Immunohistochemical Analysis of Oral Spindle Cell Hemangioma

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.