Cerqueira Érica, Correia Sofia, Ramalhosa Fátima, Lopes Teresa, Mendes Abreu João
Maxillofacial Surgery, ULS Coimbra, Coimbra, PRT.
Pathology, Clinical and Academic Centre of Coimbra, Coimbra, PRT.
Cureus. 2024 Apr 11;16(4):e58035. doi: 10.7759/cureus.58035. eCollection 2024 Apr.
Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient's dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.
毛细血管内骨血管瘤是一种影响骨组织的良性血管肿瘤,然而其在颌骨中的发生在文献中鲜有报道。我们报告一例位于一名28岁男性下颌骨联合处的毛细血管内骨血管瘤病例。最初患者的牙医将其诊断为牙髓源性感染性病变,病情突然恶化,表现为下颌骨外生性病变迅速扩大和牙齿松动,这促使人们考虑各种可能的诊断。随后进行了切开活检,引发了多次反复出血,导致患者多次前往急诊科就诊,并促使患者的紧急状态升级。在组织学诊断为血管肿瘤后,患者接受了病变切除,病情进展顺利,尽管有预期的后遗症。结果,实施了一个临时修复方案,包括一个马里兰桥,目前正在进行引导骨再生和种植体支持的固定义齿修复计划。该病例强调了与这种罕见疾病相关的诊断和治疗挑战。因此,为患者实现最佳治疗效果很大程度上取决于多学科方法,强调术前全面评估、精心设计的治疗方案和快速干预的至关重要性。