Sclerotherapy for Extensive Vascular Malformation in the Tongue

Abstract

Vascular malformations (VMs) are benign lesions of blood vessels originated from an error in vascular morphogenesis during the embryologic phase. Generally, when located in the head and neck region VMs occurs in lips, tongue, buccal mucosa, gums, or palate. The VMs are usually asymptomatic, varies in size and may cause facial asymmetries. Different therapeutic modalities are available to treat VMs, which include surgical excision, cautery, cryotherapy, laser therapy, and sclerosing agents. The authors report 2 patients with extensive VM in the tongue treated with intralesional injection of a low-dose solution of monoethanolamine oleate (MO) and lidocaine. The first patient was a 69-year-old male patient and the 2nd a 65-year-old woman. In both patients, it were performed weekly application of 1:1 MO (Ethamolin) with Lidocaine (lidocaine 3% 1:50,000) in the amount of 0.1 mL of the solution per cm3 of lesion, with a total of 12 applications for each patient at the end of the treatment, with good results and without complications. It is important to be alert in which situation sclerotherapy should be used and that small doses of the sclerotherapeutic agent is essential for the prevention of complications after the procedure. Therefore, these patients showed that the sclerotherapy with MO may be an effective and simple treatment for extensive oral benign vascular lesions. In both patients, there was a great improvement in the clinical aspect of the lesions and patient's satisfaction.

Diferentes tipos e protocolos de esclerosantes vasculares no tratamento das má formações vasculares orais: revisão literária

“…As malformações vasculares são lesões benignas dos vasos sanguíneos originadas por um erro na morfogênese vascular durante a fase embriológica 15 , causados principalmente pela disfunção na regulação das vias da embriogênese e vasculogênese. São lesões do sistema sanguíneo ou linfático que podem afetar qualquer parte do corpo, sendo mais comuns na região de cabeça e pescoço 16 e correspondendo a 40% dos casos 17 .…”

“…As malformações vasculares são usualmente assintomáticas, variam em tamanho e quando mais extensas podem causar assimetrias faciais 1,15 . Frequentemente podem estar acompanhadas de sintomas dolorosos, sangramentos, defeitos funcionais e estéticos, assimetria facial, destruição óssea e mobilidade dentária 5,9,16,17,26,28 .…”

“…Em relação a predileção pelo sexo, não existe um consenso descrito na literatura. Alguns autores defendem que essas lesões não demonstram predileção pelo sexo 15,23,29,33,34 , enquanto que outros autores relatam que há predileção pelo sexo feminino, na proporção aproximada de 2:1 1, 9, 27 . Sua incidência na região do pescoço da cabeça varia de 14% a 65% 29 .…”

Late side effects of bleomycin injection into the lower lip mucosa of a nine-year-old patient with venous malformation

“…This entity mostly affects the head and neck region, including the lips, tongue, buccal mucosa, gingiva, or palate. Most VMs are venous and demonstrate slow flow 1 , 2 . VM may be present at birth but not show signs or symptoms, and a lesion may be triggered by infection, pregnancy hormones, or trauma.…”

“…VM may be present at birth but not show signs or symptoms, and a lesion may be triggered by infection, pregnancy hormones, or trauma. The presentation typically is a soft, poorly defined swelling that readily blanches with compression 1 , 3 .…”