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Wei B, Liu G, Li K, Quan H. Pediatric upper lip myopericytoma: a case report and comprehensive review. BMC Oral Health 2024; 24:478. [PMID: 38643070 PMCID: PMC11031849 DOI: 10.1186/s12903-024-04106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/05/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Myopericytoma is a rare spindle cell tumor of mesenchymal origin, typically benign, characterized by concentric proliferation of tumor cells around blood vessels within subcutaneous tissue. It primarily occurs in middle-aged adults and is often located in distal extremities, although cases have been reported in proximal extremities and head-neck regions. However, occurrences within the oral cavity are exceedingly rare. To date, literature reviews have identified only two cases in children under 10 years old and reported only five cases of myopericytoma occurring in the lip region. We provide a comprehensive review and analysis of all documented cases to better understand this condition. CASE PRESENTATION A 7-year-old girl presented to oral and maxillofacial surgery with the discovery of a painless mass on the inner aspect of the upper lip. The diagnosis of myopericytoma was confirmed by histological examination (HE staining), alcian blue staining, and immunohistochemistry. CONCLUSIONS Following surgical excision, there were no signs of recurrence at a 3-month follow-up. The pathological diagnosis of myopericytoma is quite challenging, and immunohistochemical testing is necessary.
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Affiliation(s)
- Bin Wei
- Department of Oral and Maxillofacial Surgery, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Gui Liu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
- Department of Oral Pathology, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Kun Li
- Department of Oral and Maxillofacial Surgery, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Hongzhi Quan
- Department of Oral and Maxillofacial Surgery, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China.
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, P.R. China.
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Ju WT, Zhao TC, Liu Y, Dong MJ, Wang LZ, Li J, Tan YR, Zhong LP. Clinical and pathologic analysis of myopericytoma in the oral and maxillofacial region. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:393-399. [PMID: 31350225 DOI: 10.1016/j.oooo.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/27/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to analyze myopericytoma in the oral and maxillofacial region in terms of clinical appearance, diagnosis, treatment, and outcomes. STUDY DESIGN Data on 5 new patients with myopericytoma in the oral and maxillofacial region treated at our department were collected and analyzed. RESULTS There were 2 males and 3 females (age range 10-62 years; mean age 43.8 years). All of the 5 patients presented with masses showing benign biologic behavior. Imaging examinations with use of computed tomography or magnetic resonance imaging showed heterogeneous regions with internal contrast-enhancement or cystic change in 3 cases. All of the patients underwent surgery. Histologic examination showed a broad morphologic spectrum characterized by concentric and perivascular growth of ovoid, plump spindled, and/or round myoid tumor cells. Immunohistochemical examination showed positive staining for vimentin and smooth muscle actin, and negative for CD34 and desmin. During the follow-up period (8-56 months), there was no tumor recurrence. CONCLUSIONS Myopericytoma in the oral and maxillofacial region always exhibits benign biologic behavior and a heterogeneous region with internal contrast-enhancement or cystic change on imaging examinations. Surgery is the first choice of treatment and results in good clinical outcomes.
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Affiliation(s)
- Wu-Tong Ju
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Tong-Chao Zhao
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ying Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Min-Jun Dong
- Department of Radiology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Li-Zhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Jiang Li
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yi-Ran Tan
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Lai-Ping Zhong
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Chaskes MB, Bishop JW, Bobinski M, Farwell DG. Myopericytoma of the Neck Originating From the Middle Scalene: A Case Report. EAR, NOSE & THROAT JOURNAL 2019; 99:NP72-NP74. [PMID: 31142159 DOI: 10.1177/0145561319839821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the case of a myopericytoma of the neck. A 23-year-old female noticed a small, nontender mass in her left supraclavicular fossa. The mass grew over a period of 5 months, prompting the patient to seek evaluation. There were no motor or sensory deficits. Imaging suggested a mass originating from the middle scalene muscle. Computed tomography-guided core needle biopsy demonstrated a spindle cell neoplasm with smooth muscle differentiation. Complete surgical excision was performed. Histopathological and immunohistochemical evaluation of the tissue sample suggested myopericytoma. Myopericytoma is an extremely rare tumor of the head and neck. To our knowledge, this is the first reported case of a myopericytoma originating from a scalene muscle.
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Affiliation(s)
- Mark B Chaskes
- Division of Otolaryngology, Albany Medical College, Albany, NY, USA
| | - John W Bishop
- Department of Pathology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Matthew Bobinski
- Department of Pathology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - D Gregory Farwell
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA, USA
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Muro Bushart N, Tharun L, Oheim R, Paech A, Kiene J. Tumorinduzierte Osteomalazie, verursacht durch ein FGF23-sezernierendes Myoperizytom. DER ORTHOPADE 2019; 49:1-9. [DOI: 10.1007/s00132-019-03719-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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5
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Myopericytoma of the tongue base: A case report. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Chaskes MB, Bishop JW, Bobinski M, Farwell DG. Myopericytoma of the neck originating in the middle scalene muscle: A case report. EAR, NOSE & THROAT JOURNAL 2018; 96:E5-E7. [PMID: 29121378 DOI: 10.1177/0145561317096010-1102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of myopericytoma of the neck. A 23-year-old woman noticed a small, nontender mass in her left supraclavicular fossa. The mass had grown over a period of 5 months, prompting her to seek evaluation. On examination, no motor or sensory deficits were present. Imaging suggested that a mass had originated in the middle scalene muscle. Computed-tomography-guided core needle biopsy demonstrated a spindle-cell neoplasm with smooth-muscle differentiation. Complete surgical excision was performed. Histopathologic and immunohistochemical evaluations of the tissue sample suggested a myopericytoma. Myopericytoma is an extremely rare tumor of the head and neck. To the best of our knowledge, this is the first reported case of a myopericytoma originating in a scalene muscle.
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Affiliation(s)
- Mark B Chaskes
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut St., Philadelphia, PA 19107, USA.
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Rubino S, De Berardinis R, Colombo D, De Padova A. Myopericytoma of the tongue base: A case report. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:304-305. [PMID: 29050639 DOI: 10.1016/j.otorri.2017.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 06/22/2017] [Accepted: 06/29/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Stefano Rubino
- Department of Otolaryngology and Head and Neck surgery, University of "Tor Vergata", Rome, Italy.
| | - Rita De Berardinis
- Department of Otolaryngology and Head and Neck surgery, University of "Tor Vergata", Rome, Italy
| | - Daniele Colombo
- Department of Pathology, University of "Tor Vergata", Rome, Italy
| | - Alessandro De Padova
- Department of Otolaryngology and Head and Neck surgery, University of "Tor Vergata", Rome, Italy
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Munakomi S, Chaudhary P. Case Report: A giant myopericytoma involving the occipital region of the scalp - a rare entity. F1000Res 2017; 5:2905. [PMID: 28232863 PMCID: PMC5302154 DOI: 10.12688/f1000research.10505.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 11/21/2022] Open
Abstract
Herein we report a rare case of a giant myopericytoma presenting in a 16-year-old girl as a slowly progressive swelling involving the scalp in the occipital region. It was managed by complete excision. Histological examination of the lesion revealed spindle-shaped cells forming characteristic rosettes around the blood vessels, and positive staining with smooth muscle actin.
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Affiliation(s)
- Sunil Munakomi
- Department of Neurosurgery, College of Medical Sciences, Chitwan, Nepal
| | - Pramod Chaudhary
- Department of Neurosurgery, College of Medical Sciences, Chitwan, Nepal
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Abstract
Pericytes are a heterogeneous population of cells located in the blood vessel wall. They were first identified in the 19th century by Rouget, however their biological role and potential for drug targeting have taken time to be recognised. Isolation of pericytes from several different tissues has allowed a better phenotypic and functional characterization. These findings revealed a tissue-specific, multi-functional group of cells with multilineage potential. Given this emerging evidence, pericytes have acquired specific roles in pathobiological events in vascular diseases. In this review article, we will provide a compelling overview of the main diseases in which pericytes are involved, from well-established mechanisms to the latest findings. Pericyte involvement in diabetes and cancer will be discussed extensively. In the last part of the article we will review therapeutic approaches for these diseases in light of the recently acquired knowledge. To unravel pericyte-related vascular pathobiological events is pivotal not only for more tailored treatments of disease but also to establish pericytes as a therapeutic tool.
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Prado-Calleros HM, Galarza-Lozano D, Arrieta-Gómez JR, Pombo-Nava A, Parraguirre-Martínez S, Gutiérrez CJ. Myopericytoma arising adjacent to the common carotid artery: Case report and systematic review of deep located neck myopericytomas. Head Neck 2016; 38:E2479-82. [PMID: 27061437 DOI: 10.1002/hed.24455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/30/2015] [Accepted: 02/09/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Myopericytoma is a perivascular tumor of the skin and subcutaneous tissue of the extremities, it is a rare finding in the head and neck, and even rarer is its deep location. METHODS A 38-year-old woman presented with a slowly growing mass at the right carotid triangle. Contrast-enhanced CT scan revealed a moderately enhancing mass. At surgery, the tumor was firmly attached to the common carotid artery, making it necessary to excise a small portion of the vessel wall. RESULTS The histopathologic report was myopericytoma. The postoperative course was uneventful, without tumor recurrence. CONCLUSION The very few deep located myopericytomas at the head and neck region show a predilection to appear near the great neck vessels with a possibility to require vascular repair, or at the parotid space where they can be multicentric. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2479-E2482, 2016.
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Affiliation(s)
- Héctor M Prado-Calleros
- Department of Otolaryngology, Head and Neck Surgery, General Hospital "Dr. Manuel Gea González", Mexico
| | - David Galarza-Lozano
- Department of Otolaryngology, Head and Neck Surgery, General Hospital "Dr. Manuel Gea González", Mexico
| | - José R Arrieta-Gómez
- Department of Otolaryngology, Head and Neck Surgery, General Hospital "Dr. Manuel Gea González", Mexico
| | - Alejandro Pombo-Nava
- Department of Otolaryngology, Head and Neck Surgery, General Hospital "Dr. Manuel Gea González", Mexico
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Terada T. Myopericytoma of soft tissue (thigh). HUMAN PATHOLOGY: CASE REPORTS 2016. [DOI: 10.1016/j.ehpc.2015.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Myopericytoma is a rare type of soft tissue tumor with perivascular myoid differentiation. Although the pathology characteristics of myopericytomas are well described in literature, the clinical characteristics of these tumors have received less attention. We report on a 44-year-old female who developed a myopericytoma in her right distal forearm. The patient presented with a painless solid mass that had been slowly increasing in size for approximately 5 years. Unlike typical myopericytoma in the extremity growing as a subcutaneous nodule, the tumor enveloped the distal ulna. This case suggests a different growth pattern for myopericytoma. Myopericytoma is a rare soft tissue tumor originating from perivascular myoid cells, which has only been recognized as a distinct condition in the past 15 years (Granter et al. Am J Surg Pathol. 22 (5):513-25, 1998). Most of these tumors present as a painless, slow-growing subcutaneous nodule. They have typically been described by pathologists who concentrate on the pathological features rather than the clinical characteristics of these tumors (Granter et al. Am J Surg Pathol. 22 (5):513-25, 1998; Dray et al. J Clin Pathol. 59 (1):67-73, 2006; Mentzel et al. Am J Surg Pathol. 30 (1):104-113 2006). We report a case of myopericytoma with an unusual growth pattern involving the distal forearm to highlight the clinicopathologic features of this tumor.
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Aung PP, Goldberg LJ, Mahalingam M, Bhawan J. Cutaneous Myopericytoma: A Report of 3 Cases and Review of the Literature. Dermatopathology (Basel) 2015; 2:9-14. [PMID: 27047931 PMCID: PMC4816429 DOI: 10.1159/000371875] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cutaneous myopericytoma is a rarely reported mesenchymal neoplasm with a benign biologic behavior. It is seen more commonly in males and typically occurs in adults on the distal extremities. To the best of our knowledge, there are only 13 reports describing 45 cases of cutaneous myopericytoma in the literature. The 3 cases in this report expand the clinical presentation and reinforce the histopathologic features of cutaneous myopericytoma. While the clinical presentation in 2 cases (located on the scalp and heel) was in keeping with that reported previously of a slow-growing painless firm nodule, the third case, located on the dorsal wrist, presented as a scaly keratotic nodule. Histopathologic examination of all 3 cases revealed an unencapsulated dermal nodule with concentric perivascular arrangement of plump, spindle-shaped myoid cells admixed with thin-walled blood vessels. Immunohistochemical staining revealed the lesional cells to be actin- (3/3) and caldesmon- (2/3) positive and negative for other smooth muscle markers, compatible with perivascular myopericytic differentiation.
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Affiliation(s)
- Phyu P Aung
- Dermatopathology Section, Department of Pathology, MD Anderson Cancer Center, Houston, Tex., USA
| | - Lynne J Goldberg
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Mass., USA
| | - Meera Mahalingam
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Mass., USA
| | - Jag Bhawan
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Mass., USA
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Zhang Z, Yu D, Shi H, Xie D. Renal myopericytoma: A case report with a literature review. Oncol Lett 2013; 7:285-287. [PMID: 24348865 PMCID: PMC3861592 DOI: 10.3892/ol.2013.1678] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 11/04/2013] [Indexed: 11/16/2022] Open
Abstract
Myopericytoma is a rare neoplasm that generally arises from the skin and superficial soft tissues of distal extremities, and is particularly rare in the visceral organs. The current report presents a case of giant myopericytoma showing kidney involvement, which is extremely rare. A 39-year-old male presented to the Department of Urology with a 2-month history of a painless and palpable mass in the region of the left abdomen. Unenhanced computed tomography revealed a 9×10×18-cm3 mass that was heterogeneous with central lower density. The patient underwent radical nephrectomy, including lymphadenectomy, without adjuvant therapy. The tumor was composed of spindle-shaped myoid cells with a concentric arrangement and showed immunoreactivity for smooth muscle actin and cluster of differentiation (CD)10, and had a Ki-67 index of <1%; however, staining was negative for CD34, desmin, S-100 protein, cytokeratin, human melanoma black (HMB)-45, B-cell lymphoma (Bcl)-2 and CD99. Routine follow-up revealed no local or distant metastatic signs of reccurrence for 20 months. The present report shows that renal myopericytoma may be a benign tumor, and surgical excision without adjuvant therapy may be the only potentially curative treatment approach.
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Affiliation(s)
- Zhiqiang Zhang
- Department of Urology, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Dexin Yu
- Department of Urology, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Haoqiang Shi
- Department of Urology, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Dongdong Xie
- Department of Urology, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
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Myopericytoma of the external auditory canal and tragus. The Journal of Laryngology & Otology 2013; 127:805-8. [DOI: 10.1017/s0022215113001357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Myopericytoma is a relatively recently described skin and soft tissue tumour that demonstrates perivascular myoid cell or pericytic differentiation. Whilst the range of anatomical locations has expanded to include visceral locations, head and neck myopericytomas are rarely documented. There have been no previous reports of aural myopericytoma.Case report:This paper reports the clinicopathological features of a biopsy-proven, slow-growing, 20 × 20 mm, polypoid myopericytoma that involved the external auditory canal and tragus in an 18-year-old woman. Excision was curative.Conclusion:Heightened clinicopathological awareness of the expanding anatomical distribution of myopericytoma is critical to its diagnosis when it presents in unusual and novel locations. Myopericytoma should be added to the range of external auditory canal neoplasms, especially those characterised by an admixture of spindle cells and a prominence of blood vessels, including those with a haemangiopericytomatous pattern.
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Bruder E, Alaggio R, Kozakewich HPW, Jundt G, Dehner LP, Coffin CM. Vascular and perivascular lesions of skin and soft tissues in children and adolescents. Pediatr Dev Pathol 2012; 15:26-61. [PMID: 22420724 DOI: 10.2350/11-11-1119-pb.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Vascular anomalies in children and adolescents are the most common soft tissue lesions and include reactive, malformative, and neoplastic tumefactions, with a full spectrum of benign, intermediate, and malignant neoplasms. These lesions are diagnostically challenging because of morphologic complexity and recent changes in classification systems, some of which are based on clinical features and others on pathologic findings. In recent decades, there have been significant advances in clinical diagnosis, development of new therapies, and a better understanding of the genetic aspects of vascular biology and syndromes that include unusual vascular proliferations. Most vascular lesions in children and adolescents are benign, although the intermediate locally aggressive and intermediate rarely metastasizing neoplasms are important to distinguish from benign and malignant mimics. Morphologic recognition of a vasoproliferative lesion is straightforward in most instances, and conventional morphology remains the cornerstone for a specific diagnosis. However, pathologic examination is enhanced by adjunctive techniques, especially immunohistochemistry to characterize the type of vessels involved. Multifocality may cause some uncertainty regarding the assignment of "benign" or "malignant." However, increased interest in vascular anomalies, clinical expertise, and imaging technology have contributed greatly to our understanding of these disorders to the extent that in most vascular malformations and in many tumors, a diagnosis is made clinically and biopsy is not required for diagnosis. The importance of close collaboration between the clinical team and the pathologist cannot be overemphasized. For some lesions, a diagnosis is not possible from evaluation of histopathology alone, and in a subset of these, a specific diagnosis may not be possible even after all assembled data have been reviewed. In such instances, a consensus diagnosis in conjunction with clinical colleagues guides therapy. The purpose of this review is to delineate the clinicopathologic features of vascular lesions in children and adolescents with an emphasis on their unique aspects, use of diagnostic adjuncts, and differential diagnosis.
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Affiliation(s)
- Elisabeth Bruder
- Institute for Pathology, Hospital of the University of Basel, Basel, Switzerland
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