Gingival lymphangioma circumscriptum in children: a misdiagnosed gingival lesion-insights from a multicenter case series.

Lymphatic malformations are uncommon congenital anomalies resulting from abnormal lymphatic development and are considered hamartomatous rather than neoplastic lesions. Within the oral cavity, gingival involvement may pose a diagnostic challenge due to its clinical resemblance to common reactive or inflammatory conditions. This study reports four new cases of gingival lymphatic malformations diagnosed across 3 oral pathology centers in Argentina and Chile. Clinically, the lesions presented as small, localized gingival enlargements with a vesicular or lobulated surface, sometimes displaying translucent, yellowish, or violaceous areas, predominantly affecting interdental papillae. In all cases, the lesions were not clinically suspected to represent lymphatic malformations and were initially considered reactive gingival conditions. Histopathological examination consistently revealed dilated lymphatic vessels predominantly located within the superficial lamina propria, lined by flattened endothelial cells and containing lymphatic fluid with occasional erythrocytes, accompanied by a mild inflammatory infiltrate-findings consistent with solitary superficial microcystic lymphatic malformations. All cases were managed by complete surgical excision, resulting in satisfactory healing and no evidence of recurrence during follow-up. These cases expand the limited literature on gingival lymphatic malformations and emphasize the importance of considering this entity in the differential diagnosis of localized gingival lesions. Accurate recognition and complete removal are essential to ensure optimal clinical outcomes.