Surgical and Laser Treatment of Hemangiomas of the Lips

Single or multiple cavernous hemangiomas involving the lips can be disfiguring and are subject to traumatic hemorrhage and ulceration. Furthermore, the cavernous hemangiomas may increase in size over time. The lip is a unique body tissue because of the vermilion color. Thus, surgical removal of lesions involving the vermilion borders present esthetic concerns.

A 51-year-old male presented with a chief complaint of a "red-blue puffy" and protruding lower lip of several years duration. Clinical examination revealed four raised soft tissue lesions ranging from 0.4 to 1 cm in diameter. Similar lesions were noted on the dorsal tongue surface. All lesions blanched on palpation but were not pulsatile. The preliminary diagnosis was cavernous hemangioma. Given the range in size, distribution, and esthetic concerns, the two largest lip lesions were surgically excised and the smallest was ablated by carbon dioxide laser irradiation. A small lesion involving both lips at the commissure was not treated because of lack of esthetic and functional concerns.

Treatment was successful in that no complications were incurred and the esthetic result was pleasing to the patient. This case demonstrates that laser ablation of a cavernous hemangioma with good hemostasis is possible and should be considered a viable treatment option.