Gingival swelling in a 13-year-old girl with multiple recurrences.
We present a challenging case of gingival swelling that recurred several times in 3.5 years in a 13-year-old girl. Histologic evaluation of the initial biopsy revealed groups of epithelioid cells surrounded by lymphocytes in the submucosal fibrous connective tissue, and it was diagnosed as noncaseating granulomatous inflammation. With the tissue specimens from subsequent multiple excisions and several immunohistochemical studies, the diagnoses evolved to benign cellular infiltrate of undetermined origin, epithelioid hemangioma, proliferating endothelial cell neoplasm of uncertain biologic potential, atypical vascular tumor, epithelioid hemangioendothelioma, and kaposiform hemangioendothelioma. We discuss the list of differential diagnoses from various pathologists and propose our diagnosis of epithelioid hemangioendothelioma based on its clinical behavior, histologic features, and immunohistochemical findings.
Cheng
Yi-Shing Lisa
YS
Diagnostic Sciences, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, TX 75246, USA. ycheng@bcd.tamhsc.edu
Kessler
Harvey
H
Rees
Terry D
TD
Philofsky
David
D
Pontikas
Aristidis
A
D000293:Adolescent; D000539:Alveolar Process / Q000737:chemistry / Q000601:surgery*; D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000473:pathology; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D005881:Gingiva / Q000473:pathology* / Q000601:surgery; D005887:Gingival Neoplasms / Q000473:pathology* / Q000601:surgery; D018323:Hemangioendothelioma, Epithelioid / Q000473:pathology* / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D012086:Reoperation
D015415:Biomarkers