Oral lymphangioma: a case report

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.

Oral manifestations and dental care management of a young patient with lymphangioma of the tongue: A case report

Children with lymphangioma of the tongue may require a close collaboration between physician and dentist to establish preventive, conservative approaches, and eradicate any sources of dental infections before undertaking immunosuppressive therapy.

Classical Cases of Lymphangioma - As Multiple Vesicular Eruptions

Lymphangiomas are uncommon congenital hamartomas of the lymphatic system, usually diagnosed in infancy and early childhood. They are rarely situated in oral cavity and most commonly identified on the anterior two-thirds of the tongue. Though rarely seen in the oral cavity, lymphangiomas are the entities which should be taken into consideration by the clinician while examining vesicular lesions of the oral cavity. Early recognition is of utmost importance for the initiation of proper treatment and to avoid serious complications. We hereby report two classical cases of lymphangioma of the buccal mucosa with multiple vesicular eruptions, a rare site.

Unilateral gingival lymphangioma: A first case report

Lymphangiomas are classified as vascular malformations. A 17-year-old male patient was referred with asymptomatic gingival enlargement with a vesicular feature on the buccal aspect of the central and lateral teeth of the right mandible; the lesion showed easy bleeding. After local anesthesia, subgingival, and sulcular incisions was performed on the buccal and lingual gingiva of the right central and lateral incisors of the mandible. Microscopic evaluation showed lymphangioma. A 3-year follow-up showed promising results.

Lymphangioma of the tongue - a case report and review of literature

Lymphangiomas are benign tumours resulting from a congenital malformation of the lymphatic system. They are relatively uncommon and usually diagnosed in infancy and early childhood. Commonly located at head and neck, they rarely occur in the oral cavity. Intraoral lymphangiomas occur more frequently on the dorsum of tongue, followed by palate, buccal mucosa, gingiva, and lips. Lymphangioma of the tongue is a common cause of macroglossia in children associated with difficulty in swallowing and mastication, speech disturbances, airway obstruction, mandibular prognathism, openbite and other possible deformities of maxillofacial structures. We present the case of a 13-year-old female with lymphangioma of tongue. The clinical, radiological, and treatment modalities of this case are discussed.

Lymphangioma circumscriptum in an adult: an unusual oral presentation

Lymphangioma is a benign hamartomatous tumor of lymphatic vessels. This lymphatic malformation is characterized by an abnormal proliferation of lymphatic vessels. Extra-oral lymphangiomas occur more frequently in the neck region predominantly in the posterior triangle, while intra-oral lymphangiomas are commonly seen in the tongue mainly on the dorsum surface. Various imaging modalities such as ultrasound and color Doppler are very useful in viewing the extent of the lesion. In most of the cases, surgical excision is the treatment of choice. The prognosis is good for most patients, but recurrence has also been reported in some cases, presumably because the lesion is interwoven between muscle fibers, preventing complete removal. This case report discusses the clinical features, color Doppler imaging, histopathology, and treatment of lymphangioma.

Cavernous lymphangioma: Two case reports

Lymphangiomas are congenital malformation of the lymphatic system that involve the skin and subcutaneous tissues. We are reporting two cases of cavernous lymphangioma. These cases are presented for their rarity.

Scalpel versus electrosurgery: Comparison of gingival perfusion status using ultrasound Doppler flowmetry

The main prerequisites of any surgical procedure are achievement of good visibility and access to the site with minimal bleeding and rapid and painless healing. With the advancement of technology the armamentarium for oral surgical procedures has also widened. The use of alternate methods to the traditional scalpel such as electrosurgery, laser, and chemicals has been widely experimented with. This article aims to report the gingival perfusion pre-operatively and post-operatively, comparing the use of scalpel and electrosurgery in different anatomic sites in patient. Since wound healing is influenced by its revascularization rate, which follows the pattern of new connective tissue formation, the perfusion status of the gingiva has been studied using ultrasound spectral Doppler. The results of our study show that there was 30% more blood flow by 7(th) day, 19% more blood flow by 15(th) day and 11% more blood flow by 30(th) day in sites where the scalpel was used compared with sites where electrosurgery technique was used.

Oral lymphangioma - Case reports and review of literature

Lymphangioma is a benign hamartomatous hyperplasia of lymphatic vessels. Majority of them are superficial, but a few may extend deeply into the connective tissue. Intraoral lymphangiomas occur more frequently on the dorsum of tongue, followed by palate, buccal mucosa, gingiva, and lips. Surgical excision is the treatment of choice. The prognosis is good for most patients, although large tumors of neck/tongue may result in airway obstruction and death. This case report series discusses the clinical features, histopathology, and treatment of lymphangioma.

Case series on vascular malformation and their review with regard to terminology and categorization

Malformations of vascular nature originate as anomalies caused due to errors in vasculogenesis. These tumors are generally broadly classified into vascular tumors (hemangiomas) and vascular malformations (venous malformations, arteriovenous malformations, lymphatic malformations). These descriptive tumors and malformations have been categorized based on the architectural assembly of vessels. Lymphangiomas are further subclassified microscopically into capillary, cavernous, cystic and lymphangioendothelioma, depending upon their histopathological features. Lymphatic malformations or lymphangiomas are uncommon congenital malformations of the lymphatic system, usually occurring in the head and neck region, characterized by collections of ectatic lymph vessels that form endothelial lined cystic spaces. Advancements in the knowledge of pathogenesis of such vascular malformations are continuously changing their treatment protocols. Early recognition is of utmost importance for initiation of proper treatment and avoiding serious complications. Hemangiolymphangioma is a variant of lymphangioma showing vascular component. Herewith, we present a case of vascular malformation diagnosed as hemangiolymphangioma histopathologically in a 9-year-old girl, along with a review of literature regarding its categorization.

Cystic hygroma with extensive tongue involvement

Cystic Hygroma is a congenital lymphangiomatous tumour. It commonly involves the neck but is rarely associated with lymphangioma of the tongue. Presenting here a rare case having extensive tongue involvement giving a terrifying look and severe anaemia but without respiratory distress. Herewith submitting a case report with a brief review of literature and various problems faced while managing the same.