A case of repeated recurrence of intravascular papillary endothelial hyperplasia arising in the lower lip: Reconstruction using a local flap for a partial defect

Abstract Intravascular papillary endothelial hyperplasia is an unusual benign lesion of vascular origin. A 56-year-old man presented with a mass in the right side of the lower lip. Before visiting our hospital, he had undergone 3 surgical procedures for recurrence of the mass in a short period of time. Clinical examination revealed a painless, soft, elastic, dark purple obscure mass measuring 17 × 11 mm in the right lower lip. Ultrasonography and magnetic resonance imaging suggested a hemangioma-like lesion. The possibility of malignant transformation could not be ruled out because of the clinical course up to that point, even though it had been histopathologically diagnosed as hemangioma. The lesion was surgically resected and the defect was reconstructed using a vermilion advancement flap combined with a V-Y advancement flap. The histopathological diagnosis was intravascular papillary endothelial hyperplasia. The patient has had no symptoms or any evidence of recurrence in the 4 years since the operation. His postoperative progress has been favorable both functionally and aesthetically.