Benign Oral Vascular Anomalies: Clinical Experience at a Referral Oral Medicine Service in Northeastern Brazil
Hemangiomas, Vascular Malformations, Buccal Cavity, Treatment, Sclerotherapy.
Benign buccal vascular anomalies (BBVA) comprise a heterogeneous group of lesions that include hemangiomas (HEM), vascular malformations (VM), and buccal varices (BV). The lack of a standardized protocol for the clinical management of BBVAs makes treatment challenging, increasing the use of inadequate therapeutic approaches and the risk of adverse effects. Given this, the objective of this research was to conduct a retrospective study on the therapeutic management and clinical outcomes of patients diagnosed with BBVAs at the Oral Medicine Service of the Federal University of Rio Grande do Norte. This is a retrospective, descriptive, and cross-sectional study based on the analysis of clinical records of patients diagnosed with HEM, VM, and BV treated between January 2020 and December 2025. Clinicodemographic data, clinical characteristics of the BBVAs, information regarding treatment modalities, clinical outcome data including lesion regression, recurrence, and late complications—and clinical follow-up regularity were collected. Statistical analysis was performed using Pearson’s chi-square, Fisher’s exact, and Mann-Whitney tests to identify associations between variables, considering a significance level of 5% (p < 0.05). From a total of 1,843 patients treated at the service during the study period, 78 patients were diagnosed with BBVAs. Patient age ranged from 17 to 94 years, with a predominance of females and White individuals. Most lesions were located on the lip (n=37; 48.1%) and the tongue (n=21; 27.3%), with VMs (n=33; 42.3%) and unspecified vascular lesions (n=25; 32%) being the most frequent diagnoses. Therapeutic modalities adopted included sclerotherapy, clinical monitoring (follow-up), and surgical excision, with sclerotherapy being the most frequently employed approach (n=38; 49%). The sclerosing protocol consisted of using monoethanolamine oleate (MO), administered in a single session (n=25; 78.1%) or multiple applications (n=7; 21.9%), with intervals of one to two weeks between sessions. All patients showed a clinical response to sclerotherapy, achieving complete regression in 60% (n=15) of the cases. Adverse effects were mild and transient, with edema (n=8; 47.1%) being the most frequent complication. No significant associations were identified between the clinicodemographic variables of age, sex, anatomical location, and lesion size and the therapeutic approach adopted. Lesion size and the volume of MO used did not influence the degree of regression. The high rate of loss to follow-up (n=72; 85.7%) precluded the analysis of associations between therapeutic approach and recurrence. In this context, sclerotherapy stood out as an effective alternative for the treatment of BBVAs, showing high clinical response rates and a low occurrence of complications. Furthermore, the findings suggest that therapeutic decisions should be individualized, considering aesthetic and functional impacts as well as the specific needs of each patient.