Radiologic Features of Central Hemangioma of the Jaws

Hemangioma is a proliferation of blood vessels that creates a mass resembling a neoplasm. Although the central (intraosseous) type rarely develops in the jaws, dental practitioners should be aware of the radiologic features of this vascular bone lesion, since early diagnosis is essential for preventing uncontrollable hemorrhage during surgical intervention. Objectives: to evaluate the radiologic and clinical features of central hemangioma (CH) of the jaws. Methods: 86 cases (84 from the English-language literature and two new cases) were studied and critically evaluated with emphasis on the radiological features. Results: Age at time of initial diagnosis ranged from 0-74 years (mean 23 years, median 17 years). There was approximately equal distribution between females and males. The ratio between the mandible and maxilla was 3.3:1. Of the lesions, 69% were located in the posterior region of the jaws. Lesions were radiolucent in 96% of cases of which 67% were multilocular and 33% unilocular. The borders of lesions were diffuse in two–thirds of the cases and well defined in one-third. Tooth resorption was described in 23% of the lesions and tooth displacement in 16%, both more common in the mandible. The inferior alveolar nerve canal was involved in 15% of the mandibular lesions and the sinus in 35% of the maxillary lesions. Conclusions: CH has a marked variability in its radiologic appearance and should be considered in the differential diagnosis of any unilocular or multilocular radiolucent lesion of the jaws, especially in the mandible. Some radiographic patterns, such the spoke-like and sunray appearance, frequently described in the literature, are actually extremely rare.