Oral Hemangioma Research Articles

Characteristics of Oral Hemangioma and Vascular Malformation Cases: A Study at Hasan Sadikin General Hospital, 2019-2023

This observational retrospective study conducted at Hasan Sadikin General Hospital (RSHS) in Bandung from January 2019 to February 2023 aimed to characterise oral hemangiomas and vascular malformations. Out of 52 medical records analysed, infantile hemangioma was the most common type (17%), typically presenting between ages 13 to 24 years. Predominantly located around the lip, tongue, and buccal mucosa, it seldom caused bleeding or pain, with women being more affected. Treatment often involved sclerotic agent injections. Venous malformations accounted for 58% of vascular malformations, showing similar age of presentation and distribution as hemangiomas, and were also treated with sclerotic agents. Accurate diagnosis and tailored treatment are crucial due to the diverse nature of these anomalies. Early detection using imaging techniques like ultrasound and CT angiography is imperative, given the potential impact on patients, including pain, swelling, and cosmetic concerns, particularly in the head and neck area. However, treatment approaches vary based on factors such as type and size, necessitating further research to refine diagnostic and therapeutic strategies and optimise patient outcomes.

Management of Vascular Malformations in the Oral Cavity: Case Report

Vascular anomalies are diverse, and several classifications are available for these anomalies, the most recent and accepted classification is that of the "International Society for the Study of Vascular Anomalies (ISSVA) that was made in 2014 and revised in 2018. It divides vascular anomalies into vascular tumors (including hemangiomas) and vascular malformations. Various treatment modalities are available, including laser therapy, steroid therapy, embolization, blocking therapy, sclerosing therapy, surgery or cryosurgery. This article presents the usefulness of CO2 laser and diode laser for the treatment of vascular anomalies of the oral cavity, while presenting an unusual combination, for the treatment of an oral hemangioma associated with an angiomatous epulis, between sclerotherapy and diode laser. This study not only confirmed the treatment's effectiveness in reducing lesion size and minimizing intraoperative bleeding from the epulis but also highlighted its ability to enhance aesthetic outcomes, patient comfort, and overall satisfaction.

Rare Oral Hemangioma in Pregnancy: A Case Series Providing Clinical Insight into Patient Care.

BACKGROUND Hemangiomas are defined as benign soft tissue vascular tumors that are histologically classified as capillary, cavernous, or mixed types. Hemangiomas can also be described based on clinical appearance as superficial, mixed, or deep lesions. Following a thorough search, only 3 case reports of superficial protruding lip mass were found in the literature. Other cases of tongue hemangioma have been reported in infants or young toddlers, and only rarely in adults. CASE REPORT The first case was a 43-year-old pregnant woman, with an unremarkable medical and surgical history, in the second trimester who presented to the Otolaryngology Clinic with a chief concern of a progressively growing lesion, measuring 0.7×0.5 cm, over the lateral right side of the tongue for the last 2 weeks after accidentally biting her tongue during dinner. The second case was a 26-year-old woman with unremarkable medical and surgical history who presented to our Otolaryngology Clinic with a chief concern of a non-painful soft fungating pink-red lip lesion 1.5×1 cm across the right lower lip growing for the last 4 months. This lesion appeared during the third trimester of pregnancy following a lip injury that was described as minor trauma. CONCLUSIONS Although hemangiomas can occur anywhere on the body, they are most commonly found in the head and neck. These lesions are usually recognized quickly by patients and treating physicians and are thus clinically diagnosed. Most vascular benign lesions regress on their own, but if detected early, they are surgically excised for cosmetic and functional reasons.

Intraoral Hemangioma: An Overview of the Recent Advances

Hemangiomas are common tumors that exhibit a rapid increase in the number of blood vessels when analyzed microscopically. Hemangiomas are frequently seen since the birth of the infant and possibly enlarge with age. They most likely have developmental rather than malignant roots. Oral hemangiomas are still clinically relevant to the specialist dentist and will require proper clinical treatment regardless of their benign origin and behavior. Nowadays, physical examination, auxiliary inspection, and clinical history serve as the main pillars of diagnosis. Priority should be given in hemangioma treatment to functional harm brought on by the treatment, which may lead to a worsening of the patient’s current condition and may pose a threat to the patient’s life. This shows that early diagnosis, identification, and referral to specialists are critical steps in reducing associated problems and improving prognosis. Surgery and other forms of treatment have a greater rate of morbidity, recurrence, and complications and are not always effective. Oral propranolol is still a widely used first-line medication. Oral propranolol is still a widely used first-line medication, nevertheless. Together with a review of related literature, the main focus of this study will be on the recent changes and modifications being made to ensure accurate diagnosis.

Çok Sayıda Flebolitle İzlenen Oral Hemanjiyom

Hemangioma is a rare, non-reactive, benign vascular tumor, characterized by endothelial cell proliferations and results from vascular malformation. Hemangioma mostly occurs on head and neck skin and regresses spontaneously within 5-10 years in 50-90% of cases. However, oral lesions show less regression than skin lesions. The most commonly affected area is tongue and palatal mucosa, and rarely observed in jaw bones. Diagnosis is based on anamnesis and clinical features. Blanching of the hemangioma under pressure is characteristic clinical finding. Phlebolith is calcified thrombus in veins, venules and sinusoidal walls of hemangiomas. Head and neck phleboliths almost always indicate the soft tissue hemangioma. Phleboliths observed with hemangioma in head and neck region have distinctive appearance on panoramic radiographs. Cone-beam computed tomography provides useful information about location and distribution of phleboliths. In this case report, clinical and radiological features of oral hemangioma and many associated phleboliths are presented.

Clinicopathological analysis of 80 cases of oral lobular and non lobular capillary hemangioma (pyogenic granuloma): A Retrospective study

Background: Oral pyogenic granuloma (PG) is a clinicopathological entity that could develop due to the reaction to a variety of stimuli, such as low-grade local irritation, traumatic damage, and hormonal stimulation. There are two histopathological types of pyogenic granuloma; lobular type -capillary hemangioma (LCH) and non-lobular type; with PG,LCH has highly vascular, diffuse capillary growth while non- lobular variant mimicking granulation tissue with heavily inflammated stroma. The study aims were to review the clinical and histopathological spectrum of an oral pyogenic granuloma from different intraoral sites in order to avoid diagnostic pitfalls associated with similar morphological lesions and to determine whether lobular and non-lobular histopathological subtypes being distinct entities.
 Materials and Methods: A retrospective review of eighty formalin-fixed paraffin-embedded tissue blocks (40 cases each of males and females) were retrieved from the archives of Oral & Maxillofacial Pathology at the University of Baghdad, from 1979 to 2017. According to Mills et al., criteria for lobular capillary hemangioma description, the diagnosis of each case was confirmed by the examination of Hematoxylin and Eosin stained sections by an expert pathologists.
 Results:The present result revealed that patients with oral pyogenic granuloma were with age range from 12 to 59 years, with a mean of 30.57 years. Fourty nine cases (61.25%) out of eighty were of lobular pattern and 31 cases (38.7%) of non-lobular pattern type PG. The most common site of LCH was in the buccal mucosa, 12 cases (75%), while higher case numbers were observed in the 21-30 year age group. There were non-significant differences between lobular and non-lobular pattern prevalence regarding age groups and between other studied variables.
 Conclusio: It has been proposed that LCH and non-LCH subtypes reflect distinct phases in the development of a single lesion, which exhibits variable degrees of proliferative, angiogenic, and inflammatory activities.

Imaging Findings From Different Pathological Types of Oral and Maxillofacial Intramuscular Hemangiomas for Selecting Optimum Management.

ObjectivesTo assess computed tomography (CT) and magnetic resonance imaging (MRI) findings of intramuscular hemangiomas (IMHs) in oral and maxillofacial region and correlate them with the histopathological classifications for selecting optimum management.MethodsThe clinical data and pretreatment findings of 32 patients with pathologically proven IMHs on CT (n = 10), MRI (n = 27), or both (n = 5) were analyzed retrospectively. Correspondence of clinical and imaging characters with 3 different pathological classifications (cavernous, capillary, and mixed) of IMHs was studied. A number of pitfalls and overlap of imaging features can result in misdiagnosis of different IMHs lesions.ResultsFour patients had multi-muscular lesions, and 28 had single-muscular lesions. The predilection site were the tongue (11 cases, 34.4%) and the masseter muscle (10 cases, 31.2%). Cavernous type (17 cases, 53.1%) was the most common IMHs type. All patients showed slightly hypointense or isointense on T1-weighted imaging, 3 patients showed hyperintense on T2-weighted imaging and the others showed slightly hyperintense. The most common enhancement pattern was progressive (29 cases, 90.6%). The capillary type (9 cases, 28.1%) and mixed type (6 cases, 28.1%) of IMHs on imaging indicated characteristics of lesions with rich blood supply status, the cavernous type (17cases, 53.1%) of IMHs belonged to relatively poor blood supply lesions. A total of 5 patients (15.6%) were initially misdiagnosed, there were recurrences in 4 IMHs patients. Extra functional MRI (fMRI) was performed on these 5 misdiagnosed patients, the average ADC of the 5 patients was 1.50 × 10−3 mm2/s. The presence of vermicular vessels was different among these three types of IMHs.ConclusionsThe reason for the misdiagnosis in localized IMHs may be the obvious border of mass-like lesions and the lack of enlarged vessels. Combined evaluation of presence of vermicular vessels and fMRI might be more accurately for determining the IMHs and create a preoperative plan.

Oral reactive capillary hemangiomas induced by SHR-1210 in the treatment of non-small cell lung cancer: a case report and literature review

BackgroundAntibodies to PD-1 and PD-L1 have remarkably improved the overall survival of many patients with advanced solid tumors. SHR-1210 is an anti-PD-1 monoclonal antibody. Dermatologic reactive capillary hemangiomas (RCH) were the most common and unique drug-related AEs of SHR-1210, but rare on oral mucosa and gastrointestinal mucosa. Herein we report a case of RCH occurred in oral mucosa during the clinical trials of SHR-1210 in the treatment of non-small cell lung cancer.Case presentationA male in his 60 s with a history of non-small cell lung cancer received injection of anti-PD-1 monoclonal antibodies SHR-1210. The patient developed drug-related RCH on skin after the first injection and began to have gingival hyperplasia one year after the first injection which gradually increased in size and affect eating and speaking. Anti-PD-1 treatments were continued. After periodontal treatment, two oral lesions and one skin lesion were surgically removed. Similar histological manifestation was found in all three lesions as reactive capillary hemangiomas. All lesions had a good prognosis without recurrence on oral mucosa within one year after surgery.ConclusionsOral reactive capillary hemangiomas could be induced by SHR-1210 in the treatment of non-small cell lung cancer. Surgical resection is an effective treatment with a good prognosis.

Laser Ablation of Blandin and Nuhn Mucocele: A Rare Case Report

Blandin and Nuhn glands are the mixed type of minor salivary glands located on the anterior ventral surface of the tongue. Mucoceles are rarely associated with Blandin and Nuhn gland. Out of 400 mucoceles reviewed by Harrison, only 9 arose on the tongue. Its differential diagnosis ranges from soft-tissue abscess to pyogenic granuloma, oral hemangioma, lymphangioma, lipoma, and squamous papilloma. This is a rare case report emphasizing the laser ablation of Blandin and Nuhn mucocele. The diagnosis of Blandin and Nuhn mucocele was made based on its anatomical site, size, flaccid nature, and frequent change in size characteristically increasing after consumption of food. Laser ablation was opted for the excision because it enables minimal bleeding, scarring, postoperative discomfort, and low recurrence compared to the conventional surgical excision. Histopathological examination revealed extravasation type of mucocele, suggesting that trauma may be the initiating factor.

Examination of oral hemangiomas by intraoral ultrasonography.

Oral hemangioma is a benign vascular tumor characterized by the presence of numerous blood vessels. We aimed to examine the clinical and ultrasonographic findings of patients diagnosed with oral hemangioma in our ultrasonography (USG) archive, retrospectively. This study was conducted by examining 20 patients diagnosed with oral hemangioma and underwent USG examination in the Department of Oral and Maxillofacial Radiology of Atatürk University Faculty of Dentistry from 2016 to 2020. All patients had intraoral and radiographic examinations. Patients pre-diagnosed clinically oral hemangioma were evaluated as intraoral with USG. The intraoral USG examinations were performed using both the B-mode and the color Doppler mode. The mean age of the patients was 42.4 ± 19.14years; 16 patients were female and four were male. The lesions were mostly observed on the alveolar mucosa (30%), followed by the buccal mucosa (25%), the lower lip (15%), the mouth floor (15%), the tongue (15%). In intraoral USG examinations of all oral hemangiomas, we detected submucosal located, well-defined, lobulated, non-capsule, hypo-isoechoic, heterogeneous lesion areas. Additionally, while we detected only peripheral blood flow in 6 (30%) of 20 patients, we detected both internal and peripheral blood flow in 14 (70%). In our study, the examination of the oral hemangiomas with the intraoral probe and the color Doppler mode was very helpful in the differential diagnosis. Although histopathology has an important place in definitive diagnosis, particularly intraoral USG can provide sufficient information for the diagnosis of oral hemangiomas.

A case of blue rubber bleb nevus syndrome found with recurrent oral hemangioma

A case of blue rubber bleb nevus syndrome found with recurrent oral hemangioma

New Approaches In The Diagnosis Of Oral Hemangiomas

Scientific work was carried out on the basis of the Tashkent Medical Academy, Department of Surgery (1st city hospital), and Andijan Medical Institute, Department of Oncology from 2015-2020. Clinical material includes 175 patients. The comparison group consisted of 100 patients who were treated in various hospitals in Tashkent and regions of Uzbekistan. According to the classification of vascular anomalies, the majority of patients with benign vascular tumors (DBT) were diagnosed with infantile hemangioma (IG) - 82.0%, congenital hemangioma (VH) - 11.4%, pyogenic granuloma (PG) - 5.8%. Average age of patients: children - 1.2 ± 0.4, adults - 27 ± 1.2 years. The frequency of DSO in girls was 78%, in boys - 22%. Localization area: lip - 57.6%, cheek 8%, tongue 26.3%. Complications of DSO: anatomical disorders, edema, bleeding, pain, infection, respiratory disorders occurred in 83.7% of patients.

Awareness On Oral Hemangioma Among Dental Students- A Kap Survey

Awareness On Oral Hemangioma Among Dental Students- A Kap Survey

Laser therapy in lip hemangioma: A case report

Hemangioma is a benign vascular lesion, which is common in the head and neck but rare in the oral cavity. Oral hemangioma presents as a smooth, soft, painless mass, which may be sessile or pedunculated in any size. However, most of the lesions will diminish spontaneously. Several therapeutic approaches are used for hemangiomas, such as cautery, cryotherapy, laser therapy, and sclerosing agents. Herein, we reported the case of a 36-year-old female who had a swelling on the top of her upper lip since birth. We proposed laser therapy as an efficient treatment plan because of its benefits, such as the achievement of coagulation, comfort for both practitioner and patient, and esthetic advantages. Moreover, this approach eliminates the chance of recurrence if performed perfectly.

Management of the oral hemangiomas in infants and children: Scoping review.

Background Pediatric oral hemangiomas are benign vascular tumors that can be seen from birth, particularly in females. Hemangiomas are most frequent located in the lips and usually regress spontaneously, thus they do not require any type of treatment in most cases. The present scoping review pretended to synthesize the most relevant and currently available information from the international dental literature published in the last 25 years, regarding the management of pediatric oral hemangiomas. Material and Methods An exhaustive literature search was performed in four electronic databases (PubMed, Embase, Google Scholar, and Cochrane). Initially, 241 related titles and abstracts were found. After the duplication removal, screening, and assessment processes, 37 records were included for full-text reading. Finally, 20 articles in the English language were included in the scoping review for data extraction and assessment. Results We identified and subsequently discussed three fundamental issues associated to the management of pediatric oral hemangiomas: (i) clinical characteristics, differential diagnosis, and histopathological findings; (ii) evolution and complications; and (iii) current available treatment modalities. Conclusions Although these like-tumor lesions are uncommon, pediatric dentistry practitioners must be familiar with the inherent clinical characteristics, diagnosis approaches, and currently available treatment options. Nowadays, surgical removal and non-invasive medical/pharmacologic therapies are the best management modalities for pediatric oral hemangiomas. Key words:Vascular tumors, hemangioma, oral management, children, scoping review.

Propranolol therapy for the management of oral lobular capillary hemangioma in a 2-year-old preschooler: A case report and review

Lobular capillary hemangioma (LCH), a histological variant of pyogenic granuloma (PG) is an inflammatory hyperplasia commonly seen on oral mucosa as a reaction to local irritants, trauma or hormonal influences. The term “PG” is a misnomer as it is neither pus filled nor representative of a granuloma histologically. It is an inflammatory lesion composed of proliferating vascular, fibrous, and inflammatory tissue. The benign tumor has varied clinical and histopathological presentations and occurs frequently on the gingiva in the oral cavity. The article presents a case report where 2-week propranolol therapy was used to manage oral LCH (with a rare site of presentation) in a 2-year-old preschooler with a 9-month follow-up showing no recurrence followed by review of literature.

A Case Report of a Tongue Ulcer as a Rare Presentation of Oral Hemangioma

Oral hemangioma is a rare benign vascular tumor. It may occur on lips, tongue, buccal mucosa, and palate. Hemangioma is a congenital hamartoma and its clinical presentations and patients’ history aid in its diagnosis. Histopathologically, hemangioma shows flatted endothelial cells and small capillary size space. In this report, we will describe a rare presentation of oral hemangioma as an asymptomatic tongue ulcer in a 32-year-old woman. The clinical presentation, differential diagnosis, and management will also be described in detail.

Surgical Laser Treatment for Hemangioma of the Labial Mucosa: Report of Three Clinical Cases

Hemangioma, a benign vascular neoplasm, results from uncontrolled growth of endothelial cells. Three cases of hemangioma in the lower lip were reported from among patients with aesthetic and functional complaints. After a complete anamnesis, thorough physical examination, and measurement of blood pressure, the vascular origin of the lesion was confirmed, and a clinical diagnosis of hemangioma was established. Considering the circumscribed aspect of the lesion and the systemic conditions of the patients, photocoagulation, using a high-intensity diode laser (808 ~ 830 nm ± 20 nm) of 2.5 W power in the continuous mode, was chosen as the treatment option. Absence of bleeding during surgery facilitated better visibility for the surgeon and resulted in a minimally invasive procedure. Satisfactory results were obtained in all the patients, with aesthetic and functional improvements; thus, it can concluded that the diode laser can be considered a good alternative for the treatment of oral hemangiomas.

Oral Hemangioma Management in Children: A Concise Review

Head and neck region bears the burden of approximately 60% of all the vascular anomalies diagnosed, affecting about 1 in 22 children. These lesions, how much ever small in size, when present on the face or lips they are a major cause of concern from the esthetics point of view and patient and parents usually seek treatment for the same. There are various treatment modalities available for the management, sclerotherapy with intra/peri-lesional injections of 3% Sodium tetra decylsulphate is the remains the mainstay of treatment in most cases. This article provides a concise review regarding various management options available for smaller vascular lesions especially emphasizing the role of sodium tetradcy sulphate.

An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity

ObjectivesTo evaluate cases diagnosed as “oral hemangiomas” based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. Material and methodsAll cases stored in the archives of an Oral Pathology Service and diagnosed as “oral hemangiomas” were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(−) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. ResultsOnly 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(−) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as “hemangiomas” were IHs. In the group of “capillary hemangiomas”, most cases (56.2%) were PGs. Among the three “cellular hemangiomas”, two were PGs and one was IH. Most (88.8%) “cavernous hemangiomas” were vascular malformations. ConclusionCareful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. Clinical relevanceAccurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis.