Radiologically, IPEH is contrast-enhancing and homogenous on computed tomography (CT) or MRI and might contain microcalcification areas.
Histologically, bundles of papillae with single or several stalks presenting in a dilated vascular space, projecting and even occluding the lumen, are the main features of IPEH.
Clinically, Kaposi sarcoma can be detected in the oral cavity, palate, or tongue as a reddish-brown or blue, flat, vascular lesion, and it may mimic IPEH.
Hemangiomas can be differentiated from IPEH by their lack of endothelial proliferation unless they are secondarily traumatized.
In conclusion, IPEH may clinically and radiologically mimic several other lesions.
Clinically, IPEH usually manifests as a firm and sometimes tender mass that imparts a reddish-blue color to the overlying skin or mucous membrane.
Because its clinical signs and symptoms are nonspecific, IPEH, like most other vascular malformations, poses a difficult diagnostic challenge.
Previous studies have shown that some IPEH masses are homogenous on CT and MRI, whereas others are nonhomogenous as well as contrast-enhancing.
Areas of microcalcification have been noted in IPEH lesions.