International Journal of Oral and Maxillofacial Surgery
Clinical PaperClinical PathologyIntraosseous ‘haemangioma’ of the zygoma: More appropriately termed a venous malformation
Section snippets
Case report
A 66-year-old woman presented with a gradually enlarging asymptomatic swelling of the right cheek prominence of 4 years duration. The patient was unable to recall the presence of the lesion in childhood and gave no history of previous trauma. Clinical examination revealed a 3 × 3 cm well-defined, bony hard mass involving the body of the right zygoma. A CT scan revealed a well-marginated benign appearing bony mass extending anteriorly from the body of the zygoma, demonstrating intact inner and
Histology
Routine haematoxylin and eosin sections demonstrated mature bony trabeculae separated by a network of thin-walled, dilated vascular spaces lined by flattened endothelial cells demonstrating no mitotic activity and lacking a uniform muscular layer (Figure 2). Immunohistochemistry did not reveal any uptake of GLUT-1 (Figure 3) and the smooth muscle actin stain demonstrated smooth muscles in the walls of the abnormal veins lining the vascular spaces (Figure 4). Based on the history, clinical
Discussion
Congenital vascular lesions are divided into haemangioma and vascular malformations, which exhibit unique characteristics and demand appropriately tailored treatment plans7, 12, 18. Haemangiomas often appear after birth (up to 30% are present at birth) and are characterised by a rapid proliferative stage in the very early years followed by a prolonged involutive phase until the teenage years. This involution may not be complete and the patient may be left with a fibrofatty residuum7, 19.
Competing interests
None declared
Funding
None
Ethical approval
Not required
Acknowledgements
We would like to thank Ms Becky Ward, Medical Photography Department, Poole General Hospital, for help with the illustrations.
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