Unusual presentation of an adult pedunculated hemangioma of the oropharynx

Transoral surgery with Thunderbeat© for hemangioma of the tongue base: A novel procedure. Case report

INTRODUCTION

Hemangiomas are the most common benign tumors of the head-neck region in children and mainly affect the face, oral mucosa, lips, and tongue. The base of tongue is an extremely rare site of involvement. The incidence is higher in women and occur more frequently in infants and childhood.

PRESENTATION OF CASE

We present a rare case of cavernous hemangioma of the base of tongue in a 70-year-old male patient surgically removed by Transoral Ultrasonic Surgery (TOUSS). 1-year follow up didn't show sign of recurrence.

DISCUSSION

Hemangiomas are benign proliferations of endothelial cells common in the head and neck. The etiology is uncertain: an imbalance in angiogenesis related to substances such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) with uncontrolled proliferation of vascular elements is proposed. It can be asymptomatic or, when affecting the tongue, lead to difficulty swallowing, pain, bleeding and dyspnea.

CONCLUSION

This case report aims to stress that hemangioma should be considered in differential diagnosis in case of richly vascularized tongue base lesion, also in adult population. It would like to highlight the role of transoral ultrasonic surgery (TOUSS), which is able to achieve the same advantages as TORS with lower costs and shorter learning curve.

Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma

OBJECTIVES/HYPOTHESIS

To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH).

STUDY DESIGN

Retrospective study.

METHODS

From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed.

RESULTS

Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort.

CONCLUSIONS

Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes.

LEVEL OF EVIDENCE

4 Laryngoscope, 2021.

A cavernous hemangioma of the tongue base presenting as an ectopic thyroid: A case report

Introduction

Hemangioma is a common benign tumor of blood vessels, that rarely develops in the oropharynx. Cavernous hemangioma is characterized by thin-walled dilated blood vessels lined with endothelial cells.

Case report

We report a case of a 46 years-old woman who was admitted to our department with a complaint of chronic dysphonia and dysphagia. Clinical examination, radiological investigations and thyroid scintigraphy found a mass of the tongue base, compatible with a lingual thyroid. Treatment consisted of surgical excision through a cervical approach. The histopathological examination found a cavernous hemangioma.

Conclusion

Though hemangioma is very rare in the base of tongue, it should be a part of the differential diagnosis while investigating a lesion in the oral cavity and the oropharynx, alongside the other possibilities.

Subcutaneous hemangioma on nasal dorsum: a case report

INTRODUCTION

Hemangioma is a benign tumor made up of blood vessels and typically occurs as a slightly elevated purplish or reddish area of skin. Hemangioma is mostly found superficially; subcutaneous hemangioma in the nasal dorsum is rare.

CASE PRESENTATION

In West Nusa Tenggara Regional Hospital, the authors found two cases of subcutaneous hemangioma in patients of very different ages. The first patient was a 2-year-old Sasak girl, and the other was a 40-year-old Sasak man. The pediatric patient was treated with an elliptical approach, whereas the adult patient was treated with lateral rhinotomy extended by an elliptical approach to remove the hemangioma and ligate the feeding arteries. After surgery, the adult patient was followed up for 5 months, whereas the pediatric patient was followed up for 3 months. The results for both patients were good, with minimal scar formation.

CONCLUSION

Despite the limitations of technology and human resources in a remote area of Indonesia, the surgical approach used in these cases produced good outcomes for both patients.