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... 2). On microscopic examination, a loose fibrous connective tissue containing numerous thin-walled vessels lined by endothelial cells, some containing thrombi, were seen. Admixed cellular fronds of spindleshaped cells having a fairly regular oval or elongated nuclei were present along with epithelioid cells that showed cytoplasmic vacuolations ( Fig. 3A and B). Bundles of smooth muscle were noted around the blood vessels and in the spindled cell areas in a few areas. On immunohistochemistry, CD31 was strongly positive to mark vascular distribution in the lesion (Fig. 3C). The lesion was hence diagnosed as ...
Context 2
... a fairly regular oval or elongated nuclei were present along with epithelioid cells that showed cytoplasmic vacuolations ( Fig. 3A and B). Bundles of smooth muscle were noted around the blood vessels and in the spindled cell areas in a few areas. On immunohistochemistry, CD31 was strongly positive to mark vascular distribution in the lesion (Fig. 3C). The lesion was hence diagnosed as ...
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Citations
... [7,8] Immunohistochemical stains of tumor cells are positive for CD31, factor VIII, Ki-67, and vimentin with rare positive foci of D2-40, supporting a neoplasm of vascular origin. [9] The positive CD31, a stain specific for endothelial cells, confirms the presence of endothelial cells. [9,10] One study showed CD31 positivity with Ki-67 index of 20.0%, consistent with a tumor of intermediate malignant potential. ...
... [9] The positive CD31, a stain specific for endothelial cells, confirms the presence of endothelial cells. [9,10] One study showed CD31 positivity with Ki-67 index of 20.0%, consistent with a tumor of intermediate malignant potential. Hisaoka et al. in 12 cases of spindle cell hemangioma reported Ki-67 expression from 0.1% to 14.9%. ...
... Till present, only 16 cases involving the head and neck areas have been reported. Most of them presenting as submucosal nodules although, intra-muscular and intra-orbital presentations have been reported [3]. As far as the authors know, cases located in the infratemporal fossa have never been described. ...
... Commonly, the tumor is found on the cutaneous and subcutaneous tissues of the distal extremities. So far, only 16 cases have been reported in the head and neck region [3]. To the best of authors knowledge, the present case is the first to be described in the infratemporal fossa. ...
Introduction
Spindle cell hemangioma (SCH) is a rare vascular tumor which was first described in 1986. It affects mostly the distal extremities. The head and neck are rarely involved. This article reports the first case of SCH in the infratemporal fossa.
Presentation of case
A 41-year-old woman presented with an 8-month history of right cheek swelling. Facial CT scan and MRI showed an intensely and heterogeneously enhancing tumor of the infratemporal fossa suggesting an angiomatous neoplasm. The mass was excised surgically through an anterior maxillary approach. The histopathological and immunohistochemistry analysis revealed a SCH.
Conclusion
This case report presents a unique presentation of a Spindle cell hemangioma in an unexpected location of the head and neck region. it underlines the importance for clinicians and pathologists to consider the Spindle cell hemangioma as a possible etiological diagnosis of infratemporal fossa tumors.
Vascular tumors are classified into three categories by the International Society for the Study of Vascular Anomalies (ISSVA): benign, locally aggressive/borderline, and malignant. Many of these tumors are rare, cutaneous in nature, and present in childhood. The characterization and delineation of these distinct vascular tumors is an evolving area of clinical research. The diagnosis of these lesions relies on history and clinical presentation, location, histologic appearance, immunohistochemistry, and more recently, associated genetic mutations. This article provides a brief, yet comprehensive overview of all cutaneous vascular tumors currently recognized by the ISSVA, including presentation, diagnosis, and treatment.
Spindle cell haemangioma (SCH) is a slow growing, benign vascular lesion with a preference for the distal extremities. Its occurrence in the oral cavity is rare. Clinically, it presents as solitary or multiple subcutaneous nodules, therefore, it could be considered in the differential diagnosis of benign soft tissue tumours. Microscopically it mimics some malignant vascular tumours and it is necessary to differentiate it from other malignant vascular lesions. We report a case of SCH in anterior mandibular region of a young male in his 20s. Although it is a benign lesion, the reported case displayed extensive areas of muscle infiltration and necrosis. After studying the radiographic findings and considering the absence of cellular atypia, a final diagnosis of SCH was made. Literature survey suggests that this is the eleventh case of SCH reported in oral cavity.
