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Leyman B, Govaerts D, Dormaar JT, Meeus J, Bila M, Coropciuc R, Willaert R, Politis C. A 16-year retrospective study of vascular anomalies in the head and neck region. Head Face Med 2023; 19:32. [PMID: 37528467 PMCID: PMC10391867 DOI: 10.1186/s13005-023-00376-z] [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: 01/08/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
Depending on the diagnostic modality, the classification of vascular anomalies varies and so does the nomenclature. The 'International Society for the Study of Vascular Anomalies' (ISSVA) is the most widely accepted classification in the literature and is mainly based on the radiologic and clinical presentation. The aim of this article is to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special focus on the nomenclature. All patients with a vascular anomaly presenting to the department of oral and maxillofacial surgery were reviewed in a retrospective manner. Nomenclature, diagnostic process, lesion characteristics, treatment and outcome were examined. The lesions were (re)classified according to the ISSVA classification. A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. After reclassification, the most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). A group of 39 anomalies could not be further specified. One hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of treated patients). Endovascular treatment was considered in 41 patients but applied in only eight. This strict selection led to a low a complication rate. We provide an overview of the clinical practice in the management of vascular anomalies in a university hospital. The histology report is a source of miscommunication because clinicians use the ISSVA classification, while pathologists use the WHO classification. Every professional involved should be aware of the differences in classification and nomenclature.
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Affiliation(s)
- Bernard Leyman
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Dries Govaerts
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Jakob Titiaan Dormaar
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
- Present Address: Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands
| | - Jan Meeus
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Michel Bila
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ruxandra Coropciuc
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Robin Willaert
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
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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.
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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.
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3
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Assaf WA, Kapitán M, Tuček L, Laco J. Oral Candidal Infection Misdiagnosed as a Tumour. ACTA MEDICA (HRADEC KRALOVE) 2023; 66:128-131. [PMID: 38511424 DOI: 10.14712/18059694.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
A case report on a 70-year-old male patient with atypical candidal infection on the palate that was misdiagnosed for a tumour based on clinical examination. The lesion was an accidental finding when the patient was at a registered dentist for a preventive check-up.
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Affiliation(s)
- Wail Abou Assaf
- Department of Stomatology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic.
| | - Martin Kapitán
- Department of Stomatology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Luboš Tuček
- Department of Stomatology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Jan Laco
- Fingerland Department of Pathology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
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Maruyama F, Masuda T, Nosaka N, Wakabayashi K. Case of laryngeal venous malformations requiring repeated advanced airway management in the perioperative course. Clin Case Rep 2022; 10:e6687. [PMID: 36483877 PMCID: PMC9723375 DOI: 10.1002/ccr3.6687] [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: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Laryngeal venous malformations rarely but do cause airway obstruction resulting in life-threatening events. The perioperative airway management for the patients with them has not been well established. We suggest a strategy for laryngeal venous malformations management in the patients who undergo surgery in addition to planning for airway management.
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Affiliation(s)
- Fumi Maruyama
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Takahiro Masuda
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Nobuyuki Nosaka
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Kenji Wakabayashi
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
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5
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Bleomycin intralesional injections of maxillofacial venous malformations in pediatric patients. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Wang S, Zhou Z, Li J, Wang Y, Li H, Lv R, Xu G, Zhang J, Bi J, Huo R. Identification of ACTA2 as a Key Contributor to Venous Malformation. Front Cell Dev Biol 2021; 9:755409. [PMID: 34858981 PMCID: PMC8630574 DOI: 10.3389/fcell.2021.755409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Proteomics and high connotation functional gene screening (HCS) were used to screen key functional genes that play important roles in the pathogenesis of venous malformation. Furthermore, this study was conducted to analyze and explore their possible functions, establish a gene mutation zebrafish model, and perform a preliminary study to explore their possible pathogenic mechanisms in venous malformation. Methods: Pathological and normal tissues from patients with disseminated venous malformation were selected for Tandem Mass Tag (TMT) proteomics analysis to identify proteins that were differentially expressed. Based on bioinformatics analysis, 20 proteins with significant differential expression were selected for HCS to find key driver genes and characterize the expression of these genes in patients with venous malformations. In vitro experiments were then performed using human microvascular endothelial cells (HMEC-1). A gene mutant zebrafish model was also constructed for in vivo experiments to explore gene functions and pathogenic mechanisms. Results: The TMT results showed a total of 71 proteins that were differentially expressed as required, with five of them upregulated and 66 downregulated. Based on bioinformatics and proteomics results, five highly expressed genes and 15 poorly expressed genes were selected for functional screening by RNAi technology. HCS screening identified ACTA2 as the driver gene. Quantitative polymerase chain reaction (qPCR) and western blot were used to detect the expression of ACTA2 in the pathological tissues of patients with venous malformations and in control tissues, and the experimental results showed a significantly lower expression of ACTA2 in venous malformation tissues (P < 0.05). Cell assays on the human microvascular endothelial cells (HMEC-1) model showed that cell proliferation, migration, invasion, and angiogenic ability were all significantly increased in the ACTA2 over-expression group (P < 0.05), and that overexpression of ACTA2 could improve the inhibitory effect on vascular endothelial cell proliferation. We constructed an ACTA2-knockdown zebrafish model and found that the knockdown of ACTA2 resulted in defective vascular development, disruption of vascular integrity, and malformation of micro vein development in zebrafish. Further qPCR assays revealed that the knockdown of ACTA2 inhibited the Dll4/notch1 signaling pathway, Ephrin-B2 signaling pathway, and vascular integrity-related molecules and activated the Hedgehog signaling pathway. Conclusion: This study revealed that ACTA2 deficiency is an important factor in the pathogenesis of venous malformation, resulting in the disruption of vascular integrity and malformed vascular development. ACTA2 can be used as a potential biomarker for the treatment and prognosis of venous malformations.
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Affiliation(s)
- Song Wang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zifu Zhou
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Li
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu Wang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongwen Li
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Renrong Lv
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guangqi Xu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jian Zhang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jianhai Bi
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran Huo
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Lee JS, Chung HY. Classification, diagnosis, and treatment of vascular malformations. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.9.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: In the 1980s, vascular anomalies were divided into two major subgroups—vascular tumors and vascular malformations—based on the functional framework. This concept has been fundamental to the management of vascular anomalies and expanded and refined by the International Society for the Study of Vascular Anomalies. Vascular malformations are further sub-divided into several types; however, there are many cases with insufficient information about the disease.Current Concepts: Several instances have shown that the diagnosis of vascular malformations can be achieved after a careful evaluation of patient history and examination. However, recently developed imaging technology has been of great help in the diagnosis. Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and angiography are valuable tools for diagnostic and therapeutic planning. Advanced diagnostic and therapeutic technologies have also provided more accurate and safer diagnoses and appropriate treatment. Recently, an improved method of managing vascular malformations has emerged, based on a multidisciplinary approach, which is very useful for increasing the treatment efficacy. The development of gene research has enabled the investigation of disease-related genes and the development of new medications.Discussion and Conclusion: Accurate diagnosis of vascular malformations is one of the most crucial factors in determining treatment plan and prognosis, based on which it would be possible to achieve effective results through appropriate management and a multidisciplinary team approach.
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Ultrasound-Guided Moving Shot Radiofrequency Ablation of Benign Soft Tissue Neoplasm. ACTA ACUST UNITED AC 2021; 57:medicina57080830. [PMID: 34441036 PMCID: PMC8402204 DOI: 10.3390/medicina57080830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022]
Abstract
Background and Objective: To evaluate the effectiveness of radiofrequency ablation (RFA) using the moving-shot technique for benign soft tissue neoplasm. Materials and Methods: This retrospective study reviewed eight patients with benign soft tissue neoplasm presenting with cosmetic concerns and/or symptomatic issues who refused surgery. Six patients had vascular malformation, including four with venous malformation and two with congenital hemangioma. The other two patients had neurofibroma. All patients underwent RFA using the moving-shot technique. Imaging and clinical follow-up were performed in all patients. Follow-up image modalities included ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging. The volume reduction ratio (VRR), cosmetic scale (CS), and complications were evaluated. Results: Among the seven patients having received single-stage RFA, there were significant volume reductions between baseline (33.3 ± 21.2 cm3), midterm follow-up (5.1 ± 3.8 cm3, p = 0.020), and final follow-up (3.6 ± 1.4 cm3, p = 0.022) volumes. The VRR was 84.5 ± 9.2% at final follow-up. There were also significant improvements in the CS (from 3.71 to 1.57, p = 0.017). The remaining patient, in the process of a scheduled two-stage RFA, had a 33.8% VRR after the first RFA. The overall VRR among the eight patients was 77.5%. No complications or re-growth of the targeted lesions were noted during the follow-up period. Of the eight patients, two received RFA under local anesthesia, while the other six patients were under general anesthesia. Conclusions: RFA using the moving-shot technique is an effective, safe, and minimally invasive treatment for benign soft tissue neoplasms, achieving mass volume reduction within 6 months and significant esthetic improvement, either with local anesthesia or with general anesthesia under certain conditions.
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9
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Mejia O, Bahmad HF, Oh KS, Paramo JC, Poppiti R. Parathyroid hemangioma. AUTOPSY AND CASE REPORTS 2021; 11:e2021270. [PMID: 34249786 PMCID: PMC8253379 DOI: 10.4322/acr.2021.270] [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: 02/06/2021] [Accepted: 02/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background Hemangiomas are benign neoplasms of capillary proliferation that arise from a developmental anomaly where angioblastic mesenchyme fails to form canals. Most hemangiomas arise in the head and neck region, either superficially in the skin or deeper within endocrine organs such as the parotid gland. Parathyroid hemangiomas, however, are extremely rare, with only five cases previously reported in the literature. Case presentation Herein, we present a case of a 68-year-old man with a hemangioma almost completely replacing the right upper parathyroid gland, grossly measuring 1.3 × 1.3 × 1.2 cm and weighing 700 mg, associated with primary hyperparathyroidism. Conclusions Parathyroid gland enlargement due to vascular neoplasms such as hemangiomas can mimic, both clinically and radiographically, hyperplasias and/or adenomas. Surgeons need to be aware of the presence of this entity and should consider it in the differential diagnosis of hyperparathyroidism or parathyroid gland enlargement.
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Affiliation(s)
- Odille Mejia
- Mount Sinai Medical Center, Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA
| | - Hisham F Bahmad
- Mount Sinai Medical Center, Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA
| | - Kei Shing Oh
- Mount Sinai Medical Center, Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA
| | - Juan C Paramo
- Mount Sinai Medical Center, Department of General Surgery, Miami Beach, FL, USA.,Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Robert Poppiti
- Mount Sinai Medical Center, Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA.,Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
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Xia Z, Gu H, Yuan Y, Xiang S, Zhang Z, Tao X. Value of Dynamic Contrast-Enhanced (DCE) MRI in Predicting Response to Foam Sclerotherapy of Venous Malformations. J Magn Reson Imaging 2021; 54:1108-1116. [PMID: 33991357 DOI: 10.1002/jmri.27657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Preoperative imaging assessment of venous malformations (VMs) and prediction of foam sclerotherapy efficacy might be achievable by DCE-MRI but elaborate quantitive analysis was absent. PURPOSE To evaluate the value of DCE-MRI in predicting the effectiveness of foam sclerotherapy in VMs. STUDY TYPE Retrospective. POPULATION Fifty-five patients (M:F = 17:38; mean age ± SD, 15.4 ± 13.0 years) with VMs. FIELD STRENGTH/SEQUENCE Three Tesla MRI with 3D T1 -weighted volume interpolated body examination. ASSESSMENT Patients who underwent pretreatment DCE-MRI were divided into "effective" and "ineffective" groups according to the response to foam sclerotherapy. Clinical characteristics and morphologic features were assessed. The semiquantitative parameters, such as maximum intensity time ratio (MITR), enhancement ratio (ER), and Slope, were obtained from ROI and volume of interest (VOI). The quartile and mean values of these parameters were acquired from VOI, while mean values denoted as Mean# were acquired from ROI. Establishment of two predictive models was based on ROI and VOI respectively. Model 1 was based on morphologic parameters and ROI semiquantitative parameters, while model 2 was based on morphologic parameters and VOI semiquantitative parameters. STATISTICAL ANALYSIS Mann-Whitney U-test, Cohen's kappa, multivariate logistic regression analysis (backward stepwise), and ROC analyses. RESULTS The lesion classification, presence of phlebolith, semiquantitative parameters of VOI (quartile and mean of MITR), and semiquantitative parameters of ROI (Slopemean # , MITRmean # ) were significantly different between two groups. Lesion classification (P = 0.002) and MITRmean# (P = 0.027) were independent predictors for poor efficacy in model 1 as determined by multivariate binary logistic regression analysis. For model 2, lesion classification (P = 0.006) and MITR25 (P = 0.001) were independent predictors. The predictive model based on VOI (AUC = 0.961) performed better than that based on ROI (AUC = 0.909) in predicting therapeutic response. DATA CONCLUSION DCE-MRI is promising in predicting the response to foam sclerotherapy for VMs. The whole lesion VOI-based model showed better performance and could instruct surgical approach in the future. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Zhipeng Xia
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Hao Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Ying Yuan
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shiyu Xiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zimin Zhang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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11
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Jeong GS, Bae SH, Do YS, Lee HN, Lee SJ. Transvaginal Direct Puncture and Ethanol Sclerotherapy for Cervicovaginal Venous Malformations: A Case Report and Literature Review. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:688-692. [PMID: 36238788 PMCID: PMC9432453 DOI: 10.3348/jksr.2020.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 11/17/2022]
Abstract
Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of women. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.
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Affiliation(s)
- Gu Seong Jeong
- Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Suk Hyun Bae
- Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Young Soo Do
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyoung Nam Lee
- Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sang Joon Lee
- Department of Radiology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
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12
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Evaluation of sclerotherapy of benign oral vascular lesions with monoethanolamine oleate. Clin Oral Investig 2020; 25:1767-1774. [PMID: 32748074 DOI: 10.1007/s00784-020-03479-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of sclerotherapy with monoethanolamine oleate (MEO) in a series of cases of benign oral vascular lesions (BOVL). MATERIAL AND METHODS Clinical records and images were retrieved (2015-2019), and data regarding age, gender, location, size, symptomatology, treatment and outcomes of patients were collected. All patients were diagnosed according to the classification of International Society for the Study of Vascular Anomalies and received the same treatment protocol (MEO 0.05 g/mL). The collected data were submitted to descriptive analysis and Pearson's chi-square test (p ≤ 0.05). RESULTS Thirty-seven patients were treated. Most were female (70.3%) aged 9 to 88 years (median, 57.5 ± 17.4 years). Lower lip (54.1%) was the most affected site followed by buccal mucosa (16.2%). Thirty-two lesions were asymptomatic and 35.1% showed ≤ 0.5 cm in size. In 48.6% of the patients, only one application of MEO was performed. Complete regression occurred in 62.2% of cases, whereas 27% showed partial regression. One patient showed hypersensitivity during treatment. There was no significant difference between clinical outcome and age, anatomic site, size, and number of applications of MEO. CONCLUSIONS Sclerotherapy with MEO is an acceptable and affordable treatment and can provide satisfactory results in BOVL, especially where other treatment options could compromise the esthetic aspects. CLINICAL RELEVANCE As it is a non-invasive therapy leading, in most cases, to adequate clinical results, safety, and tolerability, sclerotherapy with MEO can be considered an effective treatment for BOVL.
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Zeevi I, Chaushu G, Alterman M, Chaushu L. Sclerotherapy of Vascular Malformations in the Oral Cavity-Minimizing Postoperative Morbidity. MEDICINA-LITHUANIA 2020; 56:medicina56050254. [PMID: 32456057 PMCID: PMC7279465 DOI: 10.3390/medicina56050254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022]
Abstract
Vascular malformations (VMs) are a wide vascular or lymphatic group of lesions common on the head and neck. The objective of this study was to assess the efficacy and morbidity of sclerotherapy for the treatment of VMs in the oral and perioral area. Special attention was given to factors that may contribute to minimizing postoperative morbidity. Data from 25 patients (32 lesions) with oral VMs submitted to sclerotherapy with monoethanolamine oleate (EAO) were included. A structured form was used to collect data. An arbitrary score was determined to evaluate postoperative morbidity. Each of the following signs or symptoms received one point: pain, swelling, hematoma, ulceration, erythema, transient numbness, and transient itching. Pain and swelling were further divided into mild to moderate (1 point) and severe (2 points). Theoretically, the score was in the range of 0–9. Calculated scores ranged 0–4. The patients were further divided into two groups with scores of 0–1 denoting minimal morbidity (MIN) and 2–4 denoting significant morbidity (SIG). The number of lesions in each morbidity-score group were comparable (MIN 17and SIG 15). There were no statistically significant differences between the groups regarding age, number of applications, or average injection volume per mm lesion. Statistically significant differences were noted regarding gender (p = 0.05), lesion diameter (p = 0.030), total volume of first (p = 0.007) and second application (p = 0.05), and total injected volume (p = 0.03). Factors contributing to the risk for significant morbidity included being male, lesion diameter > 5 mm, volume > 0.3 mL per application, and total injected volume > 0.3 mL. A waiting time of 12 weeks prior to additional EAO application was required in 12 out of 29 lesions for clinical observation of complete regression. It was concluded that sclerotherapy with EAO as monotherapy is easy to apply, safe, and effective within a small number of sessions. Application of <0.3 mL EAO per session, and a waiting time of 12 weeks prior to the second application, would significantly minimize morbidity.
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Affiliation(s)
- Itai Zeevi
- Department of Oral and Maxillofacial Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel; (I.Z.); (M.A.)
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Tel-Aviv 69978, Israel;
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Campus Beilinson, Petah Tiqwa 49100, Israel
| | - Michael Alterman
- Department of Oral and Maxillofacial Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel; (I.Z.); (M.A.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Correspondence:
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Tolentino EDS, Faria LOD, Vargas RM, Camarini C, Santin GC, Chicarelli da Silva M. Monoethanolamine oleate sclerotherapy for the treatment of intraoral vascular anomalies: retrospective study and suggestion for a clinical guideline. Br J Oral Maxillofac Surg 2020; 58:416-420. [DOI: 10.1016/j.bjoms.2020.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 01/22/2020] [Indexed: 10/25/2022]
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15
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Zhu J, Shao M, Guo F, Ren J, Tang Z, Geng J, Xu Z, Jia J, Chen L, Jia Y. Downregulation of lysyl oxidase in venous malformations: Association with vascular destabilization and sclerotherapy. J Dermatol 2020; 47:518-526. [PMID: 32162383 DOI: 10.1111/1346-8138.15297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/09/2020] [Indexed: 12/15/2022]
Abstract
Venous malformations (VM) are localized defects in vascular morphogenesis manifested by dilated venous channels with reduced perivascular cell coverage. As a vital enzyme for extracellular matrix (ECM) deposition, lysyl oxidase (LOX) plays important roles in vascular development and diseases. However, the expression and significance of LOX are unknown in VM. Herein, 22 VM specimens and eight samples of normal skin tissues were evaluated immunohistochemically for the expression of LOX, α-smooth muscle cell actin (α-SMA) and transforming growth factor-β (TGF-β). In vitro studies on human umbilical vein endothelial cells (HUVEC) were employed for determining potential mechanisms. Our results showed that LOX expression was significantly reduced in VM compared with normal skin tissues, in parallel with attenuated perivascular α-SMA+ cell coverage and TGF-β downregulation in VM. Further correlation analysis indicated that LOX expression was positively correlated with perivascular α-SMA+ cell coverage and TGF-β expression in VM. Moreover, marked elevation of LOX, TGF-β and α-SMA was observed in bleomycin-treated VM samples. Furthermore, our in vitro data demonstrated that both recombinant TGF-β and bleomycin induced obvious increase of LOX expression and activity and a concomitant increase in ECM components in HUVEC, which could be reversed by LOX inhibition. To our best knowledge, this study revealed for the first time the downregulation of LOX in VM and its correlation with vascular destabilization and TGF-β-induced endothelial ECM deposition. Moreover, our results highlighted that LOX may be implicated in the sclerotherapy of VM and holds promise as a therapeutic target.
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Affiliation(s)
- Junyi Zhu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Shao
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengyuan Guo
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiangang Ren
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zirong Tang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhuan Geng
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Xu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Jia
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulin Jia
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Manzano BR, Premoli AM, Santaella NG, Ikuta CRS, Rubira CMF, Santos PSDS. Sclerotherapy as an esthetic indication in oral vascular malformations: a case series. An Bras Dermatol 2019; 94:521-526. [PMID: 31777351 PMCID: PMC6857549 DOI: 10.1016/j.abd.2019.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 06/26/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The use of monoethanolamine oleate 5% is effective for the treatment of vascular malformations with low blood flow. OBJECTIVES To report a case series of vascular malformations in the mouth and oral cavity treated with monoethanolamine oleate 5%. METHODS A retrospective descriptive study was performed in electronic patient charts covering seven years. Patient demographics, diagnostic resources, lesion site, size, and number of applications of monoethanolamine oleate 5% were collected. RESULTS A total of 21 vascular malformations were recorded, located mostly on the lower lip (52.3%) and resolved in a single application in 14 patients. The authors found 19 patients treated with sclerotherapy. Thirteen were women and six were men, with a mean age of 61 years. STUDY LIMITATION Small sample size. CONCLUSIONS Sclerotherapy is an effective treatment for vascular malformations of the lips and oral cavity, with resolution after only one or two applications (n=16).
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Affiliation(s)
- Brena Rodrigues Manzano
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
| | - Aloizio Maciel Premoli
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Natalia Garcia Santaella
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Carla Renata Sanomiya Ikuta
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Cássia Maria Fisher Rubira
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
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17
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Manna S, Meyer A, Shigematsu T, Berenstein A, Courey M. Management of a Laryngeal Venous Malformation With Nd:YAG Laser and Bleomycin Sclerotherapy. Laryngoscope 2019; 130:2199-2201. [PMID: 31710699 DOI: 10.1002/lary.28392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022]
Abstract
Literature describing neodymium:yttrium-aluminum-garnet (Nd:YAG) photocoagulation and sclerotherapy for laryngeal venous malformations (VMs) is sparse. Here we present a case in which an extensive laryngeal VM in a 28-year-old female was managed through a combination of four serial Nd:YAG laser photocoagulation sessions and four bleomycin injections over the course of 2 years. The treatment plan resulted in resulted in noticeable lesion ablation, mucosalization, and significant improvement in symptoms. To our knowledge, this case is the first instance of bleomycin injection specifically into a laryngeal VM reported in the English medical literature. Laryngoscope, 130:2199-2201, 2020.
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Affiliation(s)
- Sayan Manna
- Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Annika Meyer
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Tomoyoshi Shigematsu
- Department of Interventional Neuroradiology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Alejandro Berenstein
- Department of Interventional Neuroradiology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Mark Courey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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McNamara KK, Kalmar JR. Erythematous and Vascular Oral Mucosal Lesions: A Clinicopathologic Review of Red Entities. Head Neck Pathol 2019; 13:4-15. [PMID: 30693460 PMCID: PMC6405795 DOI: 10.1007/s12105-019-01002-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
Abstract
Erythematous lesions of the oral mucosa are common and can reflect a variety of conditions, ranging from benign reactive or immunologically-mediated disorders to malignant disease. Together with vascular abnormalities, which can vary from reddish to bluish-purple in color, the differential diagnosis for erythematous oral mucosal change is quite diverse. This review focuses on salient clinical features and histopathologic findings of selected conditions which clinically present as red or vascular-like oral mucosal alterations, including oral vascular malformations and neoplasms, pyogenic granuloma, localized juvenile spongiotic gingival hyperplasia, denture stomatitis, benign migratory glossitis (geographic tongue), orofacial granulomatosis, granulomatosis with polyangiitis (Wegener granulomatosis), megaloblastic anemia, and erythroplakia. Recognition of the characteristic clinical features of these conditions, in conjunction with thorough patient history, will allow clinicians to narrow the differential diagnosis and guide appropriate clinical decision making, including the need for tissue biopsy, in order to complete the diagnostic process and initiate optimal patient care.
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Affiliation(s)
- Kristin K. McNamara
- 0000 0001 2285 7943grid.261331.4The Ohio State University, 305 W. 12 Ave, Columbus, OH 43210 USA
| | - John R. Kalmar
- 0000 0001 2285 7943grid.261331.4The Ohio State University, 305 W. 12 Ave, Columbus, OH 43210 USA
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19
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Kato CDNADO, Ribeiro MC, do Amaral MBF, Grossmann SDMC, de Aguiar MCF, Mesquita RA. Experience with 5% ethanolamine oleate for sclerotherapy of oral vascular anomalies: A cohort of 15 consecutive patients. J Craniomaxillofac Surg 2018; 47:106-111. [PMID: 30527382 DOI: 10.1016/j.jcms.2018.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/12/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To describe the effectiveness and safety of a sclerotherapy protocol with 5% ethanolamine oleate (EO) at 0.1 mL/3 mm for oral vascular anomalies (OVAs). Our hypothesis is that EO applied at a concentration of 5% may decrease the number of sessions necessary for clinical healing. MATERIALS AND METHODS We describe a cohort of 15 consecutive patients. OVAs <20 mm were included. Clinical data of the OVAs were collected. Descriptive and bivariate statistical analyses were performed. RESULTS Fifteen of the 19 OVAs were varicosities and the lower lip was the most affected site (n = 7). The median size was 6 mm, and one session was required in 89.5% of cases for clinical healing within 28 days. The pain/burning score was low (<2) for most lesions (63.1%) and the degree of satisfaction was high (>8) for all OVAs. The number of applications, final volume of drug and time to resolution differed significantly according to the size of the anomaly. CONCLUSION The protocol with 5% EO was shown to be effective and safe to treat OVAs <20 mm, and with a decrease in the number of sessions, volume and time to resolution, without complications and with high patient satisfaction.
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Affiliation(s)
| | - Michel Campos Ribeiro
- Department of Oral and Maxillofacial Surgery, Hospital Márcio Cunha, Ipatinga, Minas Gerais, Brazil
| | | | | | - Maria Cássia Ferreira de Aguiar
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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20
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Weitz-Tuoretmaa A, Keski-Nisula L, Rautio R, Laranne J. Quality of life after endovascular sclerotherapy of low-flow venous malformations: the efficacy of polidocanol compared with ethanol. Acta Radiol 2018; 59:946-952. [PMID: 29124942 DOI: 10.1177/0284185117741774] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Limited information is available on mid-term results and quality of life (QOL) after endovascular sclerotherapy of venous malformations. Purpose To compare two agents-polidocanol and ethanol-with a focus on the influence on QOL after sclerotherapy. Material and Methods Forty-one consecutive patients with a venous malformation in the head and neck area or in the extremities were treated with polidocanol between 2008 and 2013. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluation form on symptoms as well as a QOL questionnaire. The results were compared with previously obtained material during 1991-2001, comprising 44 consecutive, similarly located venous malformation patients subject to ethanol sclerotherapy. Results No significant clinical complications were observed. Subjectively, 19 (46%) of the patients benefitted from the treatment. QOL results showed that 85% of patients had an index < 39 - where 0 represents the highest and 100 the lowest QOL. Patients in the ethanol group had marginally better overall post-treatment QOL results. Post-treatment MRI in 35 patients showed the size of the malformation unchanged in 19 (54%) patients, in ten (29%) there was a decrease (<50%) while in six (17%) the decrease was more significant (>50%). Post-treatment MRI results did not correlate with either subjective symptoms or QOL results. Conclusion Polidocanol sclerotherapy were found to be an effective, safe, and well tolerated treatment option for low flow venous malformations. Routine MRI for follow-up appears redundant and may be omitted.
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Affiliation(s)
| | - Leo Keski-Nisula
- Department of Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Riitta Rautio
- Department of Interventional Radiology, Turku University Hospital, Turku, Finland
| | - Jussi Laranne
- Department of Otorhinolaryngology, Kokkola Central Hospital, Kokkola, Finland
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21
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Campos-de Sales S, Kato CNADO, de Noronha MS, Castro WH, Mesquita RA. Gingival varices treated with monoethanolamine oleate: A rare case report. J Clin Exp Dent 2018; 10:e192-e195. [PMID: 29670740 PMCID: PMC5899791 DOI: 10.4317/jced.53893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 12/06/2017] [Indexed: 11/08/2022] Open
Abstract
Varices are benign blood vessel lesions that are common in the head and neck regions. The aim of this case report is to highlight an uncommon case of gingival varices and its diagnosis and management. This is the second time that a case of varices has been reported at this site. Monoethanolamine oleate (MO) at a 2.5% concentration was used as the treatment. A 66-year-old woman presented spontaneous gingival bleeding in the region of the mandibular first and second left molars. A macula and gingival enlargement on the interproximal papillae were observed. No bleeding was observed during the oral examination. The clinical diagnosis was varices. The patient was given two sessions of sclerotherapy with 2.5% MO applied to the lesion, with 15 days between applications. The lesion showed total clinical resolution, and the patient is in follow-up. This paper reports a rare case of varices in the gingival mandible, with the diagnosis based on the patient’s age, time evolution of the lesion’s, and its clinical characteristics. The concentration of 2.5% MO is safe and efficient, a conservative treatment, and easy to apply.
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Affiliation(s)
- Sarah Campos-de Sales
- DDS, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | | | - Mariana-Saturnino de Noronha
- DDS, Msc student, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | - Wagner-Henriques Castro
- Professor, Msc, PhD, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | - Ricardo-Alves Mesquita
- Professor, Msc, PhD, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
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22
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Ribeiro MC, de Mattos Camargo Grossmann S, do Amaral MBF, de Castro WH, Navarro TP, Procopio RJ, da Silva TA, de Nazaré Alves de Oliveira Kato C, Mesquita RA. Effectiveness and safety of foam sclerotherapy with 5% ethanolamine oleate in the treatment of low-flow venous malformations in the head and neck region: a case series. Int J Oral Maxillofac Surg 2018; 47:900-907. [PMID: 29329829 DOI: 10.1016/j.ijom.2017.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/25/2017] [Accepted: 12/12/2017] [Indexed: 01/26/2023]
Abstract
The aim of this study was to evaluate the effectiveness and safety of 5% ethanolamine oleate (EO) foam in the treatment of low-flow venous malformations in the head and neck region. Seventeen consecutive patients (six male, 11 female) and 34 low-flow venous malformations were enrolled. The vascular anomalies ranged between 20mm and 80mm in size. The typical clinical indication was a swelling (88.2%) with a purple colour (85.3%); the most frequent location was the tongue (23.5%). Ethanolamine oleate foam was produced via the Tessari method and applied at 10mg per 1cm to the vascular anomalies. This process resulted in the highest clinical healing score in 64.7% of cases, and half of the patients reported a high level of satisfaction (score >9). In the majority of cases (88.2%), the patients reported that the pain immediately postoperative was mild or moderate. There were direct relationships between vascular anomaly size and the volume of EO applied, the number of sessions, and healing (P<0.05). No recurrence was observed during 6 months of follow-up. This case series showed the effectiveness and safety of 5% EO foam for the treatment of venous malformations in the head and neck region.
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Affiliation(s)
- M C Ribeiro
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - S de Mattos Camargo Grossmann
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Vale do Rio Verde Unincor, Belo Horizonte, Minas Gerais, Brazil
| | - M B F do Amaral
- Department of Oral and Maxillofacial Surgery, Baleia Hospital/CENTRARE, Belo Horizonte, Minas Gerais, Brazil
| | - W H de Castro
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - T P Navarro
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - R J Procopio
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - T A da Silva
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - C de Nazaré Alves de Oliveira Kato
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - R A Mesquita
- Department of the Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Almeida de Arruda JA, Andrade ES, Andrade RA, Pereira JRD, Callou G. Vascular Malformation of the Face: a Rare Case with Follow-up of 18 Years. Acta Stomatol Croat 2017; 51:332-335. [PMID: 29872239 PMCID: PMC5975454 DOI: 10.15644/asc51/4/8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Vascular malformations are structural anomalies in the blood vessels. They are present at birth and persist throughout life. These malformations can be classified according to the type of vessel involved. A port-wine stain is a vascular malformation characterized by an increased number of ectatic vessels in the dermal vascular plexus, which can be found in any part of the body, including the head and neck region. Over time, most of these stains result in soft tissue hypertrophy and this growth can cause severe facial deformity. Materials and Methods This study describes a rare case of a giant proliferative vascular anomaly arising from a port-wine stain on the face. Results The report highlights the continuous and proliferative growth of the malformation observed after follow-up of 18 years, as well as the difficulty in establishing the diagnosis due to the complexity and dimension of the lesion and the conditions related to the patient’s low socioeconomic status. Conclusions We have described a rare and unusual case report of a giant proliferative vascular malformation arising from a Port-wine stain on the face.
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Affiliation(s)
| | - Emanuel S Andrade
- Department of Oral and Maxillofacial Pathology, University of Pernambuco, PE, Brazil
| | - Richard A Andrade
- Department of Oral and Maxillofacial Pathology, University of Pernambuco, PE, Brazil
| | | | - Gerhilde Callou
- Department of Oral and Maxillofacial Pathology, University of Pernambuco, PE, Brazil
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24
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Campbell SJ, Locurcio L, Witherow H. Conservative management of an inoperable arteriovenous malformation. Br J Oral Maxillofac Surg 2017; 55:744-745. [DOI: 10.1016/j.bjoms.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 04/02/2017] [Indexed: 11/28/2022]
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