A case of cavernous hemangioma of the small intestine diagnosed by scintigraphy with Tc-99m-labeled red blood cells

Giant mesenteric hemangioma of cavernous and venous mixed type: a rare case report

Background

Although vascular tumours are one of the most common soft tissue neoplasms, those occurring in the gastrointestinal system are rare and cases involving mesentery are even further rare. Herein, we reported a rare case of giant hemangioma in mesentery of the small bowel.

Case presentation

A 5-year-old girl was admitted to the emergency room with abdominal pain and vomit for two days. Ultrasonography and computed tomography showed a giant solid-cystic abdominal mass, preferring diagnosis of teratoma. A large neoplasm in the mesentery of the small bowel was found in the surgical exploration, which was then resected with the partial bowel. A brown honeycomb mass in size 16 cm×8 cm×5 cm was observed to adhere to the small bowel, and diagnosed as hemangioma of cavernous and venous mixed type in final pathology.

Conclusion

The mesenteric hemangioma is extremely rare and the variable imaging tests are non-specific, thus the diagnosis is rarely made before surgery and usually established by histopathological investigation after surgery. So the mesenteric hemangioma is supposed to be differentiated in abdominal mass, either in adults or children. Complete surgical resection is the optimal treatment.

Mesenteric Cavernous Hemangioma Involving Small Bowel and Appendix: A Rare Presentation of a Vascular Tumor

We report on a case of cavernous hemangioma of the small bowel mesentery. Fewer than five cases of large mesenteric cavernous hemangioma have been reported in the English literature. Cavernous hemangioma of the small bowel mesentery is extremely rare. A 32-year-old black male presented with 1 week of abdominal pain, nausea, vomiting, and anorexia. He had recently undergone computed tomographic guided biopsy of a pelvic mass at another facility. Repeat CT guided biopsy was nondiagnostic, mesenteric angiography was inconclusive, and magnetic resonance imaging was performed as well. Complete workup was performed to localize primary source of abdominal mass and eventual open biopsy was planned resulting in en bloc resection of the mass, which had invaded the terminal ileum and appendix. Final pathologic diagnosis was cavernous mesenteric hemangioma. The patient experienced a prolonged postoperative ileus and was eventually discharged in stable condition, tolerating a regular diet with adequate bowel and urinary function. Diagnosis of cavernous mesenteric hemangioma is difficult and multiple imaging modalities can prove inconclusive. Adequate biopsy can be difficult to obtain even in patients with small body habitus. Standard of care is resection of entire mass en bloc.