Oral Intravascular Papillary Endothelial Hyperplasia (IPEH): Analysis by Confocal Laser Scanning Microscopy in Two Cases

Intravascular papillary endothelial hyperplasia (IPEH) was first described in 1923 as Masson’s tumour and is currently believed to be a relatively uncommon benign, non-neoplastic vascular lesion. We report two cases of IPEH occurred on the mouth floor in female patients, presenting as slightly elevated great lesions with oval form, firm consistency, and red-bluish colour. FNAB was performed and the surgical samples were fixed in formaline, stained with Haematoxylin-eosin and Picrosirius red, and analyzed at Confocal Laser Scanning Microscope (CLSM). The histological examination showed an exuberant intravascular endothelial proliferation comprising papillary formations and anastomosing cavernous-like vascular channels. CLSM highlighted a well-defined lesion consisting of cystic spaces with blood content rounded by elongated irregular papillae, and vascular connective stroma. Thus, diagnosis of IPEH was made. Achieving a correct diagnosis is essential to avoid subjecting a patient to unnecessarily aggressive therapy. We performed Diode Laser excision and patients had no evidence of recurrences.