Gingival swelling in a 13-year-old girl with multiple recurrences.

Abstract

We present a challenging case of gingival swelling that recurred several times in 3.5 years in a 13-year-old girl. Histologic evaluation of the initial biopsy revealed groups of epithelioid cells surrounded by lymphocytes in the submucosal fibrous connective tissue, and it was diagnosed as noncaseating granulomatous inflammation. With the tissue specimens from subsequent multiple excisions and several immunohistochemical studies, the diagnoses evolved to benign cellular infiltrate of undetermined origin, epithelioid hemangioma, proliferating endothelial cell neoplasm of uncertain biologic potential, atypical vascular tumor, epithelioid hemangioendothelioma, and kaposiform hemangioendothelioma. We discuss the list of differential diagnoses from various pathologists and propose our diagnosis of epithelioid hemangioendothelioma based on its clinical behavior, histologic features, and immunohistochemical findings.

• Authors: Yi-Shing Lisa Cheng, Harvey Kessler, Terry D Rees, David Philofsky, Aristidis Pontikas
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 103 Issue 1 Pg. 85-91 (Jan 2007) ISSN: 1528-395X [Electronic] United States
• PMID: 17178499 (Publication Type: Case Reports, Journal Article)

Chemical References

• Biomarkers

Topics

• Adolescent
• Alveolar Process (chemistry, surgery)
• Angiolymphoid Hyperplasia with Eosinophilia (pathology)
• Biomarkers (analysis)
• Biopsy
• Diagnosis, Differential
• Epithelioid Cells (pathology)
• Female
• Gingiva (pathology, surgery)
• Gingival Neoplasms (pathology, surgery)
• Hemangioendothelioma, Epithelioid (pathology, surgery)
• Humans
• Neoplasm Recurrence, Local (pathology, surgery)
• Reoperation