Intravascular papillary endothelial hyperplasia in the lower labial mucosa mimicking a mucocele

Intravascular Papillary Endothelial Hyperplasia of Buccal Mucosa Masquerading as Mucocele - A Case Report

INTRODUCTION

Oral intravascular papillary endothelial hyperplasia (IPEH) is a rare entity with only 105 cases reported so far. Labial and buccal mucosa are the commonly affected sites. These sites are coincidently subjected to continuous minor trauma, which led the researchers to opine that IPEH could have a traumatic etiology with a further role of fibroblast growth factors.

CLINICAL PRESENTATION

We report a case of IPEH of right buccal mucosa in a 35 years old South Indian male who clinically presented as mucocele. Histopathologically, multiple lesions were found. Immunohistochemical and histochemical findings have also been presented.

DISCUSSION

The case is supported by a plausible mechanism involved in the pathogenesis. Thus, IPEH must be included in the clinical differential diagnosis of oral mucoceles and hemangioma.

TAKEAWAY LESSONS

Being a reactive lesion, it does not require extensive treatment. Clinicians and histopathologists must be aware of this uncommon yet benign condition for appropriate therapy.

Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review

BACKGROUND

Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion.

METHODS

Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases.

RESULTS

Of the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables.

CONCLUSION

Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.

Stafne bone defect of the molar region of the mandible

Background/purpose

The classic Stafne bone defect (SBD) is a rare small well-demarcated radiolucent lesion in the molar region of the mandible near the mandibular angle. This study reported a series of 5 SBD cases.

Materials and methods

This study reviewed 4000 consecutive panoramic radiographs from February 2017 to May 2017 and found 5 classic SBD cases. The clinical and radiographic findings of these 5 SBD cases were reported.

Results

We found 5 SBD cases presenting as small, well-defined, and radiolucent lesions at the typical first molar to third molar region of the mandible near the mandibular angle and below the mandibular canal. The mean age of the 5 patients at the time of diagnosis was 53.4 years (range, 45-69 years). All the 5 SBD cases occurred in male patients, 3 were on the right side and 2 were on the left side of the mandible. The mean greatest dimension of the 5 SBDs was 1.5 cm (range, 1.2-1.9 cm). All the 5 SBD cases were found incidentally on the panoramic radiographs and two of them were confirmed by cone-beam computed tomography. No surgical intervention was performed for these 5 SBD cases.

Conclusion

The classic SBDs occur most frequently in male patients in the age group between 40 years and 60 years. For the SBDs at the typical site of the molar region of the mandible near the mandibular angle and below the mandibular canal, these lesions can be monitored by panoramic radiography once per one or two years.