Submandibular gland hemangioma: Clinicopathologic features and a review of the literature

October 31, 2010     Sudesh Kumar, MS, DNB, Ashok K. Gupta, MS, DLO, MNAMS, and Jayamanti Bakshi, MS, DNB, MNAMS


We conducted a retrospective study to determine the incidence and characteristics of submandibular gland hemangioma at our institution. We reviewed the records of all patients who had undergone submandibular gland excision from January 1998 through December 2006. We found a total of 230 such cases. Of these, submandibular gland hemangioma was found in 4 patients (1.7%)-3 women and 1 man, aged 20 to 47 years (mean 34.8). Their duration of symptoms had ranged from 26 to 78 months (mean: 49.3). These symptoms had included submandibular swelling, pain or discomfort, and features of sialadenitis. Computed tomographic angiography had revealed that the hemangiomas were supplied by the facial and lingual arteries. Two of the 4 patients had undergone preoperative vascular embolization, but it had failed to significantly reduce the amount of intraoperative blood loss. Final histopathologic examination had revealed that all 4 lesions were cavernous hemangiomas and that they had replaced the normal glandular structure. No recurrence was seen during a follow-up that ranged from 47 to 72 months (mean: 56.3).

Successful treatment of cutaneous hemangioma of infancy with topical imiquimod 5%: A report of 3 cases

March 1, 2010     Andrew J. Senchak, DO, Michael Dann, MD, Benjamin Cable, MD, and Glenn Bessinger, MD, PhD


Hemangioma of infancy is the most common benign tumor of childhood. Most of these tumors spontaneously regress over several years. However, many parents seek treatment for children with cutaneous hemangiomas because of the potential for disfigurement and the attendant psychosocial effects. We report our use of the nightly application of topical imiquimod 5% cream as an alternative to traditional management in 3 infants who presented with rapidly growing facial hemangiomas. After approximately 3 to 5 months of treatment, all 3 patients had experienced a near-complete resolution of their lesions without significant side effects. Based on our experience, we believe that topical imiquimod may be an important tool for the otolaryngologist who treats cutaneous hemangiomas.

Facial nerve hemangioma of the middle ear

March 1, 2009     Issam Saliba, MD and Jose N. Fayad, MD

From the Department of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center (Dr. Saliba), and the House Ear Clinic, Los Angeles (Dr. Fayad)

A hemangioma on the floor of the mouth presenting as a ranula

October 31, 2008     Charalampos E. Skoulakis, MD, Lubna Khaldi, MD, Demetre Serletis, MD, and Themistoklis Semertzidis, MD


A painless, bluish, submucosal swelling on one side of the floor of the mouth usually indicates the presence of a ranula. Rarely, such a swelling may be caused by an inflammatory disease process in a salivary gland, a neoplasm in the sublingual salivary gland, a lymphatic nodular swelling, or embryologic cysts. We report a patient with swelling in the floor of her mouth that was clinically diagnosed as a ranula. Suspicion arose during surgery that it was a vascular tumor and, on histologic testing, the swelling was confirmed to be a hemangioma. To our knowledge, this is the first report in the literature of a hemangioma presenting as ranula.

Resection of a post-traumatic hemangioma of the forehead: Benefits and pitfalls of an endoscopic resection

August 31, 2008     Laura M. Dooley, MD, Matthew P. Page, MD, and C.W. David Chang, MD

Cavernous hemangioma of the middle turbinate: A case report

June 30, 2008     Fatma Çaylakli, MD, Alper Can Çağici, MD, Cem Hürcan, MD, Nebil Bal, MD, Osman Kizilkiliç, MD, and Fikret Kiroglu, MD


Most cavernous hemangiomas present at birth or soon after. Cavernous hemangiomas of the nasal cavity, which are rare, usually do not present until adulthood; their incidence peaks in the fourth decade of life. Most affected patients experience epistaxis or hemoptysis and an enlarging lesion in the nose. Histologically, cavernous hemangiomas appear as closely packed, dilated vascular channels lined with a layer of flattened endothelial cells. We describe the case of a 32-year-old man who was admitted to our clinic with the complaint of a nasal obstruction. On anterior rhinoscopy, he was found to have a hypervascularized and hypertrophied left middle turbinate and septal deviation. Computed tomography and magnetic resonance imaging of the paranasal sinuses demonstrated a well-defined cystic lesion that had arisen within the bony left middle turbinate and caused deviation of the septum to the right. The lesion was excised via endoscopic surgery with general anesthesia. No complications occurred during the postoperative period. Histologic examination identified the tumor as a cavernous hemangioma. To the best of our knowledge, this is the first case reported in the English-language literature of a cavernous hemangioma appearing as a cystic mass in the middle turbinate.

Cavernous hemangioma of the maxillary sinus with bone erosion

August 31, 2007     Erich Mussak, BS; Jerry Lin, MD; Mukesh Prasad, MD, FACS
We report a case of cavernous hemangioma originating in the maxillary sinus. This is an unusual location for hemangioma, and this case also had a rare presentation involving bone erosion. The substantial bone destruction and resultant widening of the right ostiomeatal complex made it difficult to differentiate this cavernous hemangioma from malignant epithelial tumors.

Nasal cavernous hemangioma

May 31, 2007     Enrique Palacios, MD, FACR; Philip J. Daroca Jr., MD

Cavernous hemangioma of the frontal bone

April 30, 2007     Sofia Avitia, MD; Ryan F. Osborne, MD, FACS

Epistaxis caused by hemangioma of the inferior turbinate

September 30, 2006     Joseph P. Mirante, MD; Dewey A. Christmas, MD; Eiji Yanagisawa, MD

Infantile supraglottic hemangioma: A case report

May 31, 2006     Mehmet Ada, MD; M. Güven Güvenç, MD; Süleyman Yilmaz, MD
Hemangiomas of the airway are benign vascular lesions that can involve any site from the nares to the tracheobronchial tree. Most of these lesions are seen in the subglottic area in infants. Supraglottic infantile hemangiomas are very rare. We report a case of supraglottic hemangioma in a 2-month-old boy who had been admitted to our hospital with inspiratory stridor and dyspnea. The hemangioma involved the left arytenoid and aryepiglottic fold. A tracheostomy was performed, and the patient was followed up endoscopically every 6 months thereafter. The hemangioma disappeared when the child was 30 months old. Subsequently, a Montgomery T-tube was placed for 6 months to assist in maintaining normal breathing. The patient remains disease-free during ongoing follow-up. We also discuss the management strategies for infantile laryngeal hemangiomas.

Endoscopic resection of a venous hemangioma of the optic nerve sheath

August 31, 2005     Daniel L. Monin, BA; Kate Blumner, MPH; Noam A. Cohen, MD, PhD; John S.J. Brooks, MD; Chien Chen, MD, PhD; David W. Kennedy, MD
We describe a case of a venous hemangioma that arose in the optic nerve sheath of the orbital apex in a 28-year-old man who presented with progressive vision loss. To the best of our knowledge, this is the first reported case of a venous hemangioma occurring at this location. A definitive diagnosis and partial excision was achieved via an endoscopic transsphenoethmoid approach with interactive, computer-assisted, frameless stereotactic surgical navigation. The intervention resulted in minimal morbidity, demonstrating yet again that this surgical approach is a safe and effective way to treat lesions of the orbital apex.
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