Y.Y.Ü. Ver. Fak. Derg.
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Gingival vascular hamartoma in a calf
M. YavuzGÜLBAHAR! Lo~man ASLAN2 İsmail ALKAN2
1 Yüzüncü Yıl Üniversitesi, Veteriner Fakültesi, Patoloji Anabilim Dalı-VAN 2 Yüzüncü Yıl Üniversitesi, Veteriner Fakültesi, Cerrahi Anabilim Dalı-VAN
SUMMARY
This report deseribes gingival vascutar hanuırtonuı.
a rare vaseular
[tsı'an ina
2-monıh-oldmale
Simmenıa1cal! The pinle- red, ulcerated, couliflower-like mass measured 3x4x5
cmin incisor region of the
nuındibulargingiva composed of numerous
ıhin-walled disorganized capillaries Iined by plump endothelial ulls having roundtd or spindle-shaped nuelei. Treatment
consuled of surgical excisionfollowed
by ıhennocauıery.Key words: V
ascular hamortoma, Cingiva. Cal!
Bir butllğıda
gingivaJ vasküler
luıınartomolgusu
ÖZET
Bu çalışmada, 2 aylık erkek Simmental bir buzağının gingivasında rastlanan vasküler hamartom olgusu tanımlanmaktadır.
Buzağının alt çenesinde incisor bölgede pembe-kırmızı renkte, karnabahar bemen', 3x4x5 cm boyutunda ve yiizeyi ülserli bir kitle ile karşılaşı/dı. Ki/lenin mikroskobik incelenmesinde, yuvarlak veya !usiform nukleusu olan, şişkin endotel hücrelerinin
çevrelediği çok sayıda ince duvarlı kapillar damarlar dikkati çekti. Olgunun sağaltımı cerrahi müdahaleyi takiben koterizasyon ile yapıldı.
AlUlhlar kelimeler: Vasküler Hamarrom, Gingiva, Buzağı.
The hamartoma is a rare malformatian that presents as mass of disorganized tissue indigenous to the particular site (9). Although the cellular components of a hamartoma are normal, there is a lass of regular growth, of ten resuıtlng in a disorganized accumulation of ceııs (21). lt has been considered that the lesion is a form of congenital anomaly rather than tf!Je neoplasm (7,9,17). Hamartamas are present at birth and grow with the individua! (7). They may be composed of epithelial, rnesenchymal or a combination of both ceU types. Because vascular tissue is ubiquitous, vascular hamartornas may occur at any sites of the body (9).
Vascular hamartornas have been reported in various locations
İn cattl. (2,5,10,16,19,21), goaı (I I), dog (3,15), caı (13) and
hoıse (14).
Gingival vascular hamartamas are rare congenital anomalies that occur on the gurn of young calves (7). The present case report deseribes gingival vascular hamartoma in a calf.
CASEREPORT
A 2-rnonthoOld Simmental bull calf was admitted for pink-red, lobulared, ulcerated and caulinower-like, hemorrha- gic gingival mass to Faculty of Yeterinary Medicine, University of YUzUncU YiL. The mass measured 3x4x5 cm was located in the labial surface of left mandibular gingiva the level of the seeand incisor tooth. It was haticed a dislocation to labial directian of incisor tooth, which was
totaııy embedded into this mass (Fig.l). The calf exhibited clinical signs such as excessive salivation and strenuously nursing. According to anamnesis, the progres.sively growing
hernalThagic gingival mass measured approximately 1-2 cm in diameter had first noticed by the owner at Lo days of age.
The calf was referred to a local veterinarian at 30 days of age and the mass measured 3-4 cm in diameter was removed surgically by the veterinarian. The owner noted secondary regrowth in the same region at ıoth days postoOperation. The mass with broad margins and second incisor tooth were again
surgicaııy removed under general anesthesia with intramus-
cularly 0,2 mg/kg xylazine hydrochloride (Rompun") follo- wed by lhennocautery and fixed in ı 0% buffered formalin.
The incisor tooth removed was decaJcified in 5% nitric acid solution. After embedding in paraffin vax, 5 ~ thick sections were sıained with hemaıoxylin-eosin (HE) and Masson's trichrome.
Microseopically, the mass consisted of numerous thin- walled disorganized capillaries Iined by plump .endoıhelial ceııs having rounded or spindle-shaped nuclei. Same capilla- ries showed indistinct lumina and occasionally, seattered ceU or ceıı groııpS showing morphological characteristics similar to the endotheHal cells were present. Most well-fonned capillaries of variable diameter were empty or collapsed bul.
a smail number contained erythrocytes or a proteinic fluid.
Scant fibrous tissue among these vessels was also present (Fig. 2 and 3). In some seetions, the hyperplastic mucosal epithelium showed superficial ulceration characterized by partial lass of the epitheHum, bacrerial calames. neutrophil leucocytes. thrombosis of some large vessels and minimal hernolThage. The architecture of the second incisor tooth was nonnal in appearance.
23
Y.Y.Ü. Veı. Fak. Derg. 1999. LO( 1-2 ):]3-25
Figure ı. 111e pink-red c,uıırıoııı.:r-Iıh· nı"" 11\ 111"",1' 'C':c,pn "I ıh,_' mandibular gingiva of ı,;;ılf. Nnıl" ıhl" ıI"I"I:.,lı"n LLL 11\<"'01' ıooıh
, ,
•• >
•
Figure 2. Th<' numı.:r"ı" ı,;;ırıllan.:~ ;ı1l\\Jn~ i lll' '~·.IIlI lılır,lıl, ,ınıııı.'
HE. ~100.
. ,
hgul'<' .t ,:h:lIIlıd, IIlicu h~ pllıl!)l' \·lld"IIı~'lı.,l ,,:11, lı." in~
round or spindle nuclci. Noı<, scaller.:d rdl or rell gmups Ihat were not formed vessellumens. HE. x4{XI.
24
D1SCUSSION
There are some reporıs of bovine eongenital or juvenil vaseular 1esions in variety of tissues. inCıuding skin and tongue (8). skill (12). meninges and kidney (5). spinal eord (2). testis (19). ovarium (10). girıgiva (4. 6.16-18.20.21) and r!isseminated throughouııhe body (i). The vaseular eongeni- ıal lesion described here reneet a distinet entiıy based on its predilceıion for gingiva as well as the previously eiıed reports. The higher incidence of eongenital or vaseular lesi- ons in the gingiva of ealves other ıhan the species reınains to be unclear. Considerable eontroversy still exists about the nattıre of vaseular eongenital lesions whether it represeııts a tme neoplasm or tumor-like malformaıion or a vasopro- liferative lesion thal is secondary lo ehronie localized in- feeıion (7.9.12). Previous reports reneet irıeonsisteııeies in the nomenclalurc regarding eongenital vaseular growth in man and animals. Morphologieally. similar lesions deseribed in ealves have been described as hamartomas in same reı>ürts (16.17.21) whereas in others they have been reported as vaseular neoplasia (4.6.8.20). The fealures of ıhese vaseular lesions alsa are compatible wiıh human pyogenic granulama (lobular eapillary hemangioma) and pregnancy tumor (9).
Given ıhe age of ıhis calf and based upon the presence of disorganized capillarics thaı dcmonstrated overgrowıh so~
I1lcwhat eoordinatcd wiıh that of surrounding ıissue (7,2 I).
ıhe lesion deseribed here was alsa diagnosed as gingival vascular hamartoma. Despiıe pathogencıic inlerest. ıhese disıineıions are of little praclical imporıanee (7). Whichcver.
1he common lesions deseribed are uniformly benign and
~onıetimes may well regress or disappear sponıaneously (7,9.20). However, dislocation or loss of ıeeth (16.17) or
boııy changes (17) were reporıed in calves wiıh gingival
\ ascular hamartomas. Moreover. paral'aresis of hindlimbs due ıo thoracie vascular hamartoma in a young goaı (I ı) and paraneoplasıie hyperglyeemia associaıer! wiıh a gingival hamartoma in a kiUen (13) were rcporıed. No diseomforting eondition in the present ease. wiıh excepıian of dislocation of incisor tootlı and Cıinical signs meııtioncd. was observed. Trealment of hamartomas or similar vascular lesions consist of surgieal exeision followed by eryoıherapy or thenno- eautery (16.17. 20. 21). Because of rcgrowıh of the some gingival vaseular hamarıomas following excision. iı has beel1 advisable cryOlherapy or ıhermocalltery ıo be effecıive in prevenling reeurrerıce of lesion (16.17,21). Alıhough ıhe re- currence of lesion in the presenı ease was observed Lo days aner first surgiea] excision. regrowth lıas rıoı been observed arter second excision followed by thermocauıery.
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