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      Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor) of the Mouth – A Case Report

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          Abstract

          We report a rare case of intravascular papillary endothelial hyperplasia (IPEH) of the oral mucosa. This neoplasm, known as Masson's tumor, is an unusual vascular lesion of proliferating endothelial cells. It is usually confined to the lumen of preexisting vessels or vascular malformations. The principal significance of IPEH is its microscopic resemblance to angiosarcoma and possible misdiagnosis as such. Achieving a correct diagnosis is essential to avoid subjecting a patient to unnecessarily aggressive therapy. For this reason, awareness of this lesion is very important for dermatologists and dentists. In this article, we discuss the clinical features, histopathological characteristics, and management of IPEH and review the pertinent literature.

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          Most cited references11

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          Hemangioendotheliome vegetant intravasculaire

          P Masson, MP Masson, P. MASSON … (1923)
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            Intravascular angiomatosis: development and distinction from angiosarcoma.

            Alex Salyer, W Salyer (1975)
            Histologic features similar to those present in angiosarcomas were found in organizing thrombi. Within the thrombi, freely anastomosing small channels, often lined by one or more layers of prominent, occasionally atypical, endothelial cells were noted. Papillary-like projections of organizing thrombus material lined by similar cells heightened the similarity of the process to angiosarcomas. The papillary-like structures appeared to develop due to a combination of endothelialization of thrombus fragments and of ingrowth of interlacing vessels. The peculiar process of thrombus organization, which has been called "intravascular angiomatosis," may be mistaken for true angiosarcoma and thus lead to unnecessary irradiation or radical surgery. The pseudoangiosarcoma differed from angiosarcoma in its confinement entirely within large vascular lumens and in its lack of mitoses, necrosis, and true solid cellular areas devoid of vascular differentiation.
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              Recurrent intracranial Masson's vegetant intravascular hemangioendothelioma. Case report and review of the literature.

              A Avellino, Susan Wallace, Jason Grant … (1999)
              In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and middle cranial fossa MVIH. When the patient was 62 years of age, she underwent preoperative embolization and subtotal resection of the intracranial lesion followed by postoperative radiotherapy. She was well and free from disease until 9 years postoperatively when she became symptomatic. At 71 years of age, the patient again underwent preoperative embolization and near-gross-total resection of the lesion. Follow-up imaging performed 15 months later revealed tumor recurrence, and she underwent stereotactic gamma knife radiosurgery. At a 2.75-year follow-up review, the patient's imaging studies revealed stable residual tumor. This case report is unique in that it documents the clinical and pathological features, surgical and postoperative treatment, and long-term follow-up review of a patient with recurrent intracranial MVIH and suggests that this unusual vascular lesion is a slow-growing benign tumor rather than a reactive process. Because the pathological composition of the lesion may resemble an angiosarcoma, understanding this benign vascular neoplasm is crucial so that an erroneous diagnosis of malignancy is not made and unnecessary adjuvant therapy is not given.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Dermatol
                Journal ID (publisher-id): CDE
                Title: Case Reports in Dermatology
                Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
                ISSN (Electronic): 1662-6567
                Publication date Collection: Jan-Apr 2010
                Publication date (Electronic): 06 February 2010
                Publication date PMC-release: 06 February 2010
                Volume: 2
                Issue: 1
                Pages: 22-26
                Affiliations
                [1] aInstitute of Dental Research, Health Sciences University Center, Universidad de Guadalajara, México, México
                [2] bDermatological Institute of Jalisco ‘Dr. José Barba Rubio’, Universidad Autónoma Metropolitana, México, México
                [3] cUniversidad Guadalajara Lamar, Universidad Autónoma Metropolitana, México, México
                [4] dHealth Care Department, Universidad Autónoma Metropolitana, México, México
                Author notes
                * Ronell Bologna-Molina, Paseo de las Galias 169, Colonia Lomas Estrella, México, DF 09890 (México), Tel./Fax +52 55 5695 2916, E-Mail ronellbologna@ 123456hotmail.com
                Article
                Publisher ID: cde0002-0022
                DOI: 10.1159/000279656
                PMC ID: 3004207
                PubMed ID: 21173922
                SO-VID: 3d7ebddc-f382-434a-ada5-9a48d45299c7
                Copyright © Copyright © 2010 by S. Karger AG, Basel
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License ( http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.

                History
                Page count
                Figures: 2, References: 9, Pages: 5
                Categories
                Subject: Published: February 2010

                ScienceOpen disciplines: Dermatology
                Keywords: intravascular endothelial hyperplasia,oral mucosa,angiosarcoma,masson's tumor,mouth
                Data availability:
                ScienceOpen disciplines: Dermatology
                Keywords: intravascular endothelial hyperplasia, oral mucosa, angiosarcoma, masson's tumor, mouth

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