Huge central intravascular papillary endothelial hyperplasia of the mandible: a case report and review of the literature

Abstract

Masson's tumor or intravascular papillary endothelial hyperplasia is an inflammatory soft tissue lesion that rarely occurs in the maxillofacial region and skeletal system. Precise clinical and para-clinical investigation is necessary for the accurate diagnosis and correct treatment of this lesion. This paper presents a massive intravascular papillary endothelial hyperplasia lesion in the bony tissue of the mandible. Histopathology features, clinical appearance, and suitable management are discussed, with a complete review of the literature. The patient underwent composite resection of the lesion as well as reconstruction. No recurrence was observed during 6 years of follow-up. To the best of our knowledge, this is the fourth case of Masson's tumor in mandibular skeletal tissue, which has unique and distinctive features due to its size and location. A rare occurrence in skeletal tissue, complex clinical presentations, and complicated histopathologic findings present diagnostic challenges for treatment of this lesion.

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

“…In this sense, several authors have suggested an estrogenic hormonal influence on the development of IPEH . 12,16,24 This fact could reflect the predominance of the disease among women, observed in both parts of the current study. Regarding age, individuals were more affected in the 5th decade of life.…”

“…This lesion comprises approximately 2% of all vascular tumors of the skin and subcutaneous tissue and predominantly occurs in the trunk, fingers, and head and neck regions 11,12 . The literature points out that some factors may be associated with the triggering of the proliferation, such as local minor trauma, hormonal influence, and changes in some growth factor stimulations 13,14 .…”

“…Clinically, the lesions are described as asymptomatic, firm, and sometimes as nodules or masses of reddish‐blue coloration with slow growth and slight elevation 16 . Intraosseous IPEH lesions in the jaws are extremely rare, and only four cases have been reported in the literature 12 . Histopathologically, endothelial cells proliferate in a papillary pattern toward the lumen of the enlarged blood vessel from the area of the organizing thrombus 2,16,17 .…”

“…10 This lesion comprises approximately 2% of all vascular tumors of the skin and subcutaneous tissue and predominantly occurs in the trunk, fingers, and head and neck regions. 11,12 The literature points out that some factors may be associated with the triggering of the proliferation, such as local minor trauma, hormonal influence, and changes in some growth factor stimulations. 13,14 IPEH is classified into three types: The primary type arises within the lumen of a dilated vessel; the second develops in a preexisting vascular lesion, such as a hemangioma, pyogenic granuloma, or arteriovenous malformation, and the third and most rare variant of IPEH is a papillary hyperplasia of extravascular origin.…”

Intravascular papillary endothelial hyperplasia in the mandible: a case report

“…8 However, the pathogenesis of IPEH is controversial because many affected patients have not reported a history of trauma. 3,7 Our patient had a history of many instances of minor trauma to the mental region during participation in boxing and baseball; moreover, he showed no evidence of periapical odontogenic infections. Although the pathogenesis of IPEH may not be solely related to trauma, our findings suggested that IPEH in our patient occurred as a result of trauma.…”