Intraosseous hemangioma of the jaws is a rare disease as compared to other skeletal and soft tissue hemangiomas. Preoperative differential diagnosis is critical in that severe bleeding can cause both intra and postoperative complications. Surgical excision of the intraosseous hemangioma can be performed with the use of steroid injection or sclerosing agent into the lesion before the surgical approach. However, even with the embolization of the blood vessels before surgical excision, there still exists a risk of massive hemorrhage during the procedure for the larger lesions. In this report, we present a case of which first tentatively diagnosed as ameloblastoma thus the use of sclerosing agents or vascular embolization was not considered before the surgery. Although there was a strong tendency to intraoperative bleeding, delicate hemostasis was achieved with surgicel(Ethicon SARL, Johnson and Johnson, Switzerland), bosmin(Jeil Pharm, Republic of Korea), and electrocautery. The final histopathological examination confirmed an intraosseous hemangioma of the mandible. The patient is undertaken for follow-up period of 1 year and the prognosis is under favorable condition.

Epithelioid hemangioma is an unusual, which was at first described as angiolymphoid hyperplasia with eosinophilia (ALHE) in 1969 and misinterpreted as the same disease with Kimura’s disease. But now it represents a distinctive vascular tumor, a different entity with those inflammatory conditions. Here, we present a case of epithelioid hemangioma appearing as a diffuse gingival nodular mass in 33‐year‐old male who had suffered from the idiopathic sharp pain of left mandible area previously and later extended to left maxillary region, therefore the gingival lesion was clinically estimated as malignancy associated with neural invasion. CT images revealed the soft tissue mass restricted to left maxillary gingiva without infiltration to underlying maxillary alveolar bone. Histologically, the circumscribed soft tissue mass consist of solid sheets of epithelioid to spindled cells, expressing reactivity for neither cytokeratin AE1/3 nor HMB‐45, but for CD31, endothelial cell marker. Therefore, the lesion was pathologically diagnosed as epithelioid hemangioma. Diagnostic evaluation for the neurologic symptoms of the patient revealed the trigeminal neuralgia, accompanying with the present epithelioid hemangioma incidentally. Awareness of epithelioid hemangioma should be emphasized not to be misdiagnosed as malignant disease like an invasive squamous cell carcinoma, malignant melanoma, or angiosarcoma. Proper evaluation and interpretation for neural symptom may lead to the correct differential diagnosis and therapeutic intervention

Hemangiomas are different from true vascular malformations in thei l‘ pathogenesis and cl inical prognosis. There are sti ll no standardized antibodies to distinguish hemangioma and vascular malformation apparently. We compared juvenile hemangioma and vascular malformation with immunohistochemjstry using va ri OllS antibodies, i.e. , ANG, bFGF, VEGF. EGFR, vWF. PCNA. p53. maspin, and TNF- . A very st rong positive expression of ANG and vWF was observed mainly in the vascular endothelial cells of juvenile hemangioma. VEGF s howed st rong positive reaction in the juveni le hemangioma, but p53 showed no positive reaction. Ancl a strong positive reaction of ANG was observed in the vascular endothelial walls of vascular malformation. p53 was frequently positive in the lining endothel ial cells in the vascular malformatJOn Using a ntiboclies such as VEG F'. ANG. vWF which a re related to the proliferation and matllrity of the vessel components. and p53 antibodies in order to confirm between juvenile hemangioma and vascular malformation would be helpful