CALIBER-PERSISTENT LABIAL ARTERY - A COMMON VASCULAR ANOMALY

Sixteen cases of caliber-persistent labial artery of the lips have bee n reported to date in the English literature. Six of these were clinic ally misdiagnosed as squamous cell carcinoma and treated with wedge re section. To date, we have seen 187 cases clinically and an additional 23 cases through our surgical oral pathology services. Careful clinica l observation usually reveals a soft linear or papular bluish elevatio n above the labial mucosal surface. The unique feature is pulsation-no t simply pulsation toward and away from the observer, which can be cau sed by an underlying artery, but lateral pulsation, which only an arte ry can exhibit. All but 2 of our 187 clinical cases were asymptomatic. To the best of our knowledge, this is the first report of caliber-per sistent labial artery of the upper lip. The upper:lower lip ratio for the clinical cases was almost 2:1. Three times as many lower lip as up per lip lesions were biopsied. Males and females were almost equally a ffected (clinical cases, 76:86; histopathologic cases, 9:13). Although a vascular term (artery, hemangioma, phlebolith, varix, vascular malf ormation) was used on the biopsy form in one half of the clinical diff erential diagnoses, none of the clinical histories mentioned pulsation . In contrast to the cases of Mike et ai. in 1980 and 1983, none of ou r cases manifested itself as an ulcer, nor was carcinoma ever mentione d in the clinical differential diagnosis. The purpose of this article is to familiarize clinicians and pathologists with the clinical and hi stopathologic features of this seldom reported but common vascular ano maly. Clinicians should carefully look for lateral pulsation in lip mu cosal papules so as to avoid unnecessary-surgery a-rid intraoperative arterial bleeding. Pathologists should recognize that a relatively lar ge-caliber superficial artery in a lip biopsy may not be an incidental finding but rather the clinical lesion that was biopsied.