Intraoral Verrucous Hemangioma: A Case Report

Case Report

J Dent App. 2015;2(5): 229-231.

Intraoral Verrucous Hemangioma: A Case Report

Lele GS1*, Salunkhe BB2 and Lele SM3

1Professor and Head, Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, India

2Postgraduate student, Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, India

3Professor, College of Dentistry, King Faisal University, Saudi Arabia

*Corresponding author: Lele GS, Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, Vadgaon Budruk, Pune 411041,India

Received: January 15, 2015; Accepted: March 27, 2015; Published: March 30, 2015


Verrucous hemangioma is a lesion with a very rare occurrence in the oral cavity. It is commonly found on the extremities. This case report describes a rare case of verrucous hemangioma present intraorally in a pediatric patient.

A 13 year old male patient reported with a complaint of lump in lower left back tooth region with associated difficulty in swallowing. On clinical examination, a proliferative growth, bluish black in colour was seen distal to mandibular left second permanent molar. Papules were observed on the soft palate extending into pharynx. Radiographic investigations and incisional biopsy was performed. Radiographic and histopathological evaluation followed by immunohistochemistry analysis helped to confirm the diagnosis as verrucous hemangioma.

Keywords: Verrucous hemangioma; Intraoral; Pediatric patient; Retromolar; Papules; Pharynx; Angiokeratoma


Verrucous hemangioma was first described by Halter in 1937. Loria et al defined this entity in 1958, and in 1967, Imperial and Helwig introduced the term ‘verrucous hemangioma’ and defined it as a congenital vascular malformation comprising a capillary or cavernous hemangioma in the dermis and subcutaneous tissue associated with reactive epidermal acanthosis, papillomatosis and hyperkeratosis [1]. It has been reported in literature with a variety of names such as, hemangioma unilateralis neviforme, unilateral verrucous hemangioma, angiokeratoma circumscriptum neviforme, nevus vascularis unius lateralis, keratotic hemangioma, nevus angiokeratoticus, nevus keratoangiomatosus and papulous angiokeratoma.

Case Report

A 13 year-old male patient reported to the department of Paediatric and Preventive Dentistry at Sinhgad Dental College and Hospital, Pune, with a chief complaint of a lump present in lower left back tooth region since 3 days. It caused pain during swallowing and had gradually increased to the present size. The patient was of normal built and stature, with a non-contributory family and medical history. He had no past dental history. On clinical examination, a proliferative growth was seen extending from distal aspect of 37 involving the pterygomandibular and retromolar areas, and was approximately 3 centimeters by 2 centimeters in size. The lesion appeared to be reddish pink in colour, interspersed with bluish black areas grouped together. Surface of the growth was irregular. Papules were seen on soft palate extending upto the pharynx which caused difficulty in swallowing and discomfort (Figure 1). On palpation, the lesion was soft and compressible. Left submandibular lymph nodes were palpable, nontender, enlarged, mobile, soft and not fixed to underlying structures. Intraoral radiographic investigations did not show any significant findings. The panoramic radiograph (Figure 2) showed no periapical or alveolar pathology. Incisional biopsy was carried out under local anesthesia and subjected to histopathological evaluation and immunohistochemistry. On dermatologic examination, no lesions were found anywhere on the skin.