Cavernous Hemangioma of the Mandible

Abstract

Objectives: To report a case of hemangioma arising from the mandible and its clinical presentation; describe the similarities with which mandibular hemangioma may mimic odontogenic and non-odontogenic lesions; and identify diagnostic and treatment modalities employed in these patients.
 Methods:
 
 Design: Case Report
 Setting: Tertiary Public Hospital
 Patient: One
 
 Results: A 12-year-old male with intractable gum bleeding exacerbated by intra-operative manipulation of a loose first premolar, and uncontrolled by left external carotid ligation, underwent segmental mandibulectomy. The resected segment revealed multiple porosities and a hollow blood-filled cavity. Histopathology confirmed the diagnosis of cavernous hemangioma.
 Conclusion: Though rare, mandibular hemangiomas should be considered in lesions involving the mandible. Diagnosis is difficult with an array of lesions that may appear clinically and radiographically similar. The non-specific signs and symptoms of mandibular hemangioma could lead to exsanguinating hemorrhage if not attended to promptly.
 
 Keywords: cavernous hemangioma, mandible, hemorrhage, external carotid ligation, mandibulectomy

Hemangioma of the Mandible in a 12-Year-Old Boy

“…2,5 Papa et al also reported a case of a 12-year-old boy, referred due to intractable gingival bleeding over a period of two months exacerbated by intraoperative manipulation of a loose first premolar. 9 Similarly, Sadain-Urao and Pontejos reported the case of a 20-year-old man with a 3-month history of progressively enlarging right mandibular area associated also with profuse bleeding from a tooth extraction site. Bleeding in the latter case was so severe that the patient had a hypotensive episode and loss of consciousness during exploration and ligation of bleeders.…”

Intra-Osseous Hemangioma of The Mandible: A Case Report

“…With respect to the addicted potentially severe complications like first of all a massive bleeding a cavernous haemangioma, even if being a very rare pathology, should be taken in consideration in all kind of similar uncertain findings [1,6,7]. Even if we could treat the occurring bleeding at once under optimal conditions (young patient without general medical risk factors under general anaesthesia, experienced surgical team, intensive care and angio-radiological department directly available) the course of our case shows the potentially lifethreatening character of such malformations.…”

“…The intra-and postoperative course shows that a local surgical revision combined with an embolization of the feeding vessels can be a sufficient treatment [1]. Therefore invasive and destructive measures such as radical resection of the according jaw or/and ligation of the carotid artery as still discussed in the literature should be preferably avoided not only considering aesthetic reasons [3,4,7,9] .…”

“…Due to the potential fatal complications in combination with the often very uncertain clinical and radiological signs and appearance the diagnosis is a challenge [2,6,7]. Even a biopsy or simple tooth extraction can result in a lethal haemorrhage [5].…”