PP102: Intraosseous hemangioma of the mandible: An unusual presentation

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Purpose Hemangioma is a benign vascular tissue neoplasm arising from the vascular tissue which generally occurs during infancy. Intraosseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare. The purpose of this presentation is to report an unusual presentation of an intraosseous hemangioma, its diagnosis and treatment outcome. Material and method A 37 year old female patient was referred to our clinic with paresthesia complaint in the lower lip. Her medical history did not indicate any systemic diseases. Intraoral examination showed no pathology. Panoramic radiography revealed a radiolucent lesion with irregular lytic borders in the right edentulous posterior region of mandible. Under local anesthesia, curettage of the lesion was performed. Results Histopathological examination showed many large and dilated endothelial sinuses which contained aggregates of erythrocytes inside connective tissue and bone marrow, indicating intraosseous hemangioma. Conclusion Intraosseous hemangiomas present difficulty in differential diagnosis. It is a bone destructive lesion which may be of varying size and appearance, but is often suggestive of a cyst. Severe haemorrhage following trauma or tooth extraction has been reported. The patient’s medical history and previous extractions in the lesion site did not show any haemorrhage indicating a lesion with a severe risk of bleeding. Also, radiographic findings did not correlate with the common signs of an intraosseous hemangioma. Treatment of intraosseous hemangioma is difficult and is done by local excision for smaller lesions and larger lesions are excised after pretreatment with sclerosing agents. Differential diagnosis and careful treatment planning is of crucial importance in hemangiomas considering the severe complications such as haemorrhage.