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

Abstract

Background Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion. Methods Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases. Results Of the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty‐nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables. Conclusion Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.

Symphyseal-Sparing Mandibulectomy for Canine Acanthomatous Ameloblastoma in Dogs: 35 Cases

“…Excisional biopsy is routinely performed in humans with oral and maxillofacial lesions and has also been performed in dogs and cats. [20][21][22][23][24][25][26][27][28][29][30][31][32][33] The principal differential diagnoses for the dogs of this study with CAA included squamous cell carcinoma (SCC) and peripheral odontogenic fibroma (POF). For patients without a preoperative histopathology report and without exact knowledge of the tumor type, clients were counseled on excisional and incisional biopsy procedures.…”

Peculiar Histological Features of Oral Intravascular Papillary Endothelial Hyperplasia

“…2,3 Particularly in the oral cavity, the presence of thrombus associated with veins is considered a rare occurrence, and there are fewer than 130 cases of IPEH reported in the literature. 1 The definitive diagnosis of IPEH can be achieved through conventional histopathological analysis using hematoxylin and eosin (H&E) staining, sometimes supplemented by immunohistochemistry techniques. 3 We describe a case of oral IPEH, highlighting its peculiar morphological features observed in different histological staining, with the aim of assisting all surgical pathologists in its accurate diagnosis, particularly in routine H&E staining.…”

“…Although oral IPEH has been considered rare 1 , it is probably underreported. Over the years, the pathogenesis of oral IPEH has been strongly linked to local trauma/microtrauma, which induces injury to the vessel wall,2 however, in our patient the history of local trauma was not confirmed.…”

“…Although the use of immunohistochemical markers is not crucial for the diagnosis of oral IPEH, they are often used to rule out malignancy. 1 Oral IPEH is uncommon, but its distinct histological features, particularly in association with a thrombus, allow for diagnosis using H&E without additional histological staining techniques. Pathologists must be familiar with these microscopic features to accurately distinguish IPEH from other benign, malignant, or reactive oral vascular lesions.…”

“…Intravascular papillary endothelial hyperplasia (IPEH) is a unique form of thrombus organization characterized by the proliferation of endothelial cells in a papillary pattern within the vascular lumen. 1 The pathogenesis of IPEH and the reason for its development only in certain thrombi has not been completely established. 2,3 Particularly in the oral cavity, the presence of thrombus associated with veins is considered a rare occurrence, and there are fewer than 130 cases of IPEH reported in the literature.…”