Cavernous hemangioma of the tongue: A rare case report

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.

Cavernous Hemangioma of the Tongue in an Adult

Hemangiomas are benign tumors characterized by the proliferation of dilated blood vessels, typically capillaries and veins. They primarily occur in infancy and childhood, with the majority affecting the head and neck region. Oral hemangiomas, though relatively rare, can affect areas such as the lips, tongue, buccal mucosa, and palate. Despite their benign nature, managing vascular malformations is crucial due to potential functional loss and lifelong aesthetic concerns. This case report involves a 76-year-old woman presenting with a soft reddish-blue mass on the dorsal aspect of her tongue, causing functional impairment. While various treatment options exist for oral vascular malformations, including sclerotherapy and cryosurgery, surgical excision was chosen in this case, considering the patient's age and the associated risks of the condition.

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.

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.

Surgical management of a massive congenital hemangioma of the tongue in an infant: A rare case report

Hemangiomas of the tongue may reach a massive size resulting in functional compromise. Surgical resection, despite the risk of hemorrhage, may be the only option if conservative measures such embolization are futile in reducing its size.

Treatment of deep-seated palatal vascular malformations by bleomycin sclerotherapy

BACKGROUND

Vascular malformations of the head and neck are common. The management of these lesions is complex and challenging due to the high complication rate and recurrence following treatment. Palatal vascular malformations (PVMs) are infrequent and present as slow growing lesions in the palate with recurrent bleeding and pain. These lesions are best managed by sclerotherapy due to their posterior location and risk of bleeding if surgery is attempted. Many sclerosants have been used for treating PVMs but the use of intralesional bleomycin for these lesions has not been reported at length. This paper describes the use of intralesional bleomycin injections for the treatment of deep-seated palatal vascular malformations.

METHODS

Intralesional bleomycin injections were given directly into the lesion with the patients under short general anaesthesia. The total dose of bleomycin ranged between 8 and 15 IU, which depends upon the body weight and was repeated every four weeks till the resolution of lesion was observed.

RESULTS

All the lesions in 12 patients regressed significantly with serial bleomycin injections. Clinically, the involved palatal mucosa became normal and magnetic resonance imaging demonstrated the significant regression of the lesion in all the cases. No complications were encountered with the use of intralesional bleomycin.

CONCLUSIONS

Intralesional bleomycin injections have proved to be an emerging modality in the management of remotely situated palatal vascular malformations. Their rapid regressive effect on the lesion coupled with a high safety margin makes bleomycin sclerotherapy the first choice of treatment for palatal vascular malformations.

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.

Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Treatment of vascular lesions located in the lip and in the oral cavity with Nd:YAG laser

Vascular lesions such as hemangiomas can be found in the oral cavity. Some therapeutic modalities can be used in the treatment of these lesions and Nd:YAG 1064 nm long pulse laser shows good results with easy application, fewer complications and satisfactory results. This study describes the technique and outcome of a case of hemangioma located on the tongue treated with Nd:YAG laser.

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.

A rare case of pure primary hemangioma of the scapula: A case report

Hemangioma is a benign vascular tumor, which may occur in any bone of the body. The most common locations are the spine and craniofacial bone; however, occurrence is extremely rare in the scapula. The current study presented the case of a 58-year-old female, with scapula hemangioma in the left shoulder who presented with joint ache that had lasted for ~1 year. The main clinical manifestations included local tenderness, an osseous lump and limited shoulder movement with a little pain, which was alleviated by rest. Roentgenogram, computed tomography and magnetic resonance imaging of the left acromion revealed a mass along the inner surface of the scapula of the left shoulder with polycystic expansion and bone destruction. The results of computed tomography and magnetic resonance imaging indicated a pure primary tumor and the lesion was subsequently resected. Notably, the postoperative pathological diagnosis was capillary hemangioma. The aim of the present study was to analyze the clinical and imaging features of scapula hemangioma, which must be considered for the differential diagnosis of scapula tumors. In the present case, no recurrence was identified by X-ray examination 1 year after surgery. The long-term efficacy of surgical treatment requires continuous observation of the patient.

A new venture with sclerotherapy in an oral vascular lesion

Vascular malformations are one of the most common lesions of the oral cavity. The lesion may be a congenital malformation observed in neonates or arteriovenous malformation observed in adults. Various surgical and medical managements are possible for vascular lesions which include surgical excision, laser therapy, cryotherapy, selective embolization, intralesional sclerosing agents, β-blockers and steroid therapy. Here we report a case of oral vascular lesion where intralesional injection with 30 mg/ml of sodium tetradecyl sulfate (STS) was given, which resulted in local complications with severe inflammatory response including pain, swelling, and surface ulceration that remained for 2 weeks. Sclerotherapy with STS still remain an effective agent in treating benign oral vascular lesions and provides alternative or support for surgical methods. Sometimes it can lead to undesirable complications like allergic reactions, local inflammatory response, etc.