Oral intravascular papillary endothelial hyperplasia (Masson's tumor): A review of literature

Intravascular papillary endothelial hyperplasia (IPEH) is an unusual reactive lesion of vascular origin which rarely occurs in the oral cavity. IPEH has a non-specific clinical presentation in the oral cavity and sites commonly involved are the lips, tongue, buccal mucosa, mandibular vestibule and gingiva. It is generally seen in the third and fourth decades of life and is more common in females. Imaging plays little role in the diagnosis of this lesion. Cytology of IPEH is unyielding and can be misdiagnosed as a malignant neoplasm. Histologically, it is characterized by an exuberant papillary endothelial cell proliferation toward the lumen of an enlarged blood vessel from the area of an organizing thrombus. The treatment is complete surgical excision with healthy margins. Prognosis is excellent. Malignant transformation and metastasis of IPEH has not been reported. The lesion may recur if it arises in a primary vascular lesion which may itself recur. The purpose of this review article is to systematically discuss the various aspects of IPEH of oral cavity reported in the English medical literature. Published articles were identified through a literature search using online databases (PUBMED, MEDLINE, SCOPUS) for papers published from the year 1976 to July 2012. Total 245 papers were extracted from the database. Cases involving the oral cavity were identified (total 117 cases) from 32 papers and selected in the present review.

► Neutral protease production from Aspergillus oryzae NRRL 2220 was carried out.
► Solid-state and submerged fermentations on tomato pomace based medium were considered.
► Experimental design allowed to select and to optimize the significant factors.
► A ratio of 8 between solid-state (21309 U/g) and submerged fermentation was found.
► Solid-state fermentation efficiency for neutral protease production was shown.