Solitary Superficial Microcystic Lymphatic Malformation (Lymphangioma Circumscriptum) of the Gingiva

Lymphangioma Circumscriptum - A Rare Cause of Gingival Enlargement: A Case Report and Review of Literature

Background

Lymphangiomas or microcystic lymphatic malformations (MLM) are hamartomatous formations that occur due to the proliferation of lymphatic vessels. They commonly manifest in the head and neck region with only a few cases reported within the oral cavity. Lymphangioma circumscriptum in the gingiva is a rare condition which presents as asymptomatic pebbly gingival enlargement. They are characterized by lesions that are microscopic thin-walled cysts. Histopathologically, they show multiple dilated lymphatic channels which are lined by endothelial cells. The lumen is filled with lymphatic fluid, red blood cells, and other inflammatory cells. These are dispersed within connective tissue stroma. Multiple modalities of treatment have been reported, including surgical excision, laser therapy, and sclerotherapy.

Case Presentation

This paper reports a rare case of multiple lymphangiomas of the gingiva in a 21-year-old female patient. The clinical picture, surgical treatment, histologic features, and immunohistochemistry [IHC] findings are presented. The histologic findings of lymphangioma were confirmed with IHC being positive for lymphatic marker D2-40. The patient was followed up for a period of 2 years, with no recurrence noted.

Conclusion

Lymphangiomas or microcystic lymphatic malformations presenting as a gingival enlargement are a rare occurrence. Therefore, lymphangiomas may also be considered in the differential diagnosis of gingival enlargements.

A rare case of extensive gingival lymphatic malformation

Lymphatic malformation is a benign lesion, seldom affecting the gingiva. Gingival lesions are characterized by pebbly hyperplasia, occasional pain, and bleeding. The treatment for large and exceptional areas of involvement may face difficulties. Herein we report a rare case of gingival lymphatic malformation in a 10-year-old girl.

Acquired lymphangioma circumscriptum secondary to tuberculosis: A rare case report

Lymphangioma circumscriptum is a benign lymphatic malformation that usually presents at birth or early childhood. Acquired oral lymphangioma has been reported secondary to radiation therapy and denture-induced trauma due to damage to previously normal lymphatics. To the best of our knowledge, this is the first report of acquired oral lymphangioma due to childhood tuberculous adenitis.

Lymphangioma circumscriptum of the tongue: A case with marked hemorrhagic component

Lymphangioma circumscriptum (LC) is considered a superficial variant of lymphangioma with characteristic small lymphatic channels. Diagnosis is routinely made through histopathology in addition to immunostaining. An unusual case of LC presenting as a painless overgrowth of the tongue in a middle-aged male is reported, with emphasis on the clinical and histopathological differential diagnosis.

Surgical treatment of oral lymphangiomas with CO2 laser: report of two uncommon cases

This paper reports the treatment of oral lymphangiomas with carbon dioxide CO2 Laser. Lymphangiomas are rare congenital lymphatic malformations. These lesions are most frequently diagnosed during childhood, are most commonly located in the head and neck region, and are extremely rare in the oral cavity. Oral lymphangiomas are of complex treatment due to the difficulty in performing a complete excision. CO2 laser is the most often used laser in the oral cavity due to its affinity with water and high absorption by the oral mucosa. Several benefits of the use of CO2 laser have been reported for surgical oral procedures. The cases reported herein were biopsy-proven lymphangiomas of the oral cavity. The surgical procedures were carried out under local anesthesia and a focused CO2 laser beam (l10.600 nm, f ~2 mm, CW/RSP) was used. At the end of the surgery, the laser beam was used on a defocused mode to promote better hemostasis. Neither sutures nor dressings were used after surgery. No medication and only mouthwashes were prescribed to all patients on the postoperative period. There were no postsurgical complaints from the patients and no relapses of the conditions were observed after follow-up periods of 12 and 18 months. The use of CO2 laser was practical, easy to carry out and effective on the treatment of oral lymphangiomas, with no lesion recurrence.