title: Epithelioid Haemangioendothelioma of the mandibular gingiva: case report and literature review.
abstract: BACKGROUND
  Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that exhibits the potential for recurrence and metastasis but rarely involves the oral cavity.
  
  
  METHODS
  We report the management and long term follow up of recurrent EHE in a 23- year-old woman. The lesion initially presented as a small area of erythematous gingival swelling with localised bone loss around the lower anterior teeth. It was treated by buccal and lingual stripping of the gingival tissues. The patient suffered local recurrence after 7 years and was treated with a wider surgical excision of the buccal and lingual gingivae, conserving the adjacent teeth and bone with an excellent cosmetic outcome. Over 21 years later, there have been no further recurrences.
  
  
  CONCLUSIONS
  This case highlights the management challenges of EHE and is the only case in the literature to have reported a case of mandibular gingivae with a long review period of 21 years.
  
  
  CONCLUSIONS
  Oral EHE is an unpredictable lesion with a relatively benign course, unlike non-oral EHE where up to one third of cases may metastasise. Because of the propensity to recur locally after excision and curettage, a wide local excision with close clinical follow has been suggested in the literature as the treatment of choice for oral lesions. However, the lack of metastases from oral lesions, the small size, mandibular site and bland histology in this case suggests that a limited soft tissue excision and bone curettage, with long term follow-up would be appropriate for similar gingival lesions in future.
authors: Department of Oral Medicine, King's College London and Guy's & St. Thomas' NHS Foundation Trust, London, UK; Department of Special Care Dentistry, University Hospital Bristol, UK. Electronic address: Shabnum_ali@hotmail.com.
authors: Shabnum
authors: S
authors: Ali
authors: Head and Neck/Oral Pathology, King's College London, UK.
authors: E W
authors: EW
authors: Odell
authors: Department of Dental Radiology, King's College London, UK.
authors: E
authors: E
authors: Whaites
authors: Previously Consultant in Oral Surgery, Guy's and St. Thomas Hospitals NHS Trust, UK.
authors: P D
authors: PD
authors: Robinson
authors: Department of Oral Medicine, King's College London and Guy's & St. Thomas' NHS Foundation Trust, London, UK.
authors: S J
authors: SJ
authors: Challacombe
keywords: Epithelioid hemangioendothelioma; Neoplasm of the oral cavity; Vascular neoplasm