Abstract
Neurovascular hamartoma (NVH) is a hamartomatous proliferation of neural, perineural, and vascular tissue, typically solitary, superficial, or deep. While odontomas are the most common hamartomas in the head and neck region, NVH is a rare pathology in the oral cavity. Due to its histological components and anatomical location, it presents a diagnostic and therapeutic challenge. We report a case of multiple asymptomatic soft nodules on the dorsal tongue diagnosed as multinodular NVH. Surgical excision and sclerosing therapy were performed. The aim is to present a low-frequency case and discuss current concepts for its diagnosis and treatment.
1
Introduction
Hamartomas are localized lesions characterized by the disorganized differentiation of normal histological components. Among hamartomas occurring in the maxillofacial region, odontomas are the most common. However, neurovascular hamartomas (NVH) represent a rare subtype, with only 25 reported cases worldwide. The etiology of these lesions remains uncertain, though a reactive origin has been proposed [ , ]. The standard treatment is surgical excision [ ]. This article aims to document a case of NVH in the maxillofacial region and describe a complementary therapeutic approach using corticosteroids.
2
Case report
A 22-year-old male patient presented with a history of two nodular lesions on the right dorsal tongue diagnosed 17 years prior as submucosal neuromas. These lesions were treated with surgical excision. The patient now presents with multiple nodular lesions on the right dorsal tongue, sessile-based, similar in color to the adjacent mucosa, smooth-surfaced, firm, and painless ( Fig. 1 -A ). Complete surgical excision was performed, and histopathological analysis confirmed a diagnosis of multinodular neurovascular hamartoma (MNVH) of the tongue (see Fig. 2 ). An adjuvant therapeutic protocol with corticosteroids was applied: intralesional dexamethasone (8 mg/2 ml) was administered in five doses, once weekly for five weeks. At the end of treatment, significant improvement in the healing process was observed. After one year of follow-up, the dorsal tongue appeared uniform in color and texture, with no lesion recurrence ( Fig. 1 -B). This therapeutic approach, combining surgical excision with intralesional corticosteroids, proved effective and is proposed as a viable strategy for managing this type of lesion.
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