BEYOND THE ORDINARY: UNVEILING AN INTRAORAL HEMANGIOENDOTHELIOMA

Haemangioendothelioma commonly occurs in the superficial or deep soft tissue of the extremities, lungs, liver, bone and lymph nodes, with oral cavity being a rare location. It often appears as a painless, solitary mass that can be red, purple, or yellowish. It is usually benign but can show variable grades of malignancy(commonly of intermediate grade). HE is capable of local recurrence and metastasis albeit at a lower rate as compared to malignant neoplasm. Clinically, it can mimic reactive lesions such as traumatic fibroma, pyogenic granuloma, chronic periodontal disease and peripheral giant cell granuloma. We present a case of growth in left buccal mucosa clinically diagnosed as Irritational fibroma which presented a diagnostically challenging histological picture. We discuss the differential diagnoses obtained from various oral pathologists and substantiate the diagnosis of haemangioendothelioma based on its clinical behaviour, histological features and immunohistochemical findings. Markers like CD31, CD34, and FLI1 are often used to confirm the diagnosis. In addition, we attempt to highlight the diagnostic dilemma that such cases can pose to the attending pathologists.