"NOT JUST A SWELLING": INTRAOSSEOUS HEMANGIOMA OF THE MANDIBLE REVEALED BY MULTIMODAL IMAGING IN TWO PEDIATRIC CASES

European Congress of DentoMaxilloFacial Radiology, Iasi, Romanya, 25 - 27 Haziran 2026, ss.157, (Özet Bildiri)

Aim: To present the multimodal imaging findings of two pediatric cases of intraosseous

mandibular hemangioma, emphasizing the complementary roles of cone-beam computed

tomography (CBCT), magnetic resonance imaging (MRI), and ultrasonography (US) in

diagnosis.

Material and Methods: Two pediatric female patients presenting with mandibular swelling

were evaluated. Multimodal imaging was performed, combining two or more of the following

modalities: CBCT, MRI, US. In both cases, US examination included both an extraoral linear

probe and an intraoral hockey stick probe in B-mode and color Doppler. Case 1: a 11-year-old

with a 2-year history of painless left mandibular swelling underwent CBCT, and US. Case 2: a

14-year-old with a 20-day history of painful pulsatile swelling with mucosal discontinuity

underwent MRI (with and without contrast) and US. Clinical and imaging findings were

correlated.

Results: In Case 1, CBCT demonstrated medullary expansion with cortical thinning from the

mandibular corpus to the ramus, initially interpreted as fibrous dysplasia. US revealed a

hypoechoic intraosseous lesion with increased vascularity adjacent to the mandibular cortex.

This vascular pattern was inconsistent with fibrous dysplasia, and strongly suggestive of an

intraosseous vascular lesion. In Case 2, MRI and US demonstrated vascular characteristics

consistent with intraosseous hemangioma despite an atypical clinical presentation with pain and

mucosal discontinuity.

Conclusion: Intraosseous mandibular hemangioma may present with varied clinical features,

including asymptomatic long-standing swellings and acute painful presentations mimicking

odontogenic infection. Multimodal imaging is essential for accurate diagnosis, particularly when

CBCT findings are inconclusive or misleading.