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Intraosseous Haemangioma Risk — MFDS Part 1 MCQ

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HardOral PathologyIntraosseous Haemangioma RiskMFDS Part 1

A 15-year-old presents with a painless mandibular swelling, intermittent spontaneous gingival bleeding and unexplained mobility of a vital permanent molar. A panoramic radiograph shows a multilocular radiolucency with coarse internal trabeculation surrounding the tooth roots. An intraosseous haemangioma or vascular malformation is suspected. What is the most appropriate next step?

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Correct answer: D — Defer invasive treatment and arrange urgent maxillofacial assessment with vascular imaging

The correct answer is D. Spontaneous gingival bleeding, unexplained mobility of a vital tooth and a trabeculated intraosseous lesion should raise concern for a vascular lesion. Extraction or biopsy can disrupt abnormal vessels and precipitate massive, potentially fatal haemorrhage. Invasive treatment should therefore be deferred pending urgent specialist assessment, vascular imaging and planned vascular control. Incisional biopsy is unsafe before the vascular nature and flow characteristics are assessed. Routine socket haemostatic measures may be inadequate following extraction. Root canal treatment is not justified because the tooth is vital and the findings are not characteristic of apical inflammatory disease. Antibiotics do not treat a vascular lesion and would delay definitive investigation.

Reference: Debnath et al. Pediatric Intraosseous Cavernous Hemangioma of the Mandible: A Case Series Highlighting Diagnostic Challenges and Surgical Management. 2026. https://pubmed.ncbi.nlm.nih.gov/42359181/