J Korean Assoc Oral Maxillofac Surg.  2021 Aug;47(4):321-326. 10.5125/jkaoms.2021.47.4.321.

Diagnostic challenge and management of intraosseous mandibular hemangiomas: a case report and literature review

• Sánchez Jorge MI
• Brinkmann JCB
• Corchón AG
• Ocaña RA

• KMID: 2519829
• DOI: http://doi.org/10.5125/jkaoms.2021.47.4.321

Abstract

Hemangioma is a benign tumor characterized by the proliferation of blood vessels. Although it often appears in soft tissues, its occurrence in bone tissue, particularly the mandible, is extremely rare. A 32-year-old female sought attention at the dental clinic complaining of a painless swelling in the posterior region of the left side of the mandible. A panoramic radiograph and computed axial tomography scan were taken, showing honeycomb and sunburst images, respectively, in the affected area. The patient underwent a biopsy, which led to the diagnosis of intraosseous hemangioma. Having assessed the characteristics of the lesion, it was decided to perform complete excision including safety margins, followed by an iliac crest bone graft to reconstruct the mandible. Awareness of the possible clinical and radiographic presentations of intraosseous hemangioma is considered important, as non-diagnosis could have severe consequences given its possible relation to dental structures.

Keyword

Hemangioma; Bone; Mandible; Tumors

Figure

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  Fig. 1 Intraoral image showing increased volume in the vestibular area adjacent to teeth #35-#37.

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  Fig. 2 Computed tomography scan. A, B. Three-dimensional reconstruction of the mandible. C, D. Sunburst image; note the presence of reactive bone spicules.

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  Fig. 3 Panoramic radiograph: honeycomb pattern in the third quadrant.

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  Fig. 4 Angiography showing the main vessels supplying the intraosseous hemangioma.

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  Fig. 5 Histologic study. H&E-stained specimen (A: ×10, B: ×20) showing the presence of bone trabeculae and spicules between numerous vascular structures with muscular walls and dilated spaces separated from one another by fibrous tissue.

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  Fig. 6 Intraoperative image after flap raising.

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  Fig. 7 Panoramic radiograph after ramus graft showing no signs of relapse.

Reference

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