What are the other Names for this Condition? (Also known as/Synonyms)

• Intraoral Angioleiomyoma
• Intraoral Vascular Leiomyoma

What is Intraoral Angiomyoma? (Definition/Background Information)

• Intraoral Angiomyoma is a benign tumor that may be present in the lips, palate, or buccal mucosa (inner cheek lining), in the mouth. The tumor affects the smooth muscles and blood vessels (arteries and veins), and hence, it is called an angiomyoma
• The tumor is observed during middle-age and older age. The exact cause of formation of the tumor and its contributory risk factors are not well-established
• Most tumors are solitary in nature, small, and asymptomatic. Intraoral Angiomyoma typically presents as a mucosal mass. The involvement of the salivary glands is rarely noted
• The diagnosis of Intraoral Angiomyoma can be confirmed through a tissue biopsy. The treatment is a complete surgical removal of the tumor
• The prognosis of Intraoral Angiomyoma is generally excellent in most cases, since it is a benign tumor. The risk of tumor recurrence is uncommon, and some tumors are rarely known to become malignant

Who gets Intraoral Angiomyoma? (Age and Sex Distribution)

• Intraoral Angiomyomas are generally present in middle-aged and older individuals
• Both males and females are affected
• There is no ethnic or racial preference observed

What are the Risk Factors for Intraoral Angiomyoma? (Predisposing Factors)

• Currently, no risk factors are evident for Intraoral Angiomyoma development

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Intraoral Angiomyoma? (Etiology)

• The exact cause of Intraoral Angiomyoma formation is unknown
• Researchers believe that pericytes that line the blood vessels play a significant role in their formation

What are the Signs and Symptoms of Intraoral Angiomyoma?

The signs and symptoms of Intraoral Angiomyoma may include:

• Intraoral Angiomyoma are slow-growing, small, and solitary tumors; often, the tumor may develop over many months and years
• The lips are the most common site of these tumors (up to 1 in 4 cases)
• Other oral cavity sites include the hard and soft palate, tongue, and inner lining of the cheeks
• Very rarely, the tumor affects the major and minor salivary glands. Among the major salivary glands, the tumor is sometimes observed in the submandibular gland
• Occasionally, large tumors may cause pain and discomfort
• Sometimes, tumor ulceration may cause bleeding

Factors, such as weather (cold, wind), pressure, pregnancy, and menstruation, are known to increase the pain in angiomyoma, in general. The pain is due to the presence of nerve fibers within the tumor. Such an increase in pain for Intraoral Angiomyoma may vary from individual to individual.

How is Intraoral Angiomyoma Diagnosed?

A diagnosis of Intraoral Angiomyoma may involve the following exams and procedures:

• Evaluation of the individual’s medical history and a through physical examination
• Plain X-ray of the head and neck region
• Ultrasound scan of the affected salivary gland
• CT or CAT scan with contrast of the head and neck usually shows a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the scanned region (for larger-sized tumors)
• MRI scans of head and neck region: A magnetic field is used to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor (for larger-sized tumors)

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include: 

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy may be recommended.
• Core biopsy of the tumor
• Open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

The differential diagnosis of an Intraoral Angiomyoma may include the following related tumors:

• Leiomyoma
• Angiomyoma
• Epithelioid leiomyoma (leiomyoblastoma)
• Myxoid angiomyoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Intraoral Angiomyoma?

Complications due to Intraoral Angiomyoma may include:

• Discomfort while speaking, eating, etc.
• Surgery to remove the tumor mass may result in facial nerve palsy (surgical complication)
• Post-surgical wound infection
• Excessive bleeding from the mouth, in some cases
• Recurrence of the tumor after surgery; however, this is very rare
• Rarely, a malignant transformation of the tumor is noted

How is Intraoral Angiomyoma Treated?

• A complete surgical excision with clear margins is the preferred mode of treatment of Intraoral Angiomyoma. This can result in a cure
• Post-operative care is important: A minimum activity level is to be ensured, until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

How can Intraoral Angiomyoma be Prevented?

• Current medical research has not established a method of preventing Intraoral Angiomyoma
• Regular medical screening at periodic intervals following treatment is beneficial

What is the Prognosis of Intraoral Angiomyoma? (Outcomes/Resolutions)

• The prognosis of Intraoral Angiomyoma is generally excellent with surgical intervention and complete removal, since it is a benign tumor. The risk of tumor recurrence following surgery is minimal
• However, in rare cases, a malignant transformation of the tumor has been observed. In such cases, the prognosis of the condition is based on the stage of the tumor and overall health of the individual, among other factors

Additional and Relevant Useful Information for Intraoral Angiomyoma:

There are 3 major types of salivary glands and these include the following:

• Parotid glands, found on the sides of the face
• Submandibular glands located at the back of mouth, on both sides of the jaw
• Sublingual glands that are seen under the floor of the mouth

The salivary glands produce saliva that helps in:

• Lubricating the mouth
• Swallowing
• Protects the teeth against bacteria
• Digestion of food