Caliber-Persistent Labial Artery: A Rarely Recognized Cause of a Lower Lip Swelling—Report of 5 Cases and Review of the Literature

Abstract

Caliber-persistent labial artery (CPLA) is a vascular anomaly of the labial artery that penetrates into the submucosa of the lip without reduction in diameter. It commonly presents as a bluish or normal-colored elevated mass and usually pulsates on manual palpation. It can resemble a mucocele or squamous cell carcinoma if surface ulceration presented. CPLA carries the risk of profuse bleeding if the artery undergoes transection during biopsy. Five patients aged between 28 and 88 years presented with discrete lesions of the lower lip. All cases were diagnosed clinically as either mucocele or squamous cell carcinoma and were treated with excisional biopsy. The specimens showed a prominent muscular vessel in the stroma that was associated with ulceration in 2 cases. Hemostasis was achieved by either application of surgical diathermy or ligation with deep sutures at the wound area. Persistence of the lesion after excision was seen in only 1 case, another single case the patient complained of persistent paresthesia at the surgical site at 7 months review after biopsy. CPLA should be considered in the differential diagnosis of any raised soft tissue lesion affecting the lip. Careful inspection with palpation for pulse during clinical examination should permit an accurate clinical diagnosis and may prevent unnecessary surgical treatment or prepare the operator for the possibility of hemorrhage during surgery. Pathologists can be alerted to the possibility of CPLA where an isolated muscular vessel is encountered during lip biopsy.