Cellular infiltrative angiolipoma of cheek in an infant

Juvenile angiolipoma in the subtemporal region, zygomatic, and pterygomaxillary fossa treated by microwave ablation – A case study and literature review

Background:

Angiolipomas are benign mesenchymal tumors that infrequently affect the head-and-neck region and can appear with infiltrating and non-infiltrating forms. Surgical excision is the treatment of choice; however, there are other alternatives to manage this condition whose consideration is quite useful to evaluate per each particular case.

Case Description:

An 11-year-old girl was diagnosed with non-infiltrating angiolipoma in the subtemporal region, the zygomatic, and pterygomaxillary fossa; she had a history of having undergone surgery on two previous occasions with a failed resection attempt due to the high vascularization of the injury and significant transoperative bleeding. The condition was managed with minimally invasive techniques through microwave ablation, requiring two sessions, achieving very satisfactory results both esthetically and in the final size of the lesion.

Conclusion:

The microwave ablation technique may turn out to be a very useful tool for the management of lesions with high vascularization such as angiolipoma. This technique offers a new possibility for initial management, both independent of and complementary to other management techniques for other lesions at the base of the skull and/or facial massif regions.

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.

Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management

Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.