Oral neurovascular hamartoma: a lesion searching for a name

J Oral Pathol Med. 2012 Apr;41(4):348-53. doi: 10.1111/j.1600-0714.2011.01101.x. Epub 2011 Nov 16.

Abstract

Background: Neurovascular hamartoma (NVH), in particular in the oral cavity, is rarely described in the literature. The low number of cases may reflect a genuine rarity of the lesion, or it may be due to its being unrecognized and/or under-reported.

Objectives: To investigate clinical and microscopic features of oral NVH and to define microscopic diagnostic criteria with emphasis on the differential diagnosis.

Methods: Archival cases diagnosed as oral NVH between 1999 and 2011 were retrieved; clinical and demographic data were collected, and a paired morphometric analysis was conducted, with each case of NVH a case of fibrous hyperplasia (FH) from the same oral location. The nerve bundle and blood vessel density were quantified in five microscopic fields at ×100 magnification.

Results: The study group included 25 oral NVH, 11 men and 14 women, aged 6-76 years, (mean 44). The majority occurred in the tongue (54%), followed by the buccal mucosa and lower lip (17% each), clinically presenting as asymptomatic 0.25-2.5 cm exophytic masses. Microscopic characteristics included poorly circumscribed masses of closely packed nerve bundles and blood vessels in a loose matrix, containing minimal or no inflammation. The mean nerve bundle density was significantly higher in NVH (4.28 ± 1.26) in comparison with FH (0.27 ± 0.27), (P < 0.00001), and mean vessel density was significantly lower (5.98 ± 1.4 vs. 7.8 ± 1.9, respectively), (P < 0.0003).

Conclusion: Oral NVH may not be as rare as previously considered. Morphometric analysis demonstrated that NVH presents a separate distinct entity.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Diagnosis, Differential
  • Female
  • Hamartoma / pathology*
  • Humans
  • Hyperplasia
  • Lip Diseases / pathology
  • Male
  • Microvessels / pathology
  • Middle Aged
  • Mouth Diseases / pathology*
  • Mouth Mucosa / blood supply
  • Mouth Mucosa / innervation
  • Mouth Mucosa / pathology
  • Nerve Fibers / pathology
  • Rare Diseases
  • Retrospective Studies
  • Terminology as Topic
  • Tongue Diseases / pathology
  • Young Adult