Beyond the Surface, Intravascular Papillary Endothelial Hyperplasia (IPEH): A Case Report

Area of Science:

• Oral pathology
• Vascular lesions
• Oncology

Background:

• Intravascular papillary endothelial hyperplasia (IPEH) is a rare vascular tumor, accounting for 2% of all vascular neoplasms.
• It predominantly affects the head and neck region, presenting diagnostic challenges due to non-specific clinical features.

Observation:

• A 65-year-old female presented with a two-month history of a non-tender, non-pulsatile reddish swelling on the left lateral border of her tongue.
• Histopathological examination revealed anastomosing papillary endothelial cell proliferation and a fibrous pseudocapsule, consistent with IPEH.

Findings:

• IPEH often mimics benign lesions like mucocele or pyogenic granuloma, and malignant tumors such as angiosarcoma, necessitating careful differential diagnosis.
• Histological hallmarks include endothelial cell proliferation forming papillary structures within a vascular lumen and a surrounding fibrous capsule.

Implications:

• Accurate differentiation of IPEH from angiosarcoma is critical to avoid overtreatment and ensure appropriate management.
• Complete surgical excision is the recommended treatment for IPEH, offering definitive resolution and minimizing recurrence risk.
• A comprehensive approach integrating clinical evaluation, detailed patient history, and thorough histopathological analysis is essential for precise diagnosis and effective patient care.