Oral Hemangiomas

Oral hemangiomas (OHs) are benign tumors that develop due to endothelial cell proliferation and occur in and around the oral cavity. While 60 to 70 percent of hemangiomas occur in the head and neck region, OHs are relatively rare and most frequently involve the lips, tongue, buccal mucosa, and palate. OHs have also been noted in the mandible and maxilla (central hemangiomas) and within the masseter and other muscles of mastication (intramuscular hemangiomas). The term “hemangioma” and “vascular malformation” have often been used interchangeably, creating significant confusion in both the clinical setting and in the literature. As Mulliken and Glowacki proposed in their 1982 classification system, “hemangiomas” are true neoplasms characterized by proliferation and increased rates of endothelial cell turnover, while “vascular malformations” are localized anomalies due to defects in vascular morphogenesis with normal rates of cell turnover. Clinically, hemangiomas can be classified as infantile (formerly called juvenile or strawberry) or congenital. Infantile hemangiomas (IHs) develop during the first 2 months of life and demonstrate rapid proliferation between 6 and 12 months of age, followed by a period of slow involution. Most IHs will spontaneously regress between 6 and 9 years of age. In contrast, congenital hemangiomas (CHs) are present at birth, do not exhibit a proliferative phase, and either rapidly involute or not at all. The majority of hemangiomas will completely involute, with 10%-20% persisting into adolescence or adulthood. While medical, interventional, and surgical regimens are available, there is no standardized treatment for OHs. Due to myriad potential complications, treatment of OHs is typically not pursued unless functional impairment exists.