口腔颌面部上皮样血管瘤6例临床病理分析及文献复习

目的:探讨口腔颌面部上皮样血管瘤的临床病理学特征、诊断、预后及临床意义。方法:收集6例口腔颌面部上皮样血管瘤病史、临床资料;大体检查、HE染色后光学显微镜下观察, 全部标本行免疫组织化学染色分析其免疫结构,并复习相关文献。结果:6例患者中,男女各3例。肿瘤分别位于耳周(4例)及腭部(2例);都表现为表浅单发性肿块,1例有创伤史。组织学表现为增生的毛细血管和小血管, 血管内皮细胞呈上皮样或组织细胞样改变;病变内见以嗜酸性粒细胞为主的慢性炎症细胞浸润。免疫组织化学检测,所有病例血管内皮细胞Vimentin、CD31、CD34阳性, SMA显示血管周围完整的肌外周细胞层,S-100、PanCK染色血管内皮细胞阴性。手术治疗后1例复发,均无转移。结论:上皮样血管瘤是一种良性血管病变,可能与局部创伤有关。手术局部完全切除是其主要治疗方式,若切除不彻底容易复发。准确的术前和术中诊断对手术完整切除有重要的意义     

Cavernous hemangioma--uncommon presentation in zygomatic bone

Hemangiomas are benign vascular neoplasms characterized by an abnormal proliferation of blood vessels. They may occur in any vascularized tissue including skin, subcutaneous tissue, muscle, and bone. 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 and occurs most commonly in the maxilla, mandible, and nasal bones. In literature, only 20 cases of zygomatic involvement have been reported. We report a case of an intraosseous hemangioma of the zygoma with the history and physical findings of slowly growing, bony, hard tumor causing facial and ocular deformity. The typical clinicopathologic and radiologic findings helped to set up the correct diagnosis. Early recognition and excision are recommended to preserve facial contour. Operative blood loss is minimal, and there is no need for preoperative angiography.     

Peripheral giant cell granuloma combined with facial hemangioma. A case report

Peripheral giant cell granuloma (PGCG) is a relatively uncommon benign tumor of the oral cavity affecting people of all ages and with no racial predilection. The etiology is still unclear but local trauma or chronic irritants may cause the development of this lesion. Hemangioma is a benign process in which there are an increased number of normal or abnormal-appearing blood vessels. In this article the clinical, radiographic and histopathologic characteristics of a patient who had a rare combination of PGCG and facial hemangioma is discussed. Surgery was the effective treatment modality for the lesion in the mandible. The characteristics of facial hemangioma and PGCG have similarities, such as the possibility of bleeding problems during surgery. As the lesion in this case was not small in size, it was not a conservative procedure. Bleeding control was established by electrocauterization. Healing was uneventful and there has been no recurrence since the surgery. A new prosthesis was fabricated for the patient. In these kinds of cases the control of bleeding must be very carefully determined and attention should be paid to the possibility of serious bleeding problems. Based on the data presented we were not able to find any correlation between the PGCG and the facial hemangioma, but new reports might have different views on the subject in the future.     

Capillary hemangioma or pyogenic granuloma: A diagnostic dilemma

Pyogenic granulomas and hemangiomas of oral cavity are well-known benign lesions. Although pyogenic granuloma is known to show a striking predilection for the gingiva and capillary hemangioma for lips, check, and tongue, palatal occurrence of these lesions is extremely rare. The clinical diagnosis of such an uncommon occurrence can be quite challenging as they sometimes may mimic more serious lesions such as malignancies. The purpose of this article is to report an unusual case of benign tumor occurring on hard palate which was clinically diagnosed as pyogenic granuloma and histopathologically as capillary hemangioma.     

Lip cavernous hemangioma in a young child

Hemangiomas are benign tumors of infancy and childhood, characterized by a phase of fast growth with endothelial cell proliferation, occurring in 10-12% of children at 1 year of age. It is known that hemangiomas of infancy are most commonly located on the head and neck region (around 60% of cases) and occur more frequently in the lips, tongue, and palate. Approximately 50% of hemangiomas have complete resolution, and 90% of them are resolved up to the age of 9. Complications occur in only 20% of the cases, the most common problem being ulceration with or without infection. The treatment depends on lesion location, size and evolution stage, and the patient's age. Surgery is usually indicated when there is no response to systemic treatments, or even for esthetic reasons, being performed as a simple excision in combination or not with plastic surgery. This paper reports a case of lip cavernous hemangioma in a 4-year-old child, who was submitted to 3 sessions of vascular sclerosis due to the size of the lesion, before undergoing simple excision of the hemangioma. Two years of postoperative clinical follow-up shows treatment success with no recurrence of the lesion.     

Examination of oral hemangiomas by intraoral ultrasonography

Oral Radiology - 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...     

Gingival hemangioma with port wine nevi of the face. A case report

Hemangioma is a proliferating mass of blood vessels. Its occurrence in gingiva is rare. The diagnosis and treatment of hemangioma is complex, and any attempt to carry out biopsy/surgical excision may lead to fatal consequences due to severe hemorrhage. A rare case of gingival hemangioma with port wine nevi of face is reported. The case is of periodontal interest because the lesion occurred on the gingiva, a reliable diagnostic approach (Ultrasound Spectra Doppler Flow) was used and a conservative treatment using a sclerosing agent was employed.     

Oral lymphangioma: a case report

Lymphangiomas are congenital malformations of lymphatic vessels filled with a clear protein-rich fluid containing few lymph cells. It can also occur in association with hemangioma. Large lymphangioma extending into the tissue spaces of neck is referred to as cystic hygroma. Herewith, we present a case of cystic hygroma associated with lymphangioma of tongue leading to macroglossia in a 5-year-old boy.     

Vascular epulis or lobular capillary hemangioma

Vascular epulide or Lobular capillary hemangioma is a form of epulide which is marked by an inflammatory infiltrate rich of blood vessels. Angiogenic factors seem to be responsible of the important vascular proliferation. Therapeutic implications include cautions toward hemorrhagic risk. Complete ablation is also required to avoid the risk of high recurrence.     

Intraosseous mandibular hemangioma. A case report and review of the literature

Intraosseous vascular lesions are rare conditions, comprising only 0.5% to 1% of all intraosseous tumors. They mainly occur in the second decade of life especially in women. The most common locations are the vertebral column and skull; nevertheless, the mandible is a quite rare location. According to the World Health Organization, hemangiomas are benign vasoformative neoplasms of endothelial origin. However, the origin of central hemangioma is debatable. Some authors believe that it is a true neoplasm, whereas others state it is a hamartomatous lesion. Clinically, the patient may be completely symptom-free or may present discomfort, pulsatile bleeding, bluish discoloration, mobile teeth, derangement of the arch form or accelerated dental exfoliation. Most frequently radiographic finding is a multilocular radiolucent image with honeycombs or soap bubble appearance. Differential diagnosis includes neoplasms such as ameloblastoma, cystic lesions such as residual cyst, keratocyst and fibro-osseous lesions such as fibrous dysplasia. There are some therapeutic alternatives, although wide surgical excision remains as the gold standard. We now present a case report of a 51-year-old woman diagnosed in a mandibular hemangioma. Clinical, radiological and histological features of this unusual tumor are described.     

颌面部毛细血管瘤增殖细胞核抗原的表达及临床意义

本文采用免疫组织化学方法(LSAB)对76例毛细血管瘤病理演变过程中不同分期的血管内皮细胞增殖细胞核抗原(PCNA)的表达变化进行了研究.结果表明:增殖期PCNA阳性率明显高于退化期及退化完成期,经统计学处理有显著差异性.由此有助于指导临床治疗方法、时机的选择和预后的判断.     

Hemangiomas of the head and neck with phleboliths: clinical features, diagnostic imaging, and treatment of 3 cases

Hemangiomas are benign vascular lesions and are classified into cavernous, capillary, and mixed types. Phleboliths are calcified nodules that can be regarded as a pathognomic feature of hemangioma. The treatment of the hemangiomas is based on location, accessibility, depth of invasion, age, and cosmetic considerations. Surgical extirpation is a mainstay of treatment when indicated. Three cases of head and neck hemangioma are reported with clinical and imaging findings.     

Primary angiosarcoma of the parotid gland arising from benign congenital hemangioma

A case of malignant transformation of a benign congenital hemangioma of the parotid gland is presented. The malignant tumor occurred in a woman with a history of congenital hemangioma surgically removed 8 years previously. No radiotherapy had been administered at the time of primary excision. The recurrent tumor consisted of a large lesion occupying nearly all the parotid gland and infiltrating the surrounding soft tissues and overlying skin. Its histopathologic features were typical of epithelioid angiosarcoma. The vast majority of vascular lesions of major salivary glands are benign. However, pathologists should be aware of the remote possibility of malignant transformation in these lesions.     

Intravascular papillary endothelial hyperplasia and osteoma: a case report of an individual with 2 different pathologies.

Intravascular papillary endothelial hyperplasia (IPEH) is an unusual, benign, non-neoplastic, vascular lesion characterized histologically by papillary fronds lined by proliferating endothelium. Osteoma is a benign osteogenic lesion characterized by proliferation of compact or cancellous bone. Osteoma of the maxillary sinus is an uncommon lesion. The purpose of this report is to present a case with 2 different lesions (intravascular papillary endothelial hyperplasia and osteoma) occurring at the same time in 1 patient that may or may not be related to each other and to stress the value of diagnostic imaging.     

Intraosseous hemangioma of the orbit

Intraosseous hemangiomas of the orbit are very rare tumors. A case of cavernous hemangioma of the superolateral orbital rim is presented. A 45-year-old woman had a 1-year history of progressive swelling in the left lateral brow area. A computed tomography scan showed a well-marginated osteolytic lesion on the frontal bone near the frontozygomatic suture. The lesion was thought to be fibrous dysplasia, and the patient underwent tumor excision. The histological diagnosis was cavernous hemangioma. Cavernous spaces were filled with blood between the bony trabeculae. The spaces were lined by benign flattened endothelium. Intraosseous hemangioma should be suspected when a patient presents with an enlarging mass fixed to bone around the orbit.     

Rare benign tumours of oral cavity--capillary haemangioma of palatal mucosa: a case report

Haemangiomas are benign tumours composed of blood vessels, they are probably developmental rather than neoplastic in origin. Haemangiomas are often present at birth but may become more apparent during life. The tumours appear as a flat or raised reddish-blue lesions and are generally solitary. They are occasionally seen on the palatal mucosa. Haemangiomas are classified on the basis of their histological appearance as capillary, mixed, cavernous or a sclerosing variety that tends to undergo fibrosis. Their differential clinical diagnosis is based on appearance. The tumours may be slowly progressive, involving extensive portions of the superficial and deep blood vessels. Function may be affected where development of the lesion is extra-invasive. Colour change on pressure is a common finding with return to the original colour on withdrawal of pressure. The case presented here was referred because of swelling and recurrent periodontal bleeding. The lesion was diagnosed as a capillary haemangioma through histopathology. Although different therapeutic procedures have been reported, in this case surgical excision was carried out under general anaesthesia following hospitalization. Despite their benign origins and behaviour, haemangiomas in the region of oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Dental practitioners and oral surgeons need to be aware of these lesions because they may pose serious bleeding risks.     

The potential role of progesterone during pregnancy as an induction of infantile hemangiom

Infantile hemangioma(IH) is one of the most common benign tumors in infants characterized by occurrence within a few weeks after birth,rapid growth during the first year and spontaneous involution over a period of several years.Despite the high incidence rate of 5%-10% in infants of mixed European descent,detailed pathogenesis of IH remains elusive.Recent studies have indicated multipotential stem cells derived from hemangioma tissue(HemSCs) could recapitulate human infantile hemangioma in immunodeficient mice.Considering the effect of progesterone on regulation of cytokines and growth factors in endometrium as well as the inhibition of immune response,using progesterone during pregnancy might help the HemSCs escape from the immune response and reside in the tissue of embryo by the aid of increased MMPs and decreased TIMPs,then proliferation was stimulated by increased growth factors like VEGF and bFGF.Thus,IH is potentially produced.     

血管瘤内皮细胞增殖机制的初步研究

目的 :探讨血管瘤内皮细胞活跃增生与猿猴病毒 40大T抗原、端粒酶活性表达及端粒长度变化的关系 ,明确血管瘤发病的相关机制。方法 :应用免疫组化、基于逆转录聚合酶链反应的端粒重复末端扩增分析法及端粒限制性片段分析化学发光、原位杂交法检测血管瘤、鳞状细胞癌、人胚肾内皮细胞的猿猴病毒 40大T抗原、端粒酶活性表达及端粒长度变化。结果 :5 4%和 45 %的血管瘤中分别检出端粒酶、猿猴病毒 40大T抗原的表达 ,猿猴病毒 40大T抗原阳性内皮细胞散在分布。血管瘤端粒长度位于 6.8～ 13 .2kb之间。结论 :猿猴病毒 40对血管内皮细胞的作用与血管瘤的发生有关 ;血管瘤端粒酶活性高于一般良性肿瘤 ,该结果解释了其突出的增殖活性     

Cavernous vascular tumor of the accessory parotid gland

Accessory parotid gland tumors are uncommon and account for only 1% to 7.7% of all parotid gland tumors. Only one case report of hemangioma of the accessory parotid gland in infancy has been issued, and no report is available on this condition in an adult. We present the case of a 44-year-old woman with an accessory parotid gland tumor, which was finally diagnosed as a cavernous hemangioma histopathologically.