Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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October 8, 2015
Oral Hemangioma
- Backgounds:
- Vascular tumors are the most common benign tumors of the head and neck in infants and children.
- Generally, not evident at birth. Incidence greater in females than males.
- Typically, they enlarge rapidly and regress slowly, rarely affecting bone structures.
- Relevant Clinical Information: Soft-tissue slightly raised lesion in oral mucosa. Usually, they are small tumors without clinical symptoms, but can ulcerate or bleed if traumatized.
- Key Diagnostic Features:
- Diagnosis is made on the basis of clinical examination and the patient’s history.
- Radiographic studies are essential for delineation of deep extension.
- Nonenhanced CT density similar to muscle and soft tissue. It presents a heterogeneous enhancement after endovenous contrast agent administration.
- MRI is considered to be the most useful imaging modality for recognition of lesion extension. Tumors show isointensity on T1WI, hyperintensity on T2WI, and heterogeneous enhancement after contrast medium infusion on T1WI.
- "Flow voids" on images represent nutrient and drainage vessels.
- DDx:
- Vascular malformation
- Venolymphatic malformation
- Treatment:
- Involution occurs spontaneously, so treatment is not necessary in most cases. Larger, potentially disfiguring or complicated hemangiomas may require intervention.
- Therapeutic options include systemic, topical, or intralesional medications (propanolol, corticosteroids); laser therapy; and surgery.
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