Multimodal Management of a Persistent Labial Hemangioma: a Case Report

Hemangiomas are benign vascular tumors that are relatively unusual in the oral cavity. The management of labial hemangiomas may be challenging for functional and esthetic reasons. In the present case, a 12-year-old boy with a large congenital hemangioma in the area of the upper lip was referred due to esthetic concerns and a history of treatment failure. The lesion was not pulsatile on palpation, and sclerotherapy with 5% ethanolamine oleate was proposed. Although the lesion became less purple after 6 sessions of sclerotherapy, indicating a decrease in vascularization, the size remained almost the same. Therefore, surgery was considered to improve lip symmetry. Arteriography showed the lesion was supplied by branches of the facial artery, which were then embolized with 3% polidocanol foam. Subsequently, the patient underwent 2 surgical interventions with a high-power diode laser, and satisfactory results were obtained. In cases of refractory labial hemangioma, treatment may require a combination of different techniques to avoid complications such as lip disfigurement, feeding difficulties, speech impairment, and psychosocial concerns.