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Oral Hemangiomas (Diagnosis)

eMedicine.com, 2011

Considered The diagnosis of hemangiomas is straightforward from the history and the clinical examination, and the differential diagnosis is limited.
For intraosseous lesions, the differential diagnosis can be more challenging, with the radiographic appearance being similar to that of a giant cell lesion or an ameloblastoma.
Workup Laboratory Studies Usually, no laboratory studies are useful in the diagnosis or management of oral hemangiomas.
Imaging Studies Workup of oral hemangiomas requires some form of imaging to determine their extent and flow characteristics.
Angiography is considered the most definitive of the studies, although the angiographic appearance of intraosseous lesions is less well defined than that of soft tissue lesions.
Ultrasonography can be used to determine that a lesion is angiomatous in nature (ie, hemangioma, lymphangioma), but it cannot be used to differentiate a hemangioma from a lymphangioma.
Contrast-enhanced MRI can be used to differentiate a hemangioma from a lymphangioma in the oral cavity.
On plain films or panoramic radiographs, a central vascular malformation of the bone usually has a honeycombed appearance or cystic radiolucencies.
Intraosseous vascular malformations show a nonspecific reticulated or honeycombed pattern that is well demarcated from normal bone.
CT scans often show an expansile process with a high-density amorphous mass that may be suggestive of fibrous dysplasia.
Procedures Procedures other than a clinical history or examination, including aspiration of intraosseous lesions, that are used to diagnose oral hemangiomas readily produce frank blood.