Immunohistochemical Analysis of Oral Spindle Cell Hemangioma

TL;DR

This paper presents a rare case of oral spindle cell hemangioma and shows how immunohistochemistry can help distinguish it from Kaposi sarcoma.

Contribution

The use of EGR and HHV 8 markers for diagnosing intraoral spindle cell hemangioma is reported for the first time.

Findings

SCH on the hard palate was misdiagnosed as Kaposi sarcoma without immunohistochemistry.

EGR and HHV 8 markers confirmed the diagnosis of SCH in this case.

Immunohistochemistry is highlighted as a critical tool for accurate diagnosis of SCH.

Abstract

Spindle cell hemangioma (SCH), formerly called “spindle cell hemangioendothelioma”, is a rare benign histological variant of hemangioma characterized by the presence of
two contrast zones, the first zone exhibits large dilated cavernous space with slit-like vascular spaces may show clear endothelial vacuoles resembling fat cells. SCH is
often considered as pseudosarcomatous entity; it imposes a diagnostic challenge for oral pathologists due to its resemblance with Kaposi sarcoma. A total of 13 cases of SCH have
been reported in the head and neck region to date and only 6 cases have been reported inside the oral cavity. We present a rare case of SCH located on the hard palate, which imitated Kaposi's
sarcoma on histopathological examination. The expressions of various markers including EGR, CD 31, and HHV 8 yielded the final diagnosis of SCH. The markers EGR and HHV 8 have never been used
in intraoral SCH before to the best of our knowledge; hence, the present report highlights the use of immunohistochemistry for the diagnosis of SCH.

Figures