1
|
Marcelin C, Dubois J, Kokta V, Giroux MF, Danino MA, Mottard S, Soulez G. Soft tissue vascular tumor-like lesions in adults: imaging and pathological analysis pitfalls per ISSVA classification. Insights Imaging 2024; 15:135. [PMID: 38853199 PMCID: PMC11162993 DOI: 10.1186/s13244-024-01712-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/01/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVES To compare the magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) findings with the pathological findings of soft tissue vascular tumors (STVTs) according to the 2018 ISSVA (International Society for the Study of Vascular Anomalies) classification to differentiate vascular tumors from vascular malformations. METHODS This retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria. RESULTS This study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531-0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = -0.0949 (-0.4661 to 0.2763)). CONCLUSION Benign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies. CRITICAL RELEVANCE STATEMENT Imaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management. KEY POINTS The imaging features of benign vascular tumors are non-specific. Histological analysis is recommended for soft tissue vascular tumors in adults. Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.
Collapse
Affiliation(s)
- C Marcelin
- Department of Adult Diagnostic and Interventional Radiology, Hôpital Pellegrin place Amélie-Raba-Léon, 33076, Bordeaux, France.
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.
| | - J Dubois
- Department of Radiology, Radiation Oncology and Nuclear Medecine, Université de Montreal, Montreal, QC, Canada
- Department of Pediatric Radiology, CHU-Sainte Justine, Montréal, QC, Canada
| | - V Kokta
- Department of Pathology, CHU-Sainte Justine, Montréal, QC, Canada
| | - M F Giroux
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
- Department of Radiology, Radiation Oncology and Nuclear Medecine, Université de Montreal, Montreal, QC, Canada
| | - M A Danino
- Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - S Mottard
- Department of Surgery, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSS) de l'est de L'ile de Montréal, Montréal, QC, Canada
| | - G Soulez
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
- Department of Radiology, Radiation Oncology and Nuclear Medecine, Université de Montreal, Montreal, QC, Canada
| |
Collapse
|
2
|
Hu WJ, Li HT, Fan ZN, Gong YB, Guo XN, Dong CX, Fan PH, Yang X, Wu G. Summary of the application value of ultrasound imaging features in the clinical differential diagnosis of intramuscular capillary-type hemangioma and fibro-adipose vascular anomaly. Front Oncol 2023; 13:1256667. [PMID: 38125939 PMCID: PMC10731448 DOI: 10.3389/fonc.2023.1256667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Objective To investigate the value of ultrasonography as a diagnostic aid in differentiating intramuscular capillary-type hemangioma (ICTH) from fibro-adipose vascular anomaly (FAVA). Methods A retrospective analysis was conducted of the clinical and ultrasound imaging data of 20 patients with ICTH and 45 patients with FAVA who were admitted to and pathologically confirmed in hospital between January 2013 and April 2023. The clinical and ultrasonographic appearances of the lesions in the two groups were compared and analyzed. A stepwise regression analysis was performed, and a joint diagnostic equation was constructed using the final variables selected. The receiver operating characteristic (ROC) curve and indicators, including sensitivity and specificity, were used to evaluate the efficacy of the joint diagnostic model. Results The two groups of patients suffering from ICTH and FAVA presented a statistically significant difference (P< 0.05) in terms of 'age', 'lesion size', 'fascial tail sign', 'presence of a fatty-tissue-like hyperecho around the lesion', 'blood flow' and 'presence of straight blood capillaries within the lesion'. Finally, the variables 'fascial tail sign' and 'presence of straight blood capillaries within the lesion' were selected to construct the model. The constructed joint diagnostic model had a sensitivity value of 70.0% (95% CI: 59.00-81.00), a specificity value of 98.0% (95% CI: 94.70-100.00) and a ROC curve value of 0.908, indicating the high efficacy of the combined diagnosis method. Conclusions Ultrasonography can be utilized to differentiate ICTH from FAVA, and the combined diagnosis method can further improve the technique's diagnostic efficacy.
Collapse
Affiliation(s)
- Wen-Jia Hu
- Department of Ultrasound, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Hai-Ting Li
- Department of Medical imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Zhi-Na Fan
- Department of Ultrasound, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Yu-Bin Gong
- Department of Hemangioma and vascular malformations, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Xiao-Nan Guo
- Department of Hemangioma and vascular malformations, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Chang-Xian Dong
- Department of Hemangioma and vascular malformations, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Pan-Hong Fan
- Department of Pathology, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| | - Xiao Yang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Gang Wu
- Department of Ultrasound, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital & Henan University People’s Hospital, Zhengzhou, China
| |
Collapse
|
3
|
Orly J, Bisdorff A, Fraissenon A, Joly A, Boulouis G, Guibaud L, Tavernier E, Mallet S, Marcelin C, Miquel J, Martin L, Droitcourt C, Gusdorf L, Abasq C, Dadban A, Chiaverini C, Vabres P, Herbreteau D, Boccara O, Wassef M, Maruani A. Intramuscular capillary-type hemangioma: Diagnosis, treatment, and outcomes. A French multicentric retrospective study of 66 cases. Eur J Radiol 2023; 165:110962. [PMID: 37423018 DOI: 10.1016/j.ejrad.2023.110962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Intramuscular capillary-type hemangiomas (ICTHs) are rare entities, belonging to the group of intramuscular "hemangiomas." The diagnosis remains challenging. We aimed to assess the diagnostic criteria, treatments and outcomes of ICTHs. METHODS This retrospective study collected all cases of ICTH followed up in 9 French hospital centers, reviewed by an adjudication expert group. RESULTS Among 133 patients screened, 66 with ICTH were included. The median age of patients at diagnosis was 28.0 years, interquartile range (21.0---36.0). The lesion, mainly presenting as a gradually increasing mass (83.9%), was painless (88.9%) and was located in the head and neck (42.4%). MRI (available in all cases) mainly revealed a well-delineated lesion, isointense to the muscle on T1-weighted images, with enhancement after contrast injection; hyperintense on T2-weighted images; and containing flow voids. Among the 66 cases, 59 exhibited typical ICTH features and 7 shared some imaging features with arteriovenous malformations. These latter were larger than typical ICTHs and more painful and appeared on imaging as less well delimited and more heterogeneous tissue masses, with larger tortuous afferent arteries, earlier draining vein opacification and mild arteriovenous shunting. We propose to name these lesions arteriovenous malformation (AVM)-like ICTH. Pathological reports were similar in typical and AVM-like ICTH, showing capillary proliferation with mainly small-size vessels, negative for GLUT-1 and positive for ERG, AML, CD31 and CD34, with low Ki67 proliferation index (<10%), and adipose tissue. The most frequent treatment for ICTH was complete surgical resection (17/47, 36.2%), preceded in some cases by embolization, which led to complete remission. CONCLUSIONS ICTH can be diagnosed on MRI when it is typical. Biopsy or angiography are required for atypical forms.
Collapse
Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | - Annouk Bisdorff
- Reference Center for Vascular Anomalies FAVA-multi, University Hospital of Lariboisière, Coordinator of the Constitutive Center for Superficial Arteriovenous Malformations in Children and Adults, AP-HP, Department of Neuroradiology, Paris, France
| | - Antoine Fraissenon
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France; Service de Radiologie Mère-Enfant, Hôpital Nord, Saint-Etienne, France; CREATIS, UMR 5220, U1294 Lyon, France
| | - Aline Joly
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Maxillo-facial Surgery, Tours, France
| | - Grégoire Boulouis
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Laurent Guibaud
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | - Stéphanie Mallet
- University Hospital Center of Marseille, Department of Dermatology, Marseille, France
| | - Clément Marcelin
- University Hospital Center of Bordeaux, Department of Radiology, Bordeaux, France
| | - Juliette Miquel
- University Hospital Center of La Réunion, Department of Pediatric Dermatology, Saint-Pierre, La Réunion, France
| | - Ludovic Martin
- University Hospital Center of Angers, Department of Dermatology, Angers, France
| | | | - Laurence Gusdorf
- University Hospital Center of Reims, Department of Dermatology, Reims, France
| | - Claire Abasq
- University Hospital Center of Brest, Department of Dermatology, Brest, France
| | - Ali Dadban
- University Hospital Center of Amiens, Department of Dermatology, Amiens, France
| | | | - Pierre Vabres
- University of Bourgogne, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Dijon, France
| | - Denis Herbreteau
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- University Hospital of Lariboisière, AP-HP, Department of Pathology, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France.
| |
Collapse
|
4
|
Cardoen L, Nicolas N, Le Gaudu V, Gauthier A, Carton M, Berrebi D, Cyrta J, Collignon C, Cordero C, Pierron G, Pannier S, Philippe-Chomette P, Orbach D, Brisse HJ. Fat-Containing Soft Tissue Tumors in Children, Adolescents, and Young Adults: Which Require Biopsy? Cancers (Basel) 2023; 15:3228. [PMID: 37370837 DOI: 10.3390/cancers15123228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE To confirm the overall benignity of fat-containing soft tissue tumors (STT) on a pediatric cohort and to define the clinical and imaging features that warrant a biopsy. METHODS A retrospective monocentric study was conducted on patients aged less than 25 years consecutively referred for fat-containing STT to our Comprehensive Cancer Center between 1998 and 2022. Tumor imaging characteristics at diagnosis (US, CT, or MRI) were correlated with pathology. RESULTS The database extraction identified 63 fat-containing tumors with clinical, histologic, and imaging data available for review. In total, 58 (92%) were benign tumors: 36 lipoblastomas and lipomas, 12 fibrous hamartomas of infancy (FHI), 5 lipofibromatosis, 2 lipomas arborescens, 2 lipomatosis and 1 spindle-cell lipoma. Five patients (8%) were diagnosed with liposarcoma. Factors significantly correlated with malignancy were age >10 years old (p < 0.001), having a cancer-predisposing condition (p < 0.001), a percentage of fat <25% (p = 0.002), and a presence of myxoid zones (p < 0.001) on imaging. CONCLUSION Most fat-containing STT in children may be classified as benign tumors based on clinics and imaging. The indication for biopsy could be limited to patients aged 10 years or more with either a cancer-predisposing condition or imaging features demonstrating either a low-fat component (<25%) or the presence of myxoid zones.
Collapse
Affiliation(s)
| | - Nayla Nicolas
- Department of Imaging, Institut Curie, 75005 Paris, France
| | | | - Arnaud Gauthier
- Department of Pathology, Institut Curie, 75005 Paris, France
| | - Matthieu Carton
- Department of Biostatistics, Institut Curie, 75005 Paris, France
| | - Dominique Berrebi
- Department of Pathology, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Joanna Cyrta
- Department of Pathology, Institut Curie, 75005 Paris, France
| | - Charlotte Collignon
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Camille Cordero
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Gaëlle Pierron
- Department of Somatic Genetics, Institut Curie, 75005 Paris, France
| | - Stéphanie Pannier
- Paediatric Orthopaedic Service, Assistance Publique des Hôpitaux de Paris, Université Paris Cité, Hôpital Necker, 75015 Paris, France
| | - Pascale Philippe-Chomette
- Department of Pediatric Surgery, Assistance Publique des Hôpitaux de Paris, Hôpital Robert Debré, 75019 Paris, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Hervé J Brisse
- Department of Imaging, Institut Curie, 75005 Paris, France
| |
Collapse
|
5
|
Orly J, Bisdorff A, Joly A, Edee AE, Tavernier E, Herbreteau D, Boccara O, Wassef M, Maruani A. Characteristics, Natural Course and Treatment of Intramuscular Capillary-type Haemangioma: A Systematic Literature Review. Acta Derm Venereol 2023; 103:adv00893. [PMID: 36939537 PMCID: PMC10041649 DOI: 10.2340/actadv.v103.4432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/29/2022] [Indexed: 03/21/2023] Open
Abstract
Intramuscular capillary-type haemangiomas (ICTH) are rare vascular anomalies that can easily be misdiagnosed as other entities. A systematic review was performed of all cases of ICTH in the literature since its first description in 1972. An adjudication committee reviewed cases to include only ICTHs. Among 1,143 reports screened, 43 were included, involving 75 patients. The most frequent differential diagnosis was intramuscular venous malformations. The mean age of patients at diagnosis was 21.2 years. ICTH was mainly described as a gradually increasing mass (81.8%), painless (73.9%), that could occur anywhere in the body but most frequently on the head and neck (44.0%). Magnetic resonance imaging (MRI) was mainly used for diagnosis (69.1%) and displayed specific features. The most frequent treatment was complete surgical removal (73.9%), which could be preceded by embolization, and led to complete remission without recurrence in all but 1 case.
Collapse
Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours.
| | - Annouk Bisdorff
- 3Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France
| | - Aline Joly
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France; CHRU Tours, Department of Maxillo-facial surgery, Tours, France
| | - Afi-Emiliène Edee
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | | | - Olivia Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- Department of Pathology, University Hospital of Lariboisière, AP-HP, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
| |
Collapse
|
6
|
Das A, Goyal A, Sangwan A, Kumar A, Bhalla AS, Kandasamy D, Chauhan S. Vascular anomalies: diagnostic features and step-wise approach. Acta Radiol 2023; 64:850-867. [PMID: 35300505 DOI: 10.1177/02841851221085379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The first part of this review article emphasized correct nomenclature, classification systems, and imaging algorithm of vascular anomalies. The second part of the review discusses the individual entities, highlighting the characteristic clinico-radiological features of the commonly encountered ones. A step-wise algorithmic approach is also proposed for the evaluation of a suspected case of vascular anomaly.
Collapse
Affiliation(s)
- Abanti Das
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Ankur Goyal
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Ankit Sangwan
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Devasenathipathy Kandasamy
- Department of Radiodiagnosis and Interventional Radiology, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Shashank Chauhan
- Department of Plastic Reconstructive Surgery, 28730All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
7
|
The Challenges of Upper Extremity Intramuscular Hemangioma: a Case Study and Systematic Review. Plast Reconstr Surg 2022; 150:367-376. [PMID: 35671450 DOI: 10.1097/prs.0000000000009324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intramuscular hemangiomas (IMHs) are rare, benign vascular tumors, comprising 0.8% of all hemangiomas. Upper extremity (UE) IMHs pose diagnostic and therapeutic challenges given their rarity, invasive nature, and potential for neurovascular involvement. We report a comprehensive systematic review of UE IMH management and a challenging case report. METHODS A systematic review was performed using PRISMA guidelines. Electronic databases were used to identify papers describing UE IMHs through 2019. Patient demographics, clinical presentation, management, complications, and outcomes were reviewed. Based on operative timing, cases were categorized as either "primary" (excision performed at initial diagnosis) or "secondary" (excision performed after failure of conservative treatment). RESULTS Eighteen articles encompassing 25 patients were included in our systematic review. Of those, 18 underwent primary excision and 7 underwent secondary excision. The majority involved the forearm or antecubital region. Complete excision, evaluated by gross examination or pathology, was reported in all primary cases and 71% secondary cases. Primary excisions demonstrated smaller mass size (19.4cm2 versus 165.3cm2) and superior reported functional outcomes (100% versus 33%). Complications were reported in 5% of the primary excisions compared to 71% of the secondary excisions, where 1 complication was a fatal hematoma. CONCLUSION The literature concerning UE IMH is limited to mostly case reports and several case series with the potential risk of bias. With careful dissection and microsurgical technique, wide local excision followed by complete reconstruction can be successfully performed at initial diagnosis for UE IMHs. At early stages, smaller lesion size significantly reduces the risk of functional impairment and complications.
Collapse
|
8
|
Pirri C, Pirri N, De Caro R, Stecco C, Özçakar L. Ultrasound imaging as an initial diagnostic method for intramuscular hemangiomas: a narrative review. Postgrad Med 2022; 134:180-186. [PMID: 35076337 DOI: 10.1080/00325481.2022.2033562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Intramuscular hemangiomas are benign vascular lesions, often misdiagnosed due to unfamiliarity. They are rare (but not very rare) causes of musculoskeletal pain and diagnosing these tumors may be challenging because of their pertinent non-specific symptomatology. Herein, as a convenient imaging tool, ultrasound examination appears to an important initial method to scan for these lesions after the clinical examination. To date, there are no studies that examined the state-of-the-art as regards the use of ultrasound imaging in the diagnosis of intramuscular hemangiomas. Accordingly, a literature search was performed using PubMed and Web of Science with the purpose to provide a conceptual understanding and awareness as regards the importance/utility of ultrasound imaging as a first step diagnostic tool for intramuscular hemangiomas at different muscles' locations.
Collapse
Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Italy
| | - Nina Pirri
- Department of Medicine-DIMED, School of Radiology, Radiology Institute, University of Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Italy
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| |
Collapse
|
9
|
Makkad RS, Agarwal G, Gupta S, Nagi R, Ragit A, Jamal F. Intramuscular Hemangioma of Masseter Muscle: Case Report of Rare Clinical Entity. Ann Maxillofac Surg 2021; 11:148-151. [PMID: 34522672 PMCID: PMC8407625 DOI: 10.4103/ams.ams_100_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/19/2021] [Accepted: 02/03/2021] [Indexed: 12/03/2022] Open
Abstract
Rationale: Intramuscular hemangiomas are unique benign vascular tumours of skeletal muscles; involving masseter and trapezius muscles in the majority of cases. The rationale was to emphasize that the diagnosis of asymptomatic swelling in the masseteric region is important as due to their deep anatomic location and unfamiliar presentation, they are often misdiagnosed as a parotid swelling or other muscular pathologies. Patient Concern: This report describes a rare case of a 25-year-old healthy male patient who presented with an asymptomatic swelling in the right masseteric region. The patient had cosmetic concerns due to the large size. Diagnosis: Colour Doppler ultrasonography was done to assess the vascularity within the lesion. Treatment: Complete excision was successfully achieved using combined Risdon's and preauricular approach. Outcome: No signs of recurrence were observed after 6 months Take-away Lessons: Appropriate selection of diagnostic modalities enables the clinician in making an accurate preoperative diagnosis of progressive swelling in the masseteric region.
Collapse
Affiliation(s)
- Ramanpal Singh Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Gunjan Agarwal
- Department of Surgical Oncology, JNM Medical College, Raipur, Chhattisgarh, India
| | - Santosh Gupta
- Department of Pathology, Suyash Hospital, Raipur, Chhattisgarh, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Akshay Ragit
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Farhin Jamal
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| |
Collapse
|
10
|
Abstract
Vascular anomalies are composed of tumors and malformations and with overlapping histologies, thus are often misdiagnosed or labeled with imprecise terminology. Lesions are common and usually diagnosed during infancy or childhood; the estimated prevalence is 4.5%. Vascular tumors rapidly enlarge postnatally and demonstrate endothelial proliferation. Malformations are errors in vascular development with stable endothelial turnover; they are typically named based on the primary vessel that is malformed (capillary, arterial, venous, lymphatic). This article reviews the pathologic and molecular genetic characteristics for select recently described vascular anomalies.
Collapse
Affiliation(s)
- Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital, 300 Longwood Avenue, BCH 3027, Boston, MA 02115, USA.
| |
Collapse
|
11
|
Pattamapaspong N, Peh WC, Shek TW. Imaging of intramuscular haemangiomas of the extremities. Singapore Med J 2021; 61:122-128. [PMID: 32488279 DOI: 10.11622/smedj.2020030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intramuscular haemangiomas are benign soft tissue tumours that are more frequently seen in children and young adults. As they may be difficult to diagnose clinically, imaging has an important role in the detection, diagnosis and preoperative planning of these lesions. Haemangiomas of the extremities may be classified into capillary, cavernous, venous and mixed types, with or without an arteriovenous shunt, depending on the predominant vascular channels. Nonvascular components such as fat, smooth muscle, fibrous tissue and thrombus may also be present. This pictorial essay highlights the imaging features of intramuscular haemangiomas, with an emphasis on magnetic resonance imaging.
Collapse
Affiliation(s)
| | - Wilfred Cg Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore
| | - Tony Wh Shek
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR
| |
Collapse
|
12
|
Zhang M, Lin H, Qin LL. Sonography of pediatric gastrointestinal venous malformations. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:269-273. [PMID: 32954508 DOI: 10.1002/jcu.22924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Gastrointestinal (GI) venous malformations are extremely rare. Such malformations present in the pediatric age group and can occur anywhere in the digestive tract (esophagus, stomach, small or large intestine, anus, and mesentery). We present the sonographic findings of three cases of pediatric GI venous malformation. Sonography is an important diagnostic method in pediatric GI venous malformations.
Collapse
Affiliation(s)
- Min Zhang
- Department of Ultrasound, Hainan General Hospital, Haikou, China
| | - Hai Lin
- Department of Pediatric Surgery, Hainan General Hospital, Haikou, China
| | - Ling-Ling Qin
- Department of Ultrasound, Hainan General Hospital, Haikou, China
| |
Collapse
|
13
|
Wassef M, Borsik M, Cerceau P, Faucon B, Laurian C, Le Clerc N, Lemarchand-Venencie F, Massoni C, Salvan D, Bisdorff-Bresson A. [Classification of vascular tumours and vascular malformations. Contribution of the ISSVA 2014/2018 classification]. Ann Pathol 2020; 41:58-70. [PMID: 33309330 DOI: 10.1016/j.annpat.2020.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022]
Abstract
The study of vascular anomalies, "angiomas", vascular tumours and vascular malformations is made difficult by the great variety and confusion of the names used in the literature for these diseases, some of which are rare. The great merit of the classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA), adopted in 2014 and modified in 2018, is to propose a unambiguous nomenclature and to try to group these lesions in a logical way, contrasting with the lists of the usual "classifications". This classification is based on the distinction between proliferative lesions (tumours and reactive lesions) and those which are due to a congenital anomaly of vascular morphogenesis (vascular malformations). It incorporates recent data on the molecular causes of these diseases. The major groups of lesions recognised in this classification will be presented and some lesions of interest briefly discussed. This classification aims to be usable by all medical specialties and applicable to all tissues and organs, even if efforts are still needed to integrate organ-specific names in order to unify the nomenclature and eliminate confusion. Even if it does not solve all the problems in this complex field, the unification of the nomenclature is a major contribution of this classification and pathologists are strongly encouraged to refer to it in daily practice.
Collapse
Affiliation(s)
- Michel Wassef
- Service d'anatomie et cytologie pathologiques, hôpital Lariboisière, APHP ; UFR de médecine Paris nord, université de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex, France; Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France.
| | - Michel Borsik
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Maison médicale, 9, rue Jean-Jacques-Bernard, 60200 Compiègne, France
| | - Pierre Cerceau
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service de chirurgie vasculaire et thoracique, hôpital Bichat, APHP, 46, rue Henri-Huchard, 75018 Paris, France
| | - Benoit Faucon
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, Centre hospitalier de Pontoise, 6, avenue de l'Île-de-France, 95300 Pontoise, France
| | - Claude Laurian
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service de chirurgie vasculaire, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Nicolas Le Clerc
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
| | - Françoise Lemarchand-Venencie
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
| | - Claudine Massoni
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Cabinet médical, 7, rue Chalgrin, 75116 Paris, France
| | - Didier Salvan
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, centre hospitalier Sud Francilien, 40, avenue Serge-Dassault, 91100 Corbeil Essonnes, France
| | - Annouk Bisdorff-Bresson
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
| |
Collapse
|
14
|
Russo D, Fraitag S, Bruneau B, Stock N, Aillet S, Dupuy A, Droitcourt C. Non-congenital dorsal tumefaction with rapid growth in a young child identified as an intramuscular hemangioma. JAAD Case Rep 2020; 6:616-618. [PMID: 32613053 PMCID: PMC7317675 DOI: 10.1016/j.jdcr.2020.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- David Russo
- University of Rennes, Rennes, France.,CHU Rennes, Department of Dermatology, Rennes, France
| | - Sylvie Fraitag
- AP-HP, Hôpital Necker-Enfants Malades, Department of Pathology, APHP, Paris, France
| | | | | | - Sylvie Aillet
- Department of Pediatric Surgery, CHU Rennes, Rennes, France
| | - Alain Dupuy
- University of Rennes, Rennes, France.,CHU Rennes, Department of Dermatology, Rennes, France.,REPERES Pharmaco-Epidemiology and Health Services Research, University Rennes 1 and French School of Public Health, Rennes, France
| | - Catherine Droitcourt
- University of Rennes, Rennes, France.,CHU Rennes, Department of Dermatology, Rennes, France.,REPERES Pharmaco-Epidemiology and Health Services Research, University Rennes 1 and French School of Public Health, Rennes, France.,INSERM, CIC, Rennes, France
| |
Collapse
|
15
|
Restrepo R, Pevsner R, Pelaez L, Plut D, Lee EY. Three Distinct Vascular Anomalies Involving Skeletal Muscle: Simplifying the Approach for the General Radiologist. Radiol Clin North Am 2020; 58:603-618. [PMID: 32276706 DOI: 10.1016/j.rcl.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Venous malformations and hemangiomas of the skeletal muscle are separate entities with different clinical presentation, histology, and imaging findings. Recent advances in the field of vascular anomalies and current efforts in the unification of terminology by the International Society for the Study of Vascular Anomalies are pivotal in understanding and differentiating intramuscular venous malformations and intramuscular capillary-type hemangioma. Fibroadipose vascular anomaly is another recently defined vascular anomaly affecting the skeletal muscle, with a distinct clinical presentation, histology, and imaging appearance. These 3 distinct vascular anomalies are reviewed and their histologic features, clinical presentation, imaging appearance, and treatment are discussed.
Collapse
Affiliation(s)
- Ricardo Restrepo
- Department of Pediatric Radiology, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA
| | - Rachel Pevsner
- Department of Pediatric Radiology, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA
| | - Liset Pelaez
- Department of Pathology, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA
| | - Domen Plut
- Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Centre, Ljubljana, Zaloska cesta 7, Ljubljana 1000, Slovenia
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| |
Collapse
|
16
|
Intramuscular fast-flow vascular anomaly contains somatic MAP2K1 and KRAS mutations. Angiogenesis 2019; 22:547-552. [PMID: 31486960 DOI: 10.1007/s10456-019-09678-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The term "intramuscular hemangioma capillary type" (IHCT) refers to a fast-flow vascular lesion that is classified as a tumor, although its phenotype overlaps with arteriovenous malformation (AVM). The purpose of this study was to identify somatic mutations in IHCT. METHODS Affected tissue specimens were obtained during a clinically indicated procedure. The diagnosis of IHCT was based on history, physical examination, imaging and histopathology. Because somatic mutations in cancer-associated genes can cause vascular malformations, we sequenced exons from 446 cancer-related genes in DNA from 7 IHCT specimens. We then performed mutation-specific droplet digital PCR (ddPCR) to independently test for the presence of a somatic mutation found by sequencing and to screen one additional IHCT sample. RESULTS We detected somatic mutations in 6 of 8 IHCT specimens. Four specimens had a mutation in MAP2K1 (p.Q58_E62del, p.P105_I107delinsL, p.Q56P) and 2 specimens had mutations in KRAS (p.K5E and p.G12D, p.G12D and p.Q22R). Mutant allele frequencies detected by sequencing and confirmed by ddPCR ranged from 2 to 15%. CONCLUSIONS IHCT lesions are phenotypically similar to AVMs and contain the same somatic MAP2K1 or KRAS mutations, suggesting that IHCT is on the AVM spectrum. We propose calling this lesion "intramuscular fast-flow vascular anomaly."
Collapse
|
17
|
Johnson CM, Navarro OM. Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol 2017; 47:1184-1195. [PMID: 28779195 DOI: 10.1007/s00247-017-3885-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/19/2017] [Accepted: 04/28/2017] [Indexed: 01/21/2023]
Abstract
Sonography can be used in the management of pediatric soft-tissue vascular anomalies for diagnosing, for assessing lesion extent and for evaluating complications and response to therapy. The sonographic technique includes a combination of gray-scale imaging with color and spectral Doppler techniques. However the interpretation of the sonographic findings requires correlation with the clinical findings, some of which can be easily obtained at the time of scanning. This has to be combined with the use of appropriate nomenclature and the most updated classification in order to categorize these children into the appropriate management pathway. In this article, which is part 1 of a two-part series, the authors review the current classification of vascular anomalies, provide a clinical and a sonographic approach to these lesions, and review the most relevant clinical and sonographic features of vascular tumors including infantile and congenital hemangiomas, tufted angioma, kaposiform hemangioendothelioma, pyogenic granuloma, intramuscular capillary-type hemangioma and angiosarcoma.
Collapse
Affiliation(s)
- Craig M Johnson
- Division of Interventional Radiology, Department of Radiology, Nemours Children's Hospital, Orlando, FL, USA
| | - Oscar M Navarro
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada. .,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
18
|
Kim IK, Seo JH, Cho HY, Lee DH, Jang JM, Kim JM, Park IS. Intramuscular hemangiomas on the masseter muscle and orbicularis oris muscle: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2017; 43:125-133. [PMID: 28462198 PMCID: PMC5410425 DOI: 10.5125/jkaoms.2017.43.2.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/03/2016] [Accepted: 09/21/2016] [Indexed: 12/18/2022] Open
Abstract
Intramuscular hemangioma (IMH) is a rare vascular disease involving skeletal muscle, comprising only 0.8% of hemangiomas. About 10% to 15% of IMHs occur in the head and neck region, mostly involving the masseter muscle. IMH occurs mostly in childhood, but is often not found until unexpected enlargement, pain, or cosmetic asymmetry occurs in adulthood. Several non-surgical treatments including cryotherapy, sclerosant injection, and arterial ligature have been described, but complete surgical resection is the curative intervention. In this report, we present two rare cases of IMH. One IMH case in a 48-year-old male occurred in the masseter muscle feeding from the transverse facial artery. Embolization of the distal branch of the facial artery was first conducted, and then the buccal mass was removed surgically via the intraoral approach. A second IMH case in a 58-year-old female occurred in the orbicularis oris muscle feeding from the superior labial artery, and the mass was excised surgically without embolization.
Collapse
Affiliation(s)
- Il-Kyu Kim
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Ji-Hoon Seo
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Hyun-Young Cho
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Dong-Hwan Lee
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Jun-Min Jang
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Joon Mee Kim
- Department of Pathology, Inha University School of Medicine, Incheon, Korea
| | - In Suh Park
- Department of Pathology, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
19
|
Sheybani EF, Eutsler EP, Navarro OM. Fat-containing soft-tissue masses in children. Pediatr Radiol 2016; 46:1760-1773. [PMID: 27866258 DOI: 10.1007/s00247-016-3690-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/28/2016] [Accepted: 08/12/2016] [Indexed: 12/27/2022]
Abstract
The diagnosis of soft-tissue masses in children can be difficult because of the frequently nonspecific clinical and imaging characteristics of these lesions. However key findings on imaging can aid in diagnosis. The identification of macroscopic fat within a soft-tissue mass narrows the differential diagnosis considerably and suggests a high likelihood of a benign etiology in children. Fat can be difficult to detect with sonography because of the variable appearance of fat using this modality. Fat is easier to recognize using MRI, particularly with the aid of fat-suppression techniques. Although a large portion of fat-containing masses in children are adipocytic tumors, a variety of other tumors and mass-like conditions that contain fat should be considered by the radiologist confronted with a fat-containing mass in a child. In this article we review the sonographic and MRI findings in the most relevant fat-containing soft-tissue masses in the pediatric age group, including adipocytic tumors (lipoma, angiolipoma, lipomatosis, lipoblastoma, lipomatosis of nerve, and liposarcoma); fibroblastic/myofibroblastic tumors (fibrous hamartoma of infancy and lipofibromatosis); vascular anomalies (involuting hemangioma, intramuscular capillary hemangioma, phosphate and tensin homologue (PTEN) hamartoma of soft tissue, fibro-adipose vascular anomaly), and other miscellaneous entities, such as fat necrosis and epigastric hernia.
Collapse
Affiliation(s)
- Elizabeth F Sheybani
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Eric P Eutsler
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Oscar M Navarro
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. .,Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
| |
Collapse
|
20
|
Fernandez-Pineda I, Jenkins JJ, Santiago TC, Prajapati HJ, Pappo AS. Awareness of intramuscular capillary type hemangioma in the differential diagnosis of soft-tissue tumors in children. Pediatr Blood Cancer 2016; 63:2252-2253. [PMID: 27392296 DOI: 10.1002/pbc.26133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
| | - J J Jenkins
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - T C Santiago
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - H J Prajapati
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - A S Pappo
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
21
|
Rizer M, Singer AD, Edgar M, Jose J, Subhawong TK. The histological variants of liposarcoma: predictive MRI findings with prognostic implications, management, follow-up, and differential diagnosis. Skeletal Radiol 2016; 45:1193-204. [PMID: 27209201 DOI: 10.1007/s00256-016-2409-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 02/07/2023]
Abstract
Liposarcoma is the single most common soft tissue sarcoma accounting for up to 35 % of sarcomas. It represents a histologically diverse group of soft tissue tumors that demonstrate a wide range of imaging appearances with varied behavior patterns. Correspondingly, more aggressive histological subtypes often require management that includes a combination of surgery, chemotherapy, and radiation therapy. Distinguishing among liposarcoma subtypes has important therapeutic and prognostic implications. In this manuscript, we review the liposarcoma subtypes and their histologic and MRI findings, prognostic implications, and differential diagnostic considerations.
Collapse
Affiliation(s)
- Magda Rizer
- Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
| | - Adam D Singer
- Department of Radiology and Imaging Sciences, Section of Musculoskeletal Imaging, Emory Healthcare, Atlanta, GA, USA
| | - Mark Edgar
- Bone and Soft Tissue Pathology, Department of Pathology, Emory Healthcare, Atlanta, GA, USA
| | - Jean Jose
- Section of Musculoskeletal Imaging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ty K Subhawong
- Section of Musculoskeletal Imaging, Miller School of Medicine, University of Miami, Miami, FL, USA
| |
Collapse
|
22
|
Magnetic resonance imaging of pediatric soft-tissue vascular anomalies. Pediatr Radiol 2016; 46:891-901. [PMID: 27229506 DOI: 10.1007/s00247-016-3567-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/06/2015] [Accepted: 01/27/2016] [Indexed: 12/11/2022]
Abstract
Magnetic resonance (MR) imaging can be used in the management of pediatric soft-tissue vascular anomalies for diagnosing and assessing extent of lesions and for evaluating response to therapy. MR imaging studies often involve a combination of T1- and T2-weighted images in addition to MR angiography and fat-suppressed post-contrast sequences. The MR imaging features of these vascular anomalies when combined with clinical findings can aid in diagnosis. In cases of complex vascular malformations and syndromes associated with vascular anomalies, MR imaging can be used to evaluate accompanying soft-tissue and bone anomalies. This article reviews the MR imaging protocols and appearances of the most common pediatric soft-tissue vascular anomalies.
Collapse
|
23
|
Patel AS, Schulman JM, Ruben BS, Hoffman WY, Dowd CF, Frieden IJ, Hess CP. Atypical MRI features in soft-tissue arteriovenous malformation: a novel imaging appearance with radiologic-pathologic correlation. Pediatr Radiol 2015; 45:1515-21. [PMID: 25916383 PMCID: PMC4553129 DOI: 10.1007/s00247-015-3359-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 03/12/2015] [Accepted: 04/06/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The absence of a discrete mass, surrounding signal abnormality and solid enhancement are imaging features that have traditionally been used to differentiate soft-tissue arteriovenous malformations from vascular tumors on MRI. We have observed that these findings are not uncommon in arteriovenous malformations, which may lead to misdiagnosis or inappropriate treatment. OBJECTIVE To estimate the frequency of atypical MRI features in soft-tissue arteriovenous malformations and assess their relationship to lesion size, location, tissue type involved and vascular architecture. MATERIALS AND METHODS Medical records, MRI and histopathology were reviewed in consecutive patients with soft-tissue arteriovenous malformations in a multidisciplinary vascular anomalies clinic. Arteriovenous malformations were divided into those with and without atypical MRI findings (perilesional T2 signal abnormality, enhancement and/or a soft-tissue mass). Lesion location, size, tissue involved and vascular architecture were also compared between groups. Tissue stains were reviewed in available biopsy or resection specimens to assess relationships between MRI findings and histopathology. RESULTS Thirty patients with treatment-naïve arteriovenous malformations were included. Fifteen lesions demonstrated atypical MRI. There was no difference in age, gender, lesion size or involved body part between the groups. However, more than half of the atypical lesions demonstrated multicompartmental involvement, and tiny intralesional flow voids were more common in atypical arteriovenous malformations. Histopathology also differed in atypical cases, showing densely packed endothelial cells with connective tissue architectural distortion and edema. CONCLUSION Arteriovenous malformations may exhibit features of a vascular tumor on MRI, particularly when multicompartmental and/or containing tiny internal vessels. These features are important to consider in suspected fast-flow vascular malformations and may have implications with respect to their treatment.
Collapse
Affiliation(s)
- Anand S Patel
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-361, San Francisco, CA, 94143, USA,
| | | | | | | | | | | | | |
Collapse
|
24
|
Additional imaging features of intramuscular capillary-type hemangioma: the importance of ultrasound. Pediatr Radiol 2014; 44:1472-4. [PMID: 24771096 DOI: 10.1007/s00247-014-2989-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/30/2014] [Indexed: 10/25/2022]
|
25
|
Chaudry G, Yilmaz S, Alomari AI. Reply to Merrow et al. regarding additional imaging features of intramuscular capillary-type hemangioma and the importance of ultrasound. Pediatr Radiol 2014; 44:1475. [PMID: 24771097 DOI: 10.1007/s00247-014-2990-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 03/30/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Gulraiz Chaudry
- Division of Vascular and Interventional Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA,
| | | | | |
Collapse
|
26
|
Blei F. Update June 2014. Lymphat Res Biol 2014. [DOI: 10.1089/lrb.2014.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|