Intravascular papillary endothelial hyperplasia of the upper lip

Abstract

Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion characterized by reactive proliferation of endothelial cells with papillary formations related to thrombosed blood vessels. IPEH in the oral region is relatively rare, and its clinical picture is not specific. Herein, we report the case of a patient with IPEH of the upper lip who had a favorable outcome. A man in his 40 s presented to our department with a nodule beneath the right upper labial mucosa. Magnetic resonance imaging showed a relatively well-defined mass. Based on the diagnosis of a benign tumor, a total excision with healthy margins was performed. Histopathological and immunohistochemical findings revealed a pure form of IPEH with a Ki-67 labeling index of 20%. No recurrence was observed 1 year postoperatively. Although IPEH in the oral region is relatively rare, and its clinical presentation is nonspecific, based on the clinical diagnosis of benign tumors, adequate excision with clear margins can reduce the risk of recurrence. As Ki-67 can be used to predict the biological behavior and risk of IPEH recurrence, careful follow-up considering the risk of recurrence suggested by the Ki-67 labeling index is needed. Thorough knowledge of IPEH is important for clinicians and pathologists to arrive at a correct diagnosis, which leads to appropriate treatment.