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Gingival Retiform Hemangioendothelioma A Case Report and Review of the Literature

Lauren Warner DMD candidate, Nadereh Ghanee DMD, Karen A Oyama MD, and Selene Saraf DMD candidate

Hemangioendothelioma is a vascular tumor with microscopic features intermediate between those of hemangiomas and angiosarcomas. Hemangioendothelioma is a rare tumor, it can occur anywhere in the body. Its occurrence has been reported in lower extremities, liver, lungs and head and neck region.

Here we are reporting a gingival case of Hemangioendothelioma with review of literature. In March 2022, a 12-year-old female patient was referred to Pacific Northwest Kaiser oral pathology clinic for a gingival growth on buccal of tooth #22. The patient and her mother mentioned the lesion had been present for months. Complete removal of the lesion was done and sent for pathology examination. Microscopic examination was done by Kaiser Pathologist. The case was sent to bone / soft tissue pathologist, pediatric pathologist and dermatopathologist for a consult, and the final pathology result was retiform hemangioendothelioma.

The microscopic result was retiform hemangioendothelioma with a comment indicating this tumor typically would affect the distal extremities of young individuals. The term hobnail Hemangioendothelioma is used for Retiform and Dabska type tumors which are closely related.

The biopsy site was checked in June 2022. Distal and facial gingiva of #22 was healed and was within normal limits. The interdental papilla between #22 and #23 showed edema or possible recurrent lesion. The biopsy site has been under surveillance. Recent follow up showed slight changes on the interdental papilla between #22 and #23 and a second biopsy has been recommended

Due to the nature of this lesion showing intermediate features and behaviors between a benign vascular lesion and an angiosarcoma, close observation is crucial.