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Lin X, Chen Z, Wu G, Jiang H, Liu Z. Correlation between the miR-618 rs2682818 C>A polymorphism and venous malformation susceptibility. Biotechnol Appl Biochem 2024; 71:1164-1169. [PMID: 38804038 DOI: 10.1002/bab.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/11/2024] [Indexed: 05/29/2024]
Abstract
Venous malformations are the most common congenital vascular malformations, and the incidence rate is high. Previous studies have confirmed that a variety of polymorphisms within the miRNA functional region are associated with tumor susceptibility. We examined the correlation between miR-618 rs2682818 C>A and risk of developing venous malformation in a southern Chinese population (1113 patients and 1158 controls). TaqMan genotyping of miR-618 rs2682818 C>A was conducted utilizing real-time fluorescent quantitative PCR. The miR-618 rs2682818 polymorphism was not correlated with susceptibility to venous malformation (CA/AA vs. CC: adjusted odds ratio [AOR] = 1.00, 95% confidence interval [CI] = 0.81-1.25, p = 0.994; AA vs. CC/CA: AOR = 1.10, 95% CI = 0.73-1.65, p = 0.646). Stratified analysis of different subtypes of venous malformation revealed that there was no significant difference in the rs2682818 C>A polymorphism genotypes across these subtypes. Our results indicate that miR-618 rs2682818 C>A polymorphism is not correlated with the susceptibility to venous malformation.
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Affiliation(s)
- Xi Lin
- Department of Interventional Radiology and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zijian Chen
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guitao Wu
- Department of Interventional Radiology and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hua Jiang
- Department of Interventional Radiology and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenyin Liu
- Department of Interventional Radiology and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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2
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Stor MLE, Horbach SER, Lokhorst MM, Tan E, Maas SM, van Noesel CJM, van der Horst CMAM. Genetic mutations and phenotype characteristics in peripheral vascular malformations: A systematic review. J Eur Acad Dermatol Venereol 2024; 38:1314-1328. [PMID: 38037869 DOI: 10.1111/jdv.19640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/29/2023] [Indexed: 12/02/2023]
Abstract
Vascular malformations (VMs) are clinically diverse with regard to the vessel type, anatomical location, tissue involvement and size. Consequently, symptoms and disease impact differ significantly. Diverse causative mutations in more and more genes are discovered and play a major role in the development of VMs. However, the relationship between the underlying causative mutations and the highly variable phenotype of VMs is not yet fully understood. In this systematic review, we aimed to provide an overview of known causative mutations in genes in VMs and discuss associations between the causative mutations and clinical phenotypes. PubMed and EMBASE libraries were systematically searched on November 9th, 2022 for randomized controlled trials and observational studies reporting causative mutations in at least five patients with peripheral venous, lymphatic, arteriovenous and combined malformations. Study quality was assessed with the Newcastle-Ottawa Scale. Data were extracted on patient and VM characteristics, molecular sequencing method and results of molecular analysis. In total, 5667 articles were found of which 69 studies were included, reporting molecular analysis in a total of 4261 patients and 1686 (40%) patients with peripheral VMs a causative mutation was detected. In conclusion, this systematic review provides a comprehensive overview of causative germline and somatic mutations in various genes and associated phenotypes in peripheral VMs. With these findings, we attempt to better understand how the underlying causative mutations in various genes contribute to the highly variable clinical characteristics of VMs. Our study shows that some causative mutations lead to a uniform phenotype, while other causal variants lead to more varying phenotypes. By contrast, distinct causative mutations may lead to similar phenotypes and result in almost indistinguishable VMs. VMs are currently classified based on clinical and histopathology features, however, the findings of this systematic review suggest a larger role for genotype in current diagnostics and classification.
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Affiliation(s)
- M L E Stor
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - S E R Horbach
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - M M Lokhorst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - E Tan
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - S M Maas
- Department of Clinical Genetics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - C J M van Noesel
- Department of Pathology, Molecular Diagnostics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - C M A M van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
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Li J, Wei X, Sun Y, Chen X, Zhang Y, Cui X, Shu J, Li D, Cai C. Phosphoserine aminotransferase deficiency diagnosed by whole-exome sequencing and LC-MS/MS reanalysis: A case report and review of literature. Mol Genet Genomic Med 2024; 12:e2400. [PMID: 38546032 PMCID: PMC10976427 DOI: 10.1002/mgg3.2400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/26/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Phosphoserine aminotransferase deficiency (PSATD) is an autosomal recessive disorder associated with hypertonia, psychomotor retardation, and acquired microcephaly. Patients with PSATD have low concentrations of serine in plasma and cerebrospinal fluid. METHODS We reported a 2-year-old female child with developmental delay, dyskinesia, and microcephaly. LC-MS/MS was used to detect amino acid concentration in the blood and whole-exome sequencing (WES) was used to identify the variants. PolyPhen-2 web server and PyMol were used to predict the pathogenicity and changes in the 3D model molecular structure of protein caused by variants. RESULTS WES demonstrated compound heterozygous variants in PSAT1, which is associated with PSATD, with a paternal likely pathogenic variant (c.235G>A, Gly79Arg) and a maternal likely pathogenic variant (c.43G>C, Ala15Pro). Reduced serine concentration in LC-MS/MS further confirmed the diagnosis of PSATD in this patient. CONCLUSIONS Our findings demonstrate the importance of WES combined with LC-MS/MS reanalysis in the diagnosis of genetic diseases and expand the PSAT1 variant spectrum in PSATD. Moreover, we summarize all the cases caused by PSAT1 variants in the literature. This case provides a vital reference for the diagnosis of future cases.
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Affiliation(s)
- Jiaci Li
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Tianjin Pediatric Research InstituteTianjinChina
- Tianjin Key Laboratory of Birth Defects for Prevention and TreatmentTianjinChina
| | - Xinping Wei
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Department of NeurologyTianjin Children's HospitalTianjinChina
| | - Yuchen Sun
- College of Traditional Chinese medicineTianjin University of Traditional Chinese MedicineTianjinChina
| | - Xiaofang Chen
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
| | - Ying Zhang
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Tianjin Medical UniversityGraduate College of Tianjin Medical UniversityTianjinChina
| | - Xiaoyu Cui
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
| | - Jianbo Shu
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Tianjin Pediatric Research InstituteTianjinChina
- Tianjin Key Laboratory of Birth Defects for Prevention and TreatmentTianjinChina
| | - Dong Li
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Department of NeurologyTianjin Children's HospitalTianjinChina
| | - Chunquan Cai
- Tianjin Children's Hospital (Children's Hospital, Tianjin University)TianjinChina
- Tianjin Pediatric Research InstituteTianjinChina
- Tianjin Key Laboratory of Birth Defects for Prevention and TreatmentTianjinChina
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Zhang G, Wang X, Zhang Q. Cdh11: Roles in different diseases and potential value in disease diagnosis and treatment. Biochem Biophys Rep 2023; 36:101576. [PMID: 38034129 PMCID: PMC10682823 DOI: 10.1016/j.bbrep.2023.101576] [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: 09/12/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Cadherin is a homophilic, Ca2+-dependent cell adhesion glycoprotein that mediates cell-cell adhesion. Among them, Cadherin-11 (CDH11), as a classical cadherin, participates in and influences many crucial aspects of human growth and development. Furthermore, The involvement of CDH11 has been identified in an increasing number of diseases, primarily including various tumorous diseases, fibrotic diseases, autoimmune diseases, neurodevelopmental disorders, and more. In various tumorous diseases, CDH11 acts not only as a tumor suppressor but can also promote migration and invasion of certain tumors through various mechanisms. Likewise, in non-tumorous diseases, CDH11 remains a pivotal factor in disease progression. In this context, we summarize the specific functionalities and mechanisms of CDH11 in various diseases, aiming to gain a more comprehensive understanding of the potential value of CDH11 in disease diagnosis and treatment. This endeavor seeks to provide more effective diagnostic and therapeutic strategies for clinical management across diverse diseases.
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Affiliation(s)
- Gaoxiang Zhang
- Weifang Medical University, Weifang, Shandong, 261000, China
| | - Xi Wang
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250013, China
| | - Qingguo Zhang
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250013, China
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Wang X, Chen H, Song F, Zuo K, Chen X, Zhang X, Liang L, Ta Q, Zhang L, Li J. Resveratrol: a potential medication for the prevention and treatment of varicella zoster virus-induced ischemic stroke. Eur J Med Res 2023; 28:400. [PMID: 37794518 PMCID: PMC10552394 DOI: 10.1186/s40001-023-01291-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Infection rate of varicella zoster virus (VZV) is 95% in humans, and VZV infection is strongly associated with ischemic stroke (IS). However, the underlying molecular mechanisms of VZV-induced IS are still unclear, and there are no effective agents to treat and prevent VZV-induced IS. OBJECTIVE By integrating bioinformatics, this study explored the interactions between VZV and IS and potential medication to treat and prevent VZV-induced IS. METHODS In this study, the VZV and IS datasets from the GEO database were used to specify the common genes. Then, bioinformatics analysis including Gene Ontology, Kyoto Encyclopedia Genes Genomes and Protein-Protein Interaction network analysis was performed. Further, the hub genes, transcription factor (TF) gene interactions, TF-miRNA co-regulatory network and potential drug were obtained. Finally, validation was performed using molecular docking and molecular dynamics simulations. RESULTS The potential molecular mechanisms of VZV-induced IS were studied using multiple bioinformatics tools. Ten hub genes were COL1A2, DCN, PDGFRB, ACTA2, etc. TF genes and miRNAs included JUN, FOS, CREB, BRCA1, PPARG, STAT3, miR-29, etc. A series of mechanism may be involved, such as inflammation, oxidative stress, blood-brain barrier disruption, foam cell generation and among others. Finally, we proposed resveratrol as a potential therapeutic medicine for the prevention and treatment of VZV-induced IS. Molecular docking and molecular dynamics results showed that resveratrol and hub genes exhibited strong binding score. CONCLUSIONS Resveratrol could be an alternative for the prevention and treatment of VZV-IS. More in vivo and in vitro studies are needed in the future to fully explore the molecular mechanisms between VZV and IS and for medication development.
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Affiliation(s)
- Xu Wang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Hao Chen
- Department of Neurovascular Surgery, First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Feiyu Song
- Jilin Connell Pharmaceutical Co., Ltd, JilinJilin, 132013, China
| | - Kuiyang Zuo
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Xin Chen
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Xu Zhang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Lanqian Liang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Qiyi Ta
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Lin Zhang
- China-Japan Union Hospital of Jilin University, Changchun, 130021, Jilin, China.
| | - Jinhua Li
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China.
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Patel ND, Chong AT, Kolla AM, Mabud TS, Kulkarni K, Masrouha K, Taslakian B, Bertino FJ. Venous Malformations. Semin Intervent Radiol 2022; 39:498-507. [PMID: 36561936 PMCID: PMC9767763 DOI: 10.1055/s-0042-1757940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Venous malformations, the most common type of vascular malformation, are slow-flow lesions resulting from disorganized angiogenesis. The International Society for the Study of Vascular Anomalies (ISSVA) classification offers a categorization scheme for venous malformations based on their genetic landscapes and association with congenital overgrowth syndromes. Venous malformations present as congenital lesions and can have broad physiologic and psychosocial sequelae depending on their size, location, growth trajectory, and tissue involvement. Diagnostic evaluation is centered around clinical examination, imaging evaluation with ultrasound and time-resolved magnetic resonance imaging, and genetic testing for more complex malformations. Interventional radiology has emerged as first-line management of venous malformations through endovascular treatment with embolization, while surgery and targeted molecular therapies offer additional therapeutic options. In this review, an updated overview of the genetics and clinical presentation of venous malformations in conjunction with key aspects of diagnostic imaging and treatment are discussed.
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Affiliation(s)
- Nihal D. Patel
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Anthony T. Chong
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Avani M. Kolla
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Tarub S. Mabud
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Kopal Kulkarni
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Karim Masrouha
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York
| | - Bedros Taslakian
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Frederic J. Bertino
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Serio VB, Palmieri M, Loberti L, Granata S, Fallerini C, Vaghi M, Renieri A, Pinto AM. Nosological and Theranostic Approach to Vascular Malformation through cfDNA NGS Liquid Biopsy. J Clin Med 2022; 11:jcm11133740. [PMID: 35807022 PMCID: PMC9267326 DOI: 10.3390/jcm11133740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 02/06/2023] Open
Abstract
Several different nosological classifications have been used over time for vascular malformations (VMs) since clinical and pathological signs are largely overlapping. In a large proportion of cases, VMs are generated by somatic mosaicism in key genes, belonging to a few different molecular pathways. Therefore, molecular characterization may help in the understanding of the biological mechanisms related to the development of pathology. Tissue biopsy is not routinely included in the diagnostic path because of the need for fresh tissue specimens and the risk of bleeding. Bypassing the need for bioptic samples, we took advantage of the possibility of isolating cell-free DNA likely released by the affected tissues, to molecularly characterize 53 patients by cfDNA-NGS liquid biopsy. We found a good match between the identified variant and the clinical presentation. PIK3CA variants were found in 67% of Klippel Trenaunay Syndrome individuals; KRAS variants in 60% of arteriovenous malformations; MET was mutated in 75% of lymphovenous malformations. Our results demonstrate the power of cfDNA-NGS liquid biopsy in VMs clinical classification, diagnosis, and treatment. Indeed, tailored repurposing of pre-existing cancer drugs, such as PIK3CA, KRAS, and MET inhibitors, can be envisaged as adjuvant treatment, in addition to surgery and/or endovascular treatment, in the above-defined VMs categories, respectively.
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Affiliation(s)
- Viola Bianca Serio
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Maria Palmieri
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Lorenzo Loberti
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
| | - Stefania Granata
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
| | - Chiara Fallerini
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Massimo Vaghi
- Radiologia Interventistica, Ospedale Maggiore di Crema, Largo Ugo Dossena, 2-26013 Crema, Italy;
- Chirurgia Vascolare, Ospedale Maggiore di Crema, Largo Ugo Dossena, 2-26013 Crema, Italy
| | - Alessandra Renieri
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
- Correspondence: ; Tel.: +39-0577-233303; Fax: +39-0577-233325
| | - Anna Maria Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
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Davila-Villa P, Padilla-Rosas M, Meza-García G, Nava-Villalba M. Vascular malformation of tongue with phlebothrombosis/phlebolith in a young patient: an unusual presentation. BMJ Case Rep 2022; 15:e245850. [PMID: 35256361 PMCID: PMC8905980 DOI: 10.1136/bcr-2021-245850] [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] [Accepted: 02/15/2022] [Indexed: 11/04/2022] Open
Abstract
Venous malformations (VMs) are a type of vascular malformation formed by abnormally developed venous channels, with variations in size, pathway and thickness and are therefore a condition which can predispose to thrombosis. We present the case of a VM associated with phlebothrombosis/phlebolith, located on the lingual dorsum of a 20-year-old female patient. Clinical examination revealed a nodule of approximately 5 mm in diameter involving the anterior third of lingual dorsum, with a firm, compressible and non-pulsatile consistency. Histopathologically, the lesion revealed a VM with evidence of phlebothrombosis and phlebolith development. Although VMs manifest infrequently in this age group, they should be considered in the differential diagnosis of other lesions with similar characteristics in young people.
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Affiliation(s)
- Perla Davila-Villa
- Microbiology and Pathology, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Miguel Padilla-Rosas
- Comprehensive Dental Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | - Mario Nava-Villalba
- Microbiology and Pathology, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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