision. Even though radiotherapy, cryotherapy, laser therapy, medical treatment, injection of sclerosing substances and the selective embolization of the lingual artery seem to have some efficacy, the author conclude that surgery is the therapy of choice in the isolated vascular lesions of the body of the tongue.

A giant compound hemangioma of lower lip

Hemangioma is one of the most common benign tumors of vascular origin affecting 10–12% of infancy. Approximately 50% of hemangiomas resolve by the age of 5 years and 90% resolve by 9 years of age. Rarely hemangiomas may persist, warranting systemic or surgical treatment. Treatment depends on size, location, and evolution stage of the lesion. In this study, we present a case of huge hemangioma involving lower lip in a 20-year-old male for whom early treatment was ignored due to poor economic status, which was recognized and treated in our institution.