1
|
Dean A, Estévez O, Centella C, Sanjuan-Sanjuan A, Sánchez-Frías ME, Alamillos FJ. Surgical Navigation and CAD-CAM-Designed PEEK Prosthesis for the Surgical Treatment of Facial Intraosseous Vascular Anomalies. J Clin Med 2024; 13:4602. [PMID: 39200744 PMCID: PMC11354805 DOI: 10.3390/jcm13164602] [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: 07/14/2024] [Revised: 07/28/2024] [Accepted: 08/01/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Intraosseous vascular anomalies in the facial skeleton present significant diagnostic and therapeutic challenges due to complex anatomy. These anomalies represent about 0.5-1% of bony neoplastic and tumor-like lesions, usually presenting as a firm, painless mass. Most described intraosseous vascular malformations are venous malformations (VMs) and, more rarely, arteriovenous malformations. Objectives: The objectives of this work are to show our experience, protocol and the applications of computer planning, virtual surgery, CAD-CAM design, surgical navigation, and computer-assisted navigated piezoelectric surgery in the treatment of facial intraosseous vascular anomalies and to evaluate the advantages and disadvantages. Methods: Three females and one male with periorbital intraosseous vascular anomalies were treated using en-block resection and immediate reconstruction with a custom-made PEEK prosthesis. One lesion was in the supraorbital rim and orbital roof, one in the frontal bone and orbital roof, and two in the zygomatic region. We accomplished the resection and reconstruction of the lesion using virtual planning, CAD-CAM design, surgical navigation and piezoelectric device navigation. Results: There were no complications related to the surgery assisted with navigation. With an accuracy of less than 1 mm, the procedure may be carried out in accordance with the surgical plan. The surgeon's degree of uncertainty during deep osteotomies and in locations with low visibility was decreased by the use of the navigated piezoelectric device. Conclusions: Resection and reconstruction of facial intraosseous vascular anomalies benefit from this new surgical strategy using CAD-CAM technologies, computer-assisted navigated piezoelectric surgery, and surgical navigation.
Collapse
Affiliation(s)
- Alicia Dean
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Orlando Estévez
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Concepción Centella
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Alba Sanjuan-Sanjuan
- Maxillofacial Surgery Department, Charleston Area Medical Center, Charleston, WV 25301, USA;
| | - Marina E. Sánchez-Frías
- Pathology Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain;
| | - Francisco J. Alamillos
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| |
Collapse
|
2
|
Ethunandan M. Management of Midfacial and Skull Vault Osseous Vascular Lesions. Oral Maxillofac Surg Clin North Am 2024; 36:61-72. [PMID: 37821289 DOI: 10.1016/j.coms.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
Collapse
Affiliation(s)
- Madan Ethunandan
- Oral & Maxillofacial Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK; Oral & Maxillofacial Surgery, Sri Ramchandra Institute of Higher Education and Research, Prour, Chennai, 600116, India.
| |
Collapse
|
3
|
Strauss SB, Steinklein JM, Phillips CD, Shatzkes DR. Intraosseous Venous Malformations of the Head and Neck. AJNR Am J Neuroradiol 2022; 43:1090-1098. [PMID: 35863785 PMCID: PMC9575427 DOI: 10.3174/ajnr.a7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022]
Abstract
Intraosseous venous malformations represent a subtype of venous vascular malformations that arise primarily in bone. In the head and neck, intraosseous venous malformations are most frequently found in the skull, skull base, and facial skeleton, with location at the geniculate ganglion of the facial nerve perhaps the most widely recognized. These non-neoplastic lesions are characterized by dilated venous channels with characteristic internal bony spicules on CT but may present with a more complex appearance on MR imaging and may share features with more aggressive lesions. Further confounding the imaging-based diagnosis of intraosseous venous malformation is the frequent misrepresentation of these lesions as hemangiomas in the radiology and clinical literature, as well as in daily practice. Because most intraosseous venous malformations can be left alone, their correct diagnosis may spare a patient unnecessary concern and intervention.
Collapse
Affiliation(s)
- S B Strauss
- From the Department of Radiology (S.B.S., C.D.P.), Weill Cornell Medical Center/Weill Cornell Medical Center, New York, New York
| | - J M Steinklein
- Department of Radiology (J.M.S., D.R.S.), Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - C D Phillips
- From the Department of Radiology (S.B.S., C.D.P.), Weill Cornell Medical Center/Weill Cornell Medical Center, New York, New York
| | - D R Shatzkes
- Department of Radiology (J.M.S., D.R.S.), Zucker School of Medicine at Hofstra/Northwell, New York, New York
| |
Collapse
|
4
|
MONEGHINI L, ZOCCA A. Within vascular malformations: histological confirmations and further aspects. ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2021. [DOI: 10.23736/s1824-4777.21.01486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
5
|
Liberale C, Rozell-Shannon L, Moneghini L, Nocini R, Tombris S, Colletti G. Stop Calling Me Cavernous Hemangioma! A Literature Review on Misdiagnosed Bony Vascular Anomalies. J INVEST SURG 2020; 35:141-150. [DOI: 10.1080/08941939.2020.1824041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | - Riccardo Nocini
- Department of Otorhinolaryngology, University Hospital of Verona, Verona, Italy
| | | | | |
Collapse
|
6
|
Li HB, Lv JF, Lu N, Lv ZS. Mechanical intestinal obstruction due to isolated diffuse venous malformations in the gastrointestinal tract: A case report and review of literature. World J Clin Cases 2020; 8:157-167. [PMID: 31970182 PMCID: PMC6962082 DOI: 10.12998/wjcc.v8.i1.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Isolated gastrointestinal venous malformations (GIVMs) are extremely rare congenital developmental abnormalities of the venous vasculature. Because of their asymptomatic nature, the diagnosis is often quite challenging. However, as symptomatic GIVMs have nonspecific clinical manifestations, misdiagnosis is very common. Here, we report a case of isolated diffuse GIVMs inducing mechanical intestinal obstruction. A literature review was also conducted to summarize clinical features, diagnostic points, treatment selections and differential diagnosis in order that doctors may have a comprehensive understanding of this disease.
CASE SUMMARY A 50-year-old man presented with recurrent painless gastrointestinal bleeding for two months and failure to pass flatus and defecate with nausea and vomiting for ten days. Digital rectal examination found bright red blood and soft nodular masses 3 cm above the anal verge. Computed tomography showed that part of the descending colon and rectosigmoid colon was thickened with phleboliths in the intestinal wall. Colonoscopy exhibited bluish and reddish multinodular submucosal masses and flat submucosal serpentine vessels. Endoscopic ultrasonography showed anechoic cystic spaces within intestinal wall. The lesions were initially thought to be isolated VMs involving part of the descending colon and rectosigmoid colon. Laparoscopic subtotal proctocolectomy, pull-through transection and coloanal anastomosis and ileostomy were performed. Histopathology revealed intact mucosa and dilated, thin-walled blood vessels in the submucosa, muscularis, and serosa involving the entire colorectum. The patient recovered with complete symptomatic relief during the 52-mo follow-up period.
CONCLUSION The diagnosis of isolated GIVMs is challenging. The information presented here is significant for the diagnosis and management of symptoms.
Collapse
Affiliation(s)
- Han-Bo Li
- Department of General Surgery, Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
- Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Jing-Fang Lv
- Department of General Surgery, Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ning Lu
- Department of General Surgery, Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zong-Shun Lv
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| |
Collapse
|
7
|
Large Orbital Pediatric Intraosseous Hemangioma. Case Rep Ophthalmol Med 2020; 2020:5728691. [PMID: 31976106 PMCID: PMC6961600 DOI: 10.1155/2020/5728691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/19/2019] [Indexed: 11/17/2022] Open
Abstract
A five-year-old male presenting with progressive right facial swelling underwent multiple biopsies before being diagnosed with a polyostotic frontal-zygomatic primary intraosseous hemangioma. Intraosseous hemangiomas are rare, more frequently afflict adult females, and very rarely involve the orbit. Our case with bony destruction and surrounding soft tissue mass measured 5.3 cm in a child mimicked a more ominous malignancy. This case is unique with its rapid progression and largest reported size, leading to additional challenges such as difficulty in achieving an adequate tissue sample and in the surgical management with respect to significant blood loss in a small child.
Collapse
|
8
|
Vertebral Intraosseous Vascular Malformations in a Familial Cerebral Cavernous Malformation Population: Prevalence, Histologic Features, and Associations With CNS Disease. AJR Am J Roentgenol 2019; 214:428-436. [PMID: 31825263 DOI: 10.2214/ajr.19.21492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE. The purpose of this study was to investigate whether MRI-typical and MRI-atypical intraosseous vascular malformations are associated with familial cerebral cavernous malformation (FCCM). MATERIALS AND METHODS. In a retrospective matched case-control study, two radiologists reviewed the spinal imaging, both CT and MRI, of 22 patients with FCCM seen between 2006 and 2017 and of age- and sex-matched control subjects for MRI-typical and MRI-atypical intraosseous vascular malformations. Quantitative analysis of lesions identified included vertebral level, size, and number of lesions. Pathologic samples from two lesions were analyzed for histologic and immunohistochemical features. Whether the presence of typical, atypical, and total intraosseous vascular malformations differed between patients and control subjects was tested. For patients with complete spinal imaging, whether intraosseous vascular malformations were associated with age, sex, brain lesion count, and spinal lesion count was also tested. RESULTS. MRI-atypical intraosseous vertebral malformations were more commonly present in patients with FCCM (p = 0.003). Sixteen lesions were found in nine patients and none in the control group. The numbers of MRI-typical intraosseous vascular malformations were similar between patients and control subjects (p = 0.480). Age was associated with typical intraosseous vascular malformations (p = 0.027), though not with atypical malformations. MRI-atypical malformations were larger (mean diameter double) than MRI-typical malformations (p = 0.023). Histologic analysis of two lesions from different patients with pathologic collapse revealed the same histologic features consistent with combined capillary-venous malformations. CONCLUSION. Vertebral capillary-venous malformations (MRI-atypical intraosseous vascular malformations) are common in patients with FCCM and may have a more aggressive clinical course than MRI-typical malformations.
Collapse
|
9
|
Intraosseous venous malformation of the craniofacial region: diagnosis and management. Br J Oral Maxillofac Surg 2019; 57:1143-1147. [DOI: 10.1016/j.bjoms.2019.10.308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022]
|
10
|
Steele L, Zbeidy S, Thomson J, Flohr C. How is the term haemangioma used in the literature? An evaluation against the revised ISSVA classification. Pediatr Dermatol 2019; 36:628-633. [PMID: 31318089 DOI: 10.1111/pde.13885] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES The International Society for the Study of Vascular Anomalies (ISSVA) classification separates vascular anomalies into vascular malformations and vascular tumors. However, misdiagnoses and misperceptions still persist around the use of the term "hemangioma." We assessed whether the term "haemangioma" (British spelling) was used as part of ISSVA terminology in the literature. METHODS We searched PubMed for all English-language publications containing the British spelling "haemangioma" in the title or abstract from January 1, 2015 to December 31, 2016. Each paper was judged by two independent reviewers, with conflicts resolved by senior review. RESULTS By the standard of the 2014 ISSVA classification, 126/195 (64.6%) publications used incorrect terminology for vascular anomalies. This was reduced to 118/195 (60.5%) when using the 2018 ISSVA classification. The most commonly misused terms were cavernous haemangioma (27.1%), haemangioma without further specification (26.3%), and hepatic/liver haemangioma (12.7%). Age was a significant predictor of accuracy of terminology (P = 0.01), with a higher accuracy in children. Correct usage also varied by the site of the vascular anomaly, being highest for lesions of the skin (76.5%) followed by muscle (58.3%), soft tissue (23.5%), bone (21.4%), viscera (7.7%), and eye (0.0%) (P = 0.02). CONCLUSIONS The term "haemangioma" is frequently used incorrectly by the standards of the 2014 and 2018 ISSVA classifications. Correct terminology is important as the natural history and treatment options vary depending on the type of vascular anomaly.
Collapse
Affiliation(s)
- Lloyd Steele
- Department of Dermatology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Sarah Zbeidy
- Department of Dermatology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Jason Thomson
- Department of Dermatology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
11
|
Clinical and Molecular Study of ELMO-2-Related Massive Intraosseous Vascular Malformations: Lessons Learned From 25 Years of Follow-up. Ann Plast Surg 2019; 83:293-299. [PMID: 30882408 DOI: 10.1097/sap.0000000000001786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Massive intraosseous vascular malformations, a relatively rare entity in the vascular malformation spectrum, deserves attention as involving the membranous bones of the craniofacial skeleton and may lead to severe life-threatening hemorrhages and even death. The main aim of this study was to summarize the 25 years of clinical experience with these vascular malformation osseous patients, focus on the molecular and genetic aspect of the clinical entity, and to emphasize the certain challenging conditions in the treatment of these patients. All the patients appeared to be unaffected at birth, whereas initial symptoms occasionally began with painless swelling in the mandible in early childhood. The disease was progressive in behavior especially in the pubertal ages and was specifically involving the maxilla and mandible of the craniofacial skeleton in all the patients. Calvarium and cranial base were the second most common involved regions among these patients (62.5%). Clavicular (50%), costal (25%), and vertebral (25%) involvements were also a significant manifestation of the disease. Tissue samples obtained from the affected individuals and the blood samples from their families were matched, revealing a loss of function mutation in the ELMO-2 gene of chromosome 20 leading to developmental abnormality of the vascular structures via RAC1 signaling and leading to abnormally enlarged vessels in the intraosseus portion of the membranous bone. Immunohistochemical staining revealed positive CD31 and smooth muscle actin staining but negative proliferation and maturity markers such as Ki-67, desmin, h-caldesmon, and myofibroblast-like desmin. The follow-up of 3 of 5 patients ended up with mortality (60%). vascular malformation osseous is intraosseous vascular malformation with aggressive biological behavior associated with ELMO-2 gene mutation. Further studies for obtaining prenatal diagnosis and achievement of gene therapy should take place. As the disease rapidly progresses as the affected individual grows, surgical interventions should be taken into consideration before the initiation of complications.
Collapse
|
12
|
Hamada M, Shimizu H, Takasu A, Nishiyama K, Yura Y. Piezosurgery for Intraosseous Venous Malformation of the Mandible. Ann Maxillofac Surg 2019; 8:333-336. [PMID: 30693258 PMCID: PMC6327793 DOI: 10.4103/ams.ams_189_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intraosseous venous malformation of the mandible is rare. A 59-year-old woman was referred to our hospital for evaluation of a radiolucent lesion in the left body of the mandible that had been detected on a routine radiologic dental checkup. The patient wished for follow-up rather than operation. After 2 years’ follow-up, the radiolucent lesion had slowly grown, and the patient decided to have an operation. The lesion was removed surgically using the piezosurgery system, and conservation of the inferior alveolar nerve was achieved under general anesthesia. After operation, she reported an initial change in sensation (paresthesia). The sensitivity was recovered after 6 months. Patient prognosis has been good to date, with no symptoms indicating recurrence. We used to treat intraosseous venous malformations using the piezosurgery system. The present report describes a patient with intraosseous venous malformation of the mandible by complete excision and conservation of the nerve. It was useful to use piezosurgery for conservation of inferior alveolar nerve.
Collapse
Affiliation(s)
- Masakazu Hamada
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hidetaka Shimizu
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Ayako Takasu
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kyoko Nishiyama
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Yoshiaki Yura
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| |
Collapse
|
13
|
Three Skulls Dating from the French Revolutionary Years Diagnosed with Tinea Capitis: A Paleopathologic Approach. J Craniofac Surg 2018; 29:1713-1716. [PMID: 30169450 DOI: 10.1097/scs.0000000000004728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The Musée Dupuytren was a Parisian pathology museum established in 1835. This museum hosted 3 skulls with severe craniofacial lesions initially tagged as aggressive forms of tinea capitis. The aim of this study was to investigate these specimens and discuss the initial diagnosis. Historical investigations were conducted based on the biographic data from the tags of the 3 skulls and entries on the catalog of the museum. Age was determined using dentition and the patency of cranial base synchondroses. The computed tomography scans were performed using standard medical devices. The 3 skulls were from the late 18th to early 19th century. Skull № 1 was a 5-year-old child and presented with microcephaly and extensive vault osteolysis compatible with an aggressive benign lesion, a malignant tumor, or a chronic infection. Skull № 2 was a 12- to 18-year-old teenager and presented with symmetrical porotic hyperostosis compatible with undernutrition and various hematologic conditions causing prolonged anemia, but also with chronic inflammation and/or infection. Skull № 3 was also from a 12- to 18-year-old teenager and presented with focal temporal osteolysis compatible with an aggressive benign or a low-grade malignant temporal soft-tissue lesion or with chronic infection. These skulls contribute to the understanding of the concept of tinea in the 19th century. They are furthermore windows on the sanitary and social conditions in Paris in the years following the French revolution and during the Napoleonian wars.
Collapse
|
14
|
Goto Y, Sasajima H, Furuno Y, Kawabe T, Ohwada K, Yamanaka T, Tatsuzawa K, Hashimoto N. Unusual Presentations of Pediatric Skull Hemangiomas: Report of Two Cases. World Neurosurg 2018; 119:20-24. [PMID: 30075263 DOI: 10.1016/j.wneu.2018.07.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Intraosseous hemangioma is a rare bone tumor, accounting for 0.7%-1.0% of all bone tumors. It can occur at any age, but only 9% of cases are younger than 10 years old. Although this tumor is usually slow-growing and clinically silent, we experienced 2 pediatric patients undergoing surgery for skull hemangioma who presented with uncommon clinical manifestations. CASE DECRIPTION Case 1 was a 9-year-old boy who presented with sudden onset of headache and was referred to our hospital. Radiologic images revealed an osteolytic oval lesion in the right parietal bone and acute subdural hemorrhage in the right cerebral hemisphere. The right parietal lesion was removed surgically. The lesion was found to have grown into the dura and to be adherent to the pia matter. The removed lesion was histologically confirmed to be a hemangioma. Case 2 was an 8-year-old girl who was referred to our hospital with an elastic mass that had been slowly enlarging for 7 years. Radiologic images revealed an osteolytic oval lesion in the right parietal bone. Surgical removal was thus planned. The lesion was found to be attached to the dura, and we removed the lesion with the surrounding bone and attached dura. Histologic examination confirmed the lesion to be a hemangioma. CONCLUSIONS Although skull hemangiomas show clinical heterogeneity, surgical removal is usually diagnostic and leads to good patient outcomes. On occasion, however, this tumor causes secondary changes in the dura, such that dural incision and dural plasty should be planned in advance of lesion removal.
Collapse
Affiliation(s)
- Yukihiro Goto
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
| | - Hiroyasu Sasajima
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Yuichi Furuno
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Takuya Kawabe
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Kei Ohwada
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Takumi Yamanaka
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Kazunori Tatsuzawa
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Naoya Hashimoto
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| |
Collapse
|
15
|
Epithelioid hemangioma of the scapula treated with chemoembolization and microwave ablation: Α case report. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2018; 52:157-161. [PMID: 28159479 PMCID: PMC6136344 DOI: 10.1016/j.aott.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/09/2016] [Accepted: 01/02/2017] [Indexed: 01/20/2023]
Abstract
Bone epithelioid hemangiomas are classified within benign vascular tumours but are commonly misdiagnosed as low-grade angiosarcomas or epithelioid hemangioendotheliomas. Current therapeutic interventions include various treatment options but local recurrence or distal lymph node involvement has been reported. We report a rare case of scapular epithelioid hemangioma that was initially treated using a combination of chemoembolization and microwave ablation. This combination has not been previously reported in the literature regarding the management of this tumour. A year after the first course of treatment, the tumour size has been reduced more than 70% and the patient has remarkable clinical improvement. Results reported in this case study demonstrated that combination of chemoembolization and microwave ablation is a feasible, safe and effective technique in the treatment of bone epithelioid hemangiomas. Even if the tumour is still present afterwards, a substantially smaller surgical excision will be needed.
Collapse
|
16
|
Taleb R, Koutlas IG, Argyris PP. Immunohistochemical and histochemical characterization of intraosseous arteriovenous malformations of the jaws: analysis of 16 cases with emphasis on GLUT-1 immunophenotype. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:165-174. [PMID: 28602263 DOI: 10.1016/j.oooo.2017.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/12/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Intraosseous vascular lesions of the craniofacial region are rare and may cause diagnostic and therapeutic challenges. The purpose of this study was to characterize 16 cases of intraosseous arteriovenous malformations (AVMs) affecting the jaws. STUDY DESIGN Immunohistochemical evaluation was performed using antibodies against α-smooth muscle actin (α-SMA), desmin, CD31, D2-40, and glucose transporter 1 (GLUT-1). Staining with elastic Verhoeff-Van Gieson and Masson trichrome histochemical stains was also performed. RESULTS No gender predilection (female:male ratio = 1:1) was observed, with patients' mean age being 50.8 years (SD of ±13.9; range 28-71 years). Predilection for the mandible was observed (12 of 16 [75%]). Immunohistochemically, diffuse endothelial CD31 staining was noted, and α-SMA strongly highlighted smooth muscle cells and pericytes. Desmin-positive vessels were identified in 9 of 16 AVMs (56.3%). D2-40 was uniformly negative in all specimens. AVMs were negative for GLUT-1 (11 of 14 [78.6%]) except for 2 cases (2 of 14 [14.3%]) exhibiting focal limited cytoplasmic GLUT-1 immunoreactivity. One case was equivocal for GLUT-1. Masson trichrome highlighted smooth muscle cells, and elastic fibers were identified in thick-walled arteries. CONCLUSIONS AVMs of the jaws generally lack expression of GLUT-1, similar to soft tissue vascular malformations. Clinicoradiographic features of intraosseous AVMs in the present study were consistent with the findings of previous studies, although mean age was higher.
Collapse
Affiliation(s)
- Reda Taleb
- Clinical Assistant Professor, Division of Oral and Maxillofacial Surgery, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ioannis G Koutlas
- Associate Professor, Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Prokopios P Argyris
- Postdoctoral Fellow, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.
| |
Collapse
|
17
|
Vaezeafshar R, Liu SY, Sidell D. Inferior alveolar nerve hemangioma. Laryngoscope 2016; 126:2168-70. [PMID: 26863892 DOI: 10.1002/lary.25869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/11/2022]
Abstract
A 14-year-old male presented with lower lip numbness and a slowly enlarging mandibular mass. Computed tomography demonstrated an expansile lesion centered in the marrow space of the left mandibular body, extending along the course of the inferior alveolar nerve (IAN), and expanding the mental foramen. Preoperative diagnosis was consistent with an IAN schwannoma. Surgical planning was performed using PROPLAN CMF software. The lesion was approached via a sagittal split osteotomy and excised en bloc with the IAN. Final pathology demonstrated a capillary hemangioma originating from the inferior alveolar nerve. Based on a detailed PubMed search, this is the first capillary hemangioma of the inferior alveolar nerve reported in the literature. Laryngoscope, 126:2168-2170, 2016.
Collapse
Affiliation(s)
- Reza Vaezeafshar
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, U.S.A
| | - Stanley Y Liu
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, U.S.A
| | - Douglas Sidell
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, U.S.A
| |
Collapse
|