Despite the fact that a biological classification of congenital vascular tumors and malformations was first published in 1982 by Mulliken and Glowacki, significant confusion still prevails due to the indiscriminate and interchangeable use of the terms hemangioma and vascular malformation. Hemangiomas are true neoplasms of endothelial cells and should be differentiated from vascular malformations which are localized defects of vascular morphogenesis. On an analysis of various scientific articles and latest edition of medical text books an inappropriate use of various terms for vascular lesions was found, contributing further towards the confusion. The widely accepted International Society for the Study of Vascular Anomalies (ISSVA) classification differentiates lesions with proliferative endothelium from lesions with structural anomalies and has been very helpful in standardizing the terminologies. In addition to overcoming obstacles in communication when describing a vascular lesion, it is important that we adhere to the correct terminology, as the therapeutic guidelines, management and follow-up of these lesions differ.
CD, ND, and NCR showed statistically significant changes in Group II in comparison with Group I, which could indicate larger and earlier risk of carcinoma for Gutka chewers than in BQT chewers.
A 17-year girl reported with painful right lower posterior teeth. Orthopantomogram showed unilocular radiolucency with scalloped non-sclerotic border at apical area of non-carious right mandibular molars and premolar. A provisional radiological diagnosis of ameloblastoma or odontogenic keratocyst was given. Histopathological examination revealed follicular areas of peripheral palisaded hyperchromatic basaloid cells and central round-polygonal clear cells. A diagnosis of clear cell odontogenic carcinoma (CCOC)-ameloblastomatous variant was made after assessing the provisional diagnoses. A nosological dilemma arose as many authors opined that the terms 'clear cell ameloblastoma' and 'clear cell odontogenic tumor' should be invalidated and CCOC should be the preferred diagnosis because of the reported aggressive nature of clear cell odontogenic neoplasms. The scientific literature gave variable biological behavior and prognosis with diverse therapeutic approaches leading to therapeutic dilemma in management of the case. The authors have attempted to resolve the diagnostic and therapeutic challenges by presenting the clinical, radiological and histological aspects of the case and discussing the differential diagnoses of clear cell lesions involving the maxillofacial region along with the therapeutic approaches and prognosis of CCOC.
Scientific articles and newer editions of medical text books show significant misapprehension among authors and scientific fraternities over the correct nosology for diagnosing and reporting vascular anomalies/malformations. This perplex have led to indiscriminate, inappropriate, and interchangeable use of terminologies while describing these vascular lesions, often resulting in incorrect diagnosis, unwarranted investigations, and improper treatment. It is often impossible to determine clinically and histopathologically whether the vascular lesion is a malformation or a neoplasm, with more than 50% of the vascular anomalies being diagnosed and termed incorrectly as hemangioma. With the help of three case reports of simple vascular malformations, each afflicting the capillaries, veins and lymphatics, we attempt to guide the clinicians in adhering to the International Society for the Study of Vascular Anomalies (ISSVA) classification. We anticipate that this case report shall be the framework that helps clinicians and pathologists to avoid misdiagnosis and misreporting of vascular malformations.
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