Spindle Cell Hemangioma of Lower Lip: The Fourth Case Report with Review of Literature

Abstract

Background: Spindle cell hemangioma previously known as spindle cell hemangioendothelioma is a benign vascular tumour with rare presentation in head and neck. Presentation in lip is even rarer with three cases reported previously.

Method: This report describes a case of spindle cell hemangioma presented as an asymptomatic growth on lower lip of a 32-year-old male. Clinicopathological characterization of this case along with previously reported 15 cases of spindle cell hemangioma of head and neck were conducted.

Result: Microscopic evaluation shows a well-circumscribed vascular neoplasm of spindled and epithelioid endothelial cells. Large ectatic thin-walled vascular spaces were seen engorged with RBCs. The neoplasm was CD31 positive. Slight predilection for female gender and young age were observed. Minimal possibility of recurrence was also observed.

Conclusion: Spindle cell hemangioma needs to be considered in the differential diagnosis of vascular tumours of head and neck to avoid misdiagnosis of aggressive vascular neoplasms.

Keywords: Hemangioendothelioma; Microscopic evaluation; Spindle cell hemangioma; Vascular tumours.

Fig. 1

Asymptomatic lobulated growth on lower lip

Fig. 2

(Haematoxylin and eosin stain, 10X) well-circumscribed lesion showing a lobular growth pattern of numerous ectatic thin-walled vessels lined by plump spindle-shaped endothelial cells and clusters of epithelioid cells

Fig. 3

Immunohistochemical marker CD31 was positive in endothelial cells lining the miniature vessels and cavernous spaces as well as spindle cells