hemangiomas are generally classified into capillary , cavernous , mixed and sclerosing types according to the type of blood cells they are composed .
hemangiomas are mostly seen in the head and neck region and thought to originate from endothelial progenitor cells .
oral capillary hemangiomas consist small - sized , and thin walled capillary - like vessels , which are lined with a layer of endothelial cells and usually are localized on oral soft tissues .
clinically , capillary hemangiomas are soft , small - sized , lobulated , or solitary lesions with a color range between red and blue due to the profundity of the lesion .
oral capillary hemangiomas are rarely seen in adults and mainly localized on oral mucosa or gingiva .
the intraosseous form of capillary hemangioma is an uncommon entity and reported to be seen in the metacarpal , frontal , and temporal bones . in this report ,
an unusual case of intraosseous capillary hemangioma of the mandible was presented with radiological and histological features .
a 68-year - old female patient referred to our clinic for further examination of the radiolucent cyst - like lesion on her mandible .
the clinical examination was normal , and the patient had no complaints regarding the lesion .
the lesion was located on left canine - premolar region with sclerotic curly borders that is suggestive of a benign lesion [ figure 1 ] .
the sclerotic boundaries of the lesion were prominently revealed on the axial ct section [ figure 2 ] .
panoramic radiography revealed radiolucent cyst - like lesion with irregular sclerotic borders localized at the mandibular canine - premolar region axial computed tomography section reveals irregular , nonuniform sclerotic borders of the lesion vertical and sulcular incisions were performed to expose the operation site .
a direct approach to the lesion was provided with surgical burs with copious saline irrigation .
surgical curettage was performed with unexpected moderate bleeding of the lesion [ figure 3 ] .
the surgical specimen has a solid structure with bluish - brown color [ figure 4 ] .
a provisional diagnosis of central giant cell granuloma was made due to the intraoperative unexpected bleeding .
histological examination revealed numerous small - sized vessels that are consistent with capillary vessels [ figure 5 ] .
a single layer of endothelial lining was present in the proliferating capillary vessels [ figure 6 ] .
bleeding of the lesion can be clearly seen postoperative appearance of the surgical specimen capillary hemangioma consisting of proliferated , small - sized blood vessels ( he 40 ) proliferated blood vessels lined by a single layer of bland endothelial cells ( he 100 )
intraosseous hemangiomas of the jaws are benign vasoformative neoplasms . they are asymptomatic and mostly discovered incidentally on plain radiographs .
intraosseous hemangiomas are commonly localized in calvaria and spine and affects long bones and other skeletal bones less frequently .
patients with high- pressure hemangiomas often report a sense of pulsation at the related region .
reported two cases of cellular hemangioma , which may correspond to capillary hemangioma on the mandible in their study according to a previously suggested classification system .
several cases of cavernous intraosseous hemangiomas of the jaws were reported with clinical and histopathological features .
a preoperative arteriogram is recommended for screening of the supplying vascular structures and observation of soft tissue extension .
trabecular thickening and sclerotic punctate areas which are called polka - dots can be seen on ct examinations of skeletal intraosseous hemangiomas .
plain radiography and ct findings of intraosseous mandibular hemangiomas include unilocular radiolucency with sclerotic rims , resembling a jaw cyst or sunburst or honeycomb appearance radiating from central to the periphery with or without radiopaque areas .
capillary intraosseous hemangioma in the current report showed irregular , but well - defined borders in both panoramic radiography , and ct imaging which is consistent with reports of intraosseous mandibular cavernous hemangioma in the literature .
if the lesion is asymptomatic or superficial and cause no esthetical problems , they can be left untreated . in general , surgical excision with or without preoperative embolization is suggested in the treatment of intraosseous or soft tissue hemangiomas .
preoperative embolization was not considered due to the small size and indolent radiographic appearance of the lesion .
however , capillary hemangioma of the mandible has been an uncommon and undefined entity . to our knowledge ,
radiographic findings of the lesion are similar with a cavernous form of intraosseous mandibular hemangioma .
ct imaging of intraosseous hemangiomas enables the clinician to examine the borders and content of the lesion more carefully , and helps the surgeon to decide the treatment modality that is suitable for the current case .
 intraosseous hemangioma is a benign vascular neoplasm , which is mostly seen in vertebrae , maxillofacial bones , and long bones . 
 intraosseous hemangioma is rarely seen on jaw bones compared to other skeletal bones and usually occurs in the cavernous form . 
 capillary intraosseous hemangioma of jaws is an uncommon form of intraosseous hemangioma and has not been thoroughly described so far . in this study , a case of capillary intraosseous hemangioma of the mandible was presented with relevant literature review . 
INTRODUCTION
CASE REPORT
DISCUSSION
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