Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) of the Mouth – A Case Report

Abstract

We report a rare case of intravascular papillary endothelial hyperplasia (IPEH) of the oral mucosa. This neoplasm, known as Masson’s tumor, is an unusual vascular lesion of proliferating endothelial cells. It is usually confined to the lumen of preexisting vessels or vascular malformations. The principal significance of IPEH is its microscopic resemblance to angiosarcoma and possible misdiagnosis as such. Achieving a correct diagnosis is essential to avoid subjecting a patient to unnecessarily aggressive therapy. For this reason, awareness of this lesion is very important for dermatologists and dentists. In this article, we discuss the clinical features, histopathological characteristics, and management of IPEH and review the pertinent literature.

Masson's tumor in the ulnar artery

“…2 Our patient presented with an aneurysmal ulnar artery and the primary form of Masson's tumor, which is the most common form of Masson's tumor constituting more than 50% of the cases seen in the literature. 1 Masson's tumors are found more frequently in women than in men, but they show no age or race predilection.…”

“…1 Despite comprising only 2% to 4% of all skin and soft tissue vascular tumors, multiple case reports have described Masson's tumors arising in the hand, forearm, neck, oral mucosa, and salivary glands as well as in both arteries and veins. [1][2][3][4] However, the diagnosis of Masson's tumor can be difficult with a broad differential diagnosis, including intravascular fasciitis, intravascular pyogenic granuloma, and angiosarcoma. 4 We describe a patient with intravascular epithelial papillary hyperplasia presenting as an ulnar artery aneurysm.…”

Intracerebral Masson's Tumor—Slow-Filling Vascular Lesion Demonstrated by Indocyanine Green Video Angiography

“…It is characterised by papillary proliferation of the vascular endothelium and can be described as being: a) Primary, if arising from a normal vessel, b) Secondary, if originating from a pre-existing vascular condition e.g. aneursyms 14,15 or c) if extravascular in nature 4 .…”

“…Although relatively uncommon, it is most often seen in skin and soft tissue where it resembles a sarcoma 2 . However, it can arise from any vascular origin in the body and has been described in a variety of locations such as the oral cavity 3,4 , ulnar artery 5 , internal auditory canal 6 , bladder 7 , hand 8 and skull 9 . The central nervous system can also be affected by this lesion.…”

The first recurrent intravascular papillary endothelial hyperplasia (Masson’s tumor) of the kidney

“…[7] Then a pseudotumoural lesion caused by endothelial proliferation with papillary formation proceeded by an accumulation of thrombotic material, which serves to make easy development of the lesion. [5,11] Although IPEH is generally found in the lumen of dilated veins, it is rarely detected in hemangiomas, hematomas, and lymphagiomas. [5] It is the intravascular endothelial proliferation that in many respects mimics an angiosarcoma.…”