Internal Jugular Vein Pyogenic Capillary Hemangioma: A Case Report

Ultrasonographic features of an intravascular lobular capillary hemangioma originating in the basilic vein: Case report and literature review

Intravascular lobular capillary hemangioma (ILCH) is a rare variant of pyogenic granuloma, which develops within the lumen of a blood vessel. Here, we report the case of a 38-year-old male presenting with a mobile, incompressible, nonpulsatile nodule in the superficial fascia of the forearm. A first ultrasonographic examination diagnosed the mass as intravascular thrombosis with partial recanalization. Three months later, a second ultrasonographic examination concluded to the existence of an intravascular tumor, which finally turned out at pathological examination to be ILCH. Here, we report the ultrasonographic features of ILCH and the differential diagnosis between ILCH and other intravascular masses like thrombus.

Intravenous pyogenic granuloma in the internal jugular vein: A case report and literature review

RATIONALE

Intravenous pyogenic granuloma (IVPG) is a special type of pyogenic granuloma, and its preoperative diagnosis is difficult. We report a rare case of IVPG that develops in the lumen of the internal jugular vein (IJV). Here, we analyze the imaging characteristics of present case and summarize the imaging characteristics of previous reported cases.

PATIENT CONCERNS

A 44-year-old man who presented with a growth in the IJV without any symptoms.

DIAGNOSES

A diagnosis of IVPG was made, based on the pathological examination after surgery.

INTERVENTIONS

The patient underwent surgery to excise the vein segment containing the neoplasm.

OUTCOMES

The patient did not present with any complications in the postoperative follow-up period.

LESSONS

For clinician, IVPG's preoperative diagnosis is difficult. Although histopathology remains the gold standard for diagnosis, the combination of multiple types of imaging examinations is necessary to rule out the differential diagnoses of IVPG.

Intravenous lobular capillary haemangioma presenting as neck discomfort associated with neck anteflexion

Lobular capillary haemangioma, also known as pyogenic granuloma, is a benign vascular tumour that usually originates in the skin and mucosal membrane. It sometimes derives from the lumen of a vein and the clinical presentations are various and non-specific. A 72-year-old woman complained of a sensation of pressure in her left neck for 1 month when cooking. Her left cephalic vein was enlarged with no signs of oedema, and cervical ultrasound revealed a space-occupying lesion in the left subclavian vein. Contrast-enhanced CT and MRI revealed an intravascular tumour. This tumour was removed with operation, and histopathological examination revealed intravascular capillary haemangioma. Intravascular lobular capillary haemangioma is a rare condition that occurs in the veins of the neck and upper extremities. Intravascular tumours could cause a unique symptom, such as neck discomfort associated with neck anteflexion.

Venous outlet syndrome caused by capillary hemangioma of the subclavian vein

We report a case of intravenous lobular capillary hemangioma in the subclavian vein, causing venous thoracic outlet syndrome. A 32-year-old woman was referred to our unit with facial and left arm oedema. Ultrasound evaluation, computed tomography and magnetic resonance imaging showed a hypervascular mass in the middle portion of the subclavian vein, with arrest of venous flow. Through an infraclavicular approach, we excised the venous axis with the endovascular palpable tumour that extended from the axillary-subclavian junction to the jugular-subclavian junction, without reconstruction. The postoperative period was uneventful. The patient recovered well without recurrence at one year from surgery.

Intravenous lobular capillary haemangioma (pyogenic granuloma): A case report and a review of imaging findings as reported in the literature

INTRODUCTION

Intravenous lobular capillary haemangioma (IVLCH) is a rare benign lesion with minimal published reports containing a description of its appearance at medical imaging. We present the ultrasound and MRI images of a histologically proven IVLCH and provide the first review of the imaging findings reported in the literature.

METHODS

The imaging findings of a case of IVLCH are presented. A PubMed search of English language articles was performed from 1966 to October 2016, and all relevant papers were reviewed. Imaging findings from those papers are summarised.

RESULTS

Key features on ultrasound are of a well-defined, usually hypoechoic, mass which is highly vascular. The host vein is usually apparent. MRI imaging usually shows T1 signal isointense to muscle and variable T2 signal, either isointense or of high signal relative to the vein. The lesions enhance with gadolinium.

CONCLUSION

Intravenous lobular capillary haemangioma has distinctive ultrasound but less consistent MRI features although radiological diagnosis should usually be possible. Review of reported cases shows that a previously described gender bias is incorrect.

Intravenous Lobular Capillary Hemangioma in the Subclavian Vein

We report the case of a 73-year-old man with severe edema of the right upper extremity. Computed tomography, magnetic resonance imaging, and venography revealed an intravenous tumor in the middle portion of the right subclavian vein. The tumor was completely resected, and an accompanying thrombus was also removed using the transmanubrial osteomuscular sparing approach. The patient recovered well without any complications or recurrence. The histopathologic diagnosis was intravenous lobular capillary hemangioma, which is also called pyogenic granuloma. To our knowledge, this is the first reported surgical case involving this type of benign tumor originating in a thoracic vein.