1
|
Wang J, Yang Y, Guo J, Yao Y, Dong L, Mou Y, Zhang Y, Song X. Cervical lymphangioma in adults: A report of seven cases and review of the literature. Laryngoscope Investig Otolaryngol 2022; 7:751-756. [PMID: 35734075 PMCID: PMC9194990 DOI: 10.1002/lio2.801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/07/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cervical lymphangioma usually occurs in children and is relatively rare in adults. The purpose of this study was to investigate the characteristics of cervical lymphangiomas in adults. Methods We retrospectively reviewed the medical records and analyzed clinical data obtained from seven adult patients who suffered from cervical lymphangioma from January 2008 to June 2021. Results Five (71.43%) of seven cases were asymptomatic and four (57.14%) lymphangiomas had a maximum diameter ≥ 10 cm. Each cervical lymphangioma was located adjacent to the carotid sheath. All the cervical lymphangiomas were completely surgically excised and were pathologically diagnosed as cystic lymphangioma. After a median 32 months follow-up period, no recurrence was observed. Conclusion Cervical lymphangiomas from adults are often large asymptomatic masses infiltrating or adjacent to surrounding vital structures which brings many difficulties to the surgery, requiring an experienced surgeon to remove the mass.
Collapse
Affiliation(s)
- Jianwei Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Yujuan Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Jing Guo
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Yao Yao
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Luchao Dong
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Yakui Mou
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Yu Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| | - Xicheng Song
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases
| |
Collapse
|
2
|
Chen H, Ren C, Zhang L, Zhong Y. Management of a neonatal giant lymphatic malformations with dyspnea. Asian J Surg 2022; 45:1910-1911. [PMID: 35430156 DOI: 10.1016/j.asjsur.2022.03.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hezhou Chen
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 11731, Sichuan Province, China
| | - Chunnian Ren
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 11731, Sichuan Province, China
| | - Libing Zhang
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 11731, Sichuan Province, China
| | - You Zhong
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 11731, Sichuan Province, China.
| |
Collapse
|
3
|
Gorostidi F, Glasson N, Salati V, Sandu K. Pediatric vascular anomalies with airway compromise. J Oral Pathol Med 2022; 51:888-896. [PMID: 35347777 PMCID: PMC10084185 DOI: 10.1111/jop.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/08/2022] [Indexed: 11/27/2022]
Abstract
Vascular anomalies are rare lesions of diverse nature that may affect the head and neck region. Any mass in or around the upper airway has the potential to obstruct or compromise it. The absolute priority, before etiologic treatment, is the evaluation of the risk for the airway and its management. Prenatal diagnosis of an upper airway obstruction requires a planned delivery in a center having a specialized team experienced in managing a compromised feto-neonatal airway, and who could perform an ex-utero intrapartum treatment to secure the airway. Even after birth, the airway remains central in the patient's overall management. Signs and symptoms of airway compromise must be evaluated keeping in mind the specific requirements of infants and small children and being aware that rapid worsening may occur. The treatment is then tailored to the patient and his lesion with the goal of improving symptoms while avoiding treatment-related complications. Maintaining reasonable expectations by the patient and families are part of a successful management. Cure is achievable for small and localized lesions, but symptom relief and mitigation of functional, esthetic and psychological impairments is the goal for large and complex lesions. If a tracheotomy was required, decannulation is one of the primary management goals.
Collapse
Affiliation(s)
- François Gorostidi
- Department of Otolaryngology and Head Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Nicolas Glasson
- Department of Otolaryngology and Head Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Victoria Salati
- Department of Otolaryngology and Head Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Kishore Sandu
- Department of Otolaryngology and Head Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
4
|
Wang Q, Zhou Q, Zhao Z, Liu C, Zheng J. Successful Sclerotherapy for Cervicofacial Macrocystic Lymphatic Malformations Using Polidocanol and Pingyangmycin Combined Foam Sclerosants. Lymphat Res Biol 2022; 20:507-513. [PMID: 35041550 DOI: 10.1089/lrb.2021.0053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Sclerotherapy is the first-line therapeutic method for lymphatic malformations (LMs). This retrospective cohort study evaluated the effectiveness and safety of a novel combined foam sclerosant: polidocanol and pingyangmycin foam (PPF), for treating cervicofacial macrocystic LMs. Methods and Results: From July 2018 to October 2020, 51 patients with cervicofacial macrocystic LMs were enrolled in this study. All patients received intralesional 3% polidocanol or PPF injections. The outcome was evaluated regarding demographic and clinical characteristics, degree of treatment response, and post-treatment complications. Overall, 16 patients (31.4%) underwent PPF sclerotherapy. All these patients (100%) showed remarkable reduction in lesion size within three sessions. Excellent responses were shown in 88.5% of these patients within three sessions, which is higher than single polidocanol sclerotherapy (80%). The average sessions (duration) of PPF sclerotherapy were 2.5, which was significantly shorter than the single foam sclerotherapy (p < 0.05). Treatment duration was significantly associated with age, lesion location, lesion size, and number of cysts (p < 0.05). No severe complications were noted in this study. Local or systemic complications, such as swelling and mild fever occurred but subsided without any specific treatment. Conclusions: PPF is a safe, and effective combined foam sclerosant for the treatment of cervicofacial macrocystic LMs. This combined foam can improve treatment response and reduce treatment duration compared with a single sclerosant. It can be broadly used if further large-scale clinical trials verify its efficacy and safety.
Collapse
Affiliation(s)
- Qizhang Wang
- Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Zhou
- Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zeliang Zhao
- Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Liu
- Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiawei Zheng
- Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
5
|
Rodríguez-García FA, Gallegos-Sierra C, Villarreal-Salgado JL, Jimenez-Pavon K, Morfin-Meza K, Ramos-Maciel J, Fierro-Rodríguez DA, Romero-Algara E, Bonilla-Catalán P, Dorado-Hernández E, Torres-Salazar QL. Surgical extraction of an unusual macrocystic lymphatic malformation in the buttock: case report. ANNALS OF PEDIATRIC SURGERY 2021. [DOI: 10.1186/s43159-021-00133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Macrocystic lymphatic malformation is a rare benign skin disorder, especially the anogenital area, which covers less than .5% of the reported cases. It can cause vesicular and papular lesions on the face, trunk, extremities, and, less frequently, anogenital areas. Although there are currently several therapeutic options, surgical excision is the most widely used, considering the lowest recurrence rate.
Case presentation
In this article, we describe the case of a 15-year-old male patient who presented with herpetiform skin lesions, corresponding to the diagnosis of macrocystic lymphatic malformation, in the lower region of the right buttock. After confirmation of the diagnosis by histopathology, surgical excision was performed with a tensor fascia lata graft, with successful aesthetic and functional results.
Conclusions
Considering the diagnosis of macrocystic lymphatic malformation is of utmost importance, although its presence is unusual, to differentiate it from other herpetiform lesions. Despite the existence of multiple approaches today, definitive treatment with surgical extraction is necessary, both to improve the cosmetic aspect and to prevent associated complications. It is suggested that histopathological and imaging diagnostic tools be used as a routine element, in order to increase therapeutic success, as well as decrease the risk of recurrences.
Evidence-based medicine ranking
Level IV
Collapse
|
6
|
Lin HJ, Lin FCF, Yang TL, Chang CH, Kao CH, Tsai SCS. Cervical lymphatic malformations amenable to transhairline robotic surgical excision in children: A case series. Medicine (Baltimore) 2021; 100:e27200. [PMID: 34664849 PMCID: PMC8448076 DOI: 10.1097/md.0000000000027200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Lymphatic malformations are rare benign malformations that predominantly occur in the head and neck region. The advent of surgical robots in head and neck surgery may provide beneficial outcomes for pediatric patients. Here, we describe our experiences with transhairline incisions for robot-assisted surgical resection of cervical lymphatic malformations in pediatric patients.In this prospective longitudinal cohort study, we recruited consecutive patients under 18 years of age who were diagnosed with congenital cervical lymphatic malformations and scheduled for transhairline approach robotic surgery at a single medical center. We documented the docking times, console times, surgical results, complications, and postoperative follow-up outcomes.The studied patients included 2 with mixed-type lymphatic malformations and 2 with macrocystic-type lymphatic malformations. In all 4 patients, the incision was hidden in the hairline; the incision length was <5 cm in 3 patients but was extended to 6 cm in 1 patient. Elevating the skin flap and securely positioning it with Yang retractor took <1 hour in all cases. The mean docking time was 5.5 minutes, and the mean console time was 1 hour and 46 minutes. All 4 surgeries were completed endoscopically with the robot. The average total drainage volume in the postoperative period was 21.75 mL. No patients required tracheotomy or nasogastric feeding tubes. Neither were adverse surgery-associated neurovascular sequelae observed. All 4 patients were successfully treated for their lymphatic malformations, primarily with robotic surgical excisions.Cervical lymphatic malformations in pediatric patients could be accessed, properly visualized, and safely resected with transhairline-approach robotic surgery. Transhairline-approach robotic surgery is an innovative method for meeting clinical needs and addressing esthetic concerns.
Collapse
Affiliation(s)
- Han-Jie Lin
- Department of Otolaryngology, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, Republic of China
| | - Frank Cheau-Feng Lin
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chun-Hsiang Chang
- Department of Otolaryngology, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, Republic of China
| | - Chia-Hui Kao
- Department of Pediatrics, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, Republic of China
| | - Stella Chin-Shaw Tsai
- Department of Otolaryngology, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, Republic of China
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, Republic of China
| |
Collapse
|
7
|
Intermittent Administration Regimen of Sirolimus for Refractory Cervicofacial Lymphatic Malformation. J Craniofac Surg 2021; 33:850-854. [PMID: 34538791 DOI: 10.1097/scs.0000000000008063] [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
BACKGROUND The cervicofacial lymphatic malformations (LMs) often have poor outcomes due to their microcystic component and diffuse infiltration. Mostly, traditional treatments are inadequate for these refractory cases. Recent researches have shown that sirolimus is effective in the treatment of complicated LMs, however, there is still no standard strategy. OBJECTIVE To evaluate the efficacy and safety of intermittent oral sirolimus in treating refractory cervicofacial LMs as a second-line treatment. METHODS Fifteen pediatric patients of refractory cervicofacial LMs were retrospectively analyzed in this study. All the cases had received traditional therapy before, but could not completely control the symptoms and eliminate lesions. As a remedy, sirolimus was then proceeded with an intermittent administration regimen, that is 3 continuous months as a course and started the next course after 1 month interval. The clinical characteristics, imaging data of patients, the changes in the signs and symptoms observed, and associated adverse effects were collected and analyzed. RESULTS The patients initiated sirolimus therapy at the average age of 2.3 years (range 28 days-8 years 9 months). At the end point of the study, 2 patients remained on sirolimus in continuous courses of treatment. Of 13 patients who withdrawn therapy, 4 had restarted due to recurrence of symptoms and re-expansion of LMs. All patients demonstrated reduction in residual LMs and complete disappearance of symptoms during treatment, and 2 patients with complete resolution on imaging. Toxicity was tolerant in this series. There was no patient develop opportunistic or systemic bacterial infection. CONCLUSIONS Sirolimus is commended as a second-line treatment to treat intractable cervicofacial LMs after failure of traditional therapy. The intermittent administration regimen is efficacious to completely control symptoms and partially reduce residual lesions with good tolerance and limited side effects.
Collapse
|
8
|
Velez Torres JM, Duarte EM, Diaz-Perez JA, Leibowitz J, Weed DT, Thomas G, Sargi Z, Civantos FJ, Arnold DJ, Gomez-Fernandez C, Montgomery EA, Rosenberg AE. Mesenchymal Neoplasms of Salivary Glands: A Clinicopathologic Study of 68 Cases. Head Neck Pathol 2021; 16:353-365. [PMID: 34251596 PMCID: PMC9187808 DOI: 10.1007/s12105-021-01360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/06/2021] [Indexed: 12/13/2022]
Abstract
Salivary gland neoplasms are uncommon, and most exhibit epithelial differentiation. Mesenchymal neoplasms of the salivary gland are rare, and the incidence ranges from 1.9% to 5%. The aim of this study is to identify the types and clinical-pathological features of mesenchymal salivary neoplasm and review their differential diagnosis. A retrospective search for mesenchymal neoplasms of salivary glands from our institution's pathology archives from the 2004-2021 period and consultation files of one of the authors (AER) was performed. The clinical data were obtained from available medical records, and the histological slides and ancillary studies were retrieved and reviewed. We identified a total of 68 cases that form the study cohort. Thirty-five patients were male, and thirty-three patients were female, with a mean age of 48 years (range, 7 months-79 years), and the male to female ratio was 1:.94. Sixty-three (92.6%) of sixty-eight tumors were benign and included: 38 (56%) lipomas, 9 (13%) hemangiomas, 7 (10.3%) schwannomas, 3 (4.4%) neurofibromas, 3 (4.4%) lymphangioma, 2 (3%) solitary fibrous tumors, 1 (1.5%) myofibroma. Five of sixty-eight (7.4%) were malignant and included: 3 (4.4%) Adamantinoma-like Ewing sarcomas, 1 (1.5%) malignant peripheral nerve sheath tumor (MPNST), and 1 (1.5%) malignant solitary fibrous tumor. The involved sites included: parotid (55), submandibular gland (5), parapharyngeal space (5), buccal mucosa minor salivary gland (2), and sublingual gland (1). Sixty-seven patients underwent surgical resection. One patient with lymphangioma manifested a recurrence/persistence a week post-surgery. One patient with a parotid hemangioma developed post-operative numbness, and another patient developed chronic postauricular pain after surgery. Two patients with MPNST and one patient with adamantinoma-like Ewing sarcoma underwent neoadjuvant chemoradiation and were disease-free after treatment. The remaining 37 patients with available follow-up ranging from 7 days to 96 months (mean, 18 months) had a favorable outcome and were disease-free after treatment. Mesenchymal neoplasms of salivary gland are rare; most are benign and demonstrate adipocytic, endothelial, and schwannian differentiation; awareness of their development is important for adequate diagnosis. The mainstay of treatment is surgical excision, with the extent determined by tumor type. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.
Collapse
Affiliation(s)
- Jaylou M. Velez Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | | | - Julio A. Diaz-Perez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Jason Leibowitz
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Donald T. Weed
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Giovanna Thomas
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Zoukaa Sargi
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Francisco J. Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - David J. Arnold
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Carmen Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Elizabeth A. Montgomery
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Andrew E. Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| |
Collapse
|
9
|
Govindarajan V, Burks JD, Luther EM, Thompson JW, Starke RM. Medical Adjuvants in the Treatment of Surgically Refractory Arteriovenous Malformations of the Head and Face: Case Report and Review of Literature. Cerebrovasc Dis 2021; 50:493-499. [PMID: 34198289 DOI: 10.1159/000515168] [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: 11/17/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Arteriovenous malformations (AVMs) of the brain and face present unique challenges for clinicians. Cerebral AVMs may induce hemorrhage or form aneurysms, while facial AVMs can cause significant disfigurement and pain. Moreover, facial AVMs often draw blood supply from arteries providing critical blood flow to other important structures of the head which may make them impossible to treat curatively. Medical adjuvants may be an important consideration in the management of these patients. SUMMARY We conducted a systematic review of the literature to identify other instances of molecular target of rapamycin (mTOR) inhibitors used as medical adjuvants for the treatment of cranial and facial AVMs. We also present 2 cases from our own institution where patients were treated with partial embolization, followed by adjuvant therapy with rapamycin. After screening a total of 75 articles, 7 were identified which described use of rapamycin in the treatment of inoperable cranial or facial AVM. In total, 21 cases were reviewed. The median treatment duration was 12 months (3-24.5 months), and the highest recorded dose was 3.5 mg/m2. 76.2% of patients demonstrated at least a partial response to rapamycin therapy. In 2 patients treated at our institution, symptomatic and radiographic improvement were noted 6 months after initiation of therapy. Key Messages: Early results have been encouraging in a small number of patients with inoperable AVM of the head and face treated with mTOR inhibitors. Further study of medical adjuvants such as rapamycin may be worthwhile.
Collapse
Affiliation(s)
- Vaidya Govindarajan
- Department of Neurological Surgery,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Joshua D Burks
- Department of Neurological Surgery,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Evan M Luther
- Department of Neurological Surgery,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - John W Thompson
- Department of Neurological Surgery,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Robert M Starke
- Department of Neurological Surgery,University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
10
|
Shouchane-Blum K, Yassur I, Sternfeld A, Regev M, Gal-Or O, Kornreich L, Ehrlich R, Ehrenberg M. Orbital Lymphatic-Venous Malformation Accompanied by an Intraocular Vascular Malformation: A Rare Case Study. Case Rep Ophthalmol 2021; 12:396-401. [PMID: 34054491 PMCID: PMC8136313 DOI: 10.1159/000515272] [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: 01/08/2021] [Accepted: 02/15/2021] [Indexed: 11/20/2022] Open
Abstract
Lymphatic-venous malformations (LVMs) are development defects that result in abnormal connections between the lymphatic and venous systems. The authors describe a 7-weeks-old female infant who presented with a right orbital LVM extending to the ipsilateral cheek and subconjunctiva of the right eye, intracranial developmental venous anomalies in the right cerebellum, and a significant right eye intraocular retinal vascular malformation. Since orbital LVM is usually diagnosed in infancy or childhood, pediatric ophthalmologists should actively look for intraocular vascular malformations as such findings can poorly affect a patient's vision.
Collapse
Affiliation(s)
- Karny Shouchane-Blum
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iftach Yassur
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Sternfeld
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Miriam Regev
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | - Orly Gal-Or
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liora Kornreich
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Imaging Department, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Rita Ehrlich
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Ehrenberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| |
Collapse
|
11
|
Shaye DA, Burks CA, Gadkaree SK, Ncogoza I, Tuyishimire G, Nyabyenda V, Gassore A. Self-compounded Doxycycline Sclerotherapy for the Treatment of Lymphatic Malformations in Low-Resource Settings. World J Surg 2020; 44:3616-3619. [DOI: 10.1007/s00268-020-05667-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2020] [Indexed: 12/29/2022]
|
12
|
Ierardi AM, Colletti G, Biondetti P, Dessy M, Carrafiello G. Percutaneous sclerotherapy with gelified ethanol of low-flow vascular malformations of the head and neck region: preliminary results. ACTA ACUST UNITED AC 2020; 25:459-464. [PMID: 31650962 DOI: 10.5152/dir.2019.18542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the safety and effectiveness of percutaneous sclerotherapy using gelified ethanol in patients with low-flow malformations (LFMs). METHODS A retrospective study was performed, analyzing treatment and outcome data of 6 patients that presented with 7 LFMs (3 lymphatic and 3 venous). Median diameter of LFMs was 6 cm (interquartile range [IQR], 4.5-8.5 cm). Data regarding pain, functional and/or cosmetic issues were assessed. Diagnosis was performed clinically and confirmed by Doppler ultrasound, while extension of disease was assessed by magnetic resonance imaging (MRI). Percutaneous puncture was performed with 23G needle directly or with ultrasound guidance. All the LFMs were treated with gelified ethanol injection. The median volume injected per treatment session was 4.4 mL. RESULTS Technical and clinical success were obtained in all cases. No recurrences were recorded during a median follow up of 17 months (IQR, 12-19 months). Among the 6 patients, 5 had complete relief (83%) and one showed improvement of symptoms. The median VAS score was 7 (IQR, 6-7.5) before and 0 (IQR, 0-0) after treatment. All patients had functional and esthetic improvement (100%). Four patients (66.7%) revealed very good acceptance and two patients (33.3%) good acceptance. No major complications or systemic side effects were observed. CONCLUSION Gelified ethanol percutaneous sclerotherapy was easy to handle, well-tolerated, safe and effective in the short-term follow-up. Longer follow-up of efficacy is mandatory for further conclusions.
Collapse
Affiliation(s)
- Anna Maria Ierardi
- Department of Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy
| | - Giacomo Colletti
- Department of Maxillofacial Surgery, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy
| | - Pierpaolo Biondetti
- Department of Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy
| | - Margherita Dessy
- Department of Maxillofacial Surgery, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy
| | - Gianpaolo Carrafiello
- Department of Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan University, Milan, Italy
| |
Collapse
|
13
|
Moore PE, Boyer D, Perkins R, Katz ES, Castro-Codesal ML, MacLean JE, Akil N, Esther CR, Kaslow J, Lewis TC, Krone KA, Quizon A, Simpson R, Benscoter D, Spielberg DR, Melicoff E, Kuklinski CA, Blatter JA, Dy J, Rettig JS, Horani A, Gross J. American Thoracic Society 2019 Pediatric Core Curriculum. Pediatr Pulmonol 2019; 54:1880-1894. [PMID: 31456278 DOI: 10.1002/ppul.24482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/04/2019] [Indexed: 11/07/2022]
Abstract
The American Thoracic Society Pediatric Core Curriculum updates clinicians annually in pediatric pulmonary disease in a 3 to 4 year recurring cycle of topics. The 2019 course was presented in May during the Annual International Conference. An American Board of Pediatrics Maintenance of Certification module and a continuing medical education exercise covering the contents of the Core Curriculum can be accessed online at www.thoracic.org.
Collapse
Affiliation(s)
- Paul E Moore
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Debra Boyer
- Division of Respiratory Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ryan Perkins
- Division of Respiratory Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Eliot S Katz
- Division of Respiratory Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maria L Castro-Codesal
- Division of Pediatric Respirology, Pulmonary, and Asthma, Department of Pediatrics, University of Alberta, Alberta, Canada
| | - Joanna E MacLean
- Division of Pediatric Respirology, Pulmonary, and Asthma, Department of Pediatrics, University of Alberta, Alberta, Canada
| | - Nour Akil
- Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Charles R Esther
- Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jacob Kaslow
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Toby C Lewis
- Department of Pediatrics, University of Michigan Medical School, Ann Harbor, Michigan
| | - Katie A Krone
- Division of Respiratory Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Annabelle Quizon
- Division of Pediatric Pulmonology, Rady Children's Hospital, University of California San Diego, San Diego, California
| | - Ryne Simpson
- Division of Pulmonary Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Dan Benscoter
- Division of Pulmonary Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - David R Spielberg
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Ernestina Melicoff
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Cadence A Kuklinski
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Joshua A Blatter
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Jamie Dy
- Department of Pediatrics, UCSF, San Francisco, California
| | - Jordan S Rettig
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amjad Horani
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Jane Gross
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, National Jewish Hospital, Denver, Colorado
| |
Collapse
|
14
|
Kotsis T, Exarchos G, Metaxa L, Triantos S. Recurrent Neck Lymphangioma in a Young Adult: Twenty-Three Years After Successful Treatment. Vasc Endovascular Surg 2018; 53:170-176. [PMID: 30497351 DOI: 10.1177/1538574418814057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lymphangiomas are rare benign malformations of the lymphatic system, commonly present in children, over the head and neck area. Occasionally, they can grow significantly in size and especially those located over the cervical region can cause airway obstruction and become life-threatening. Recurrent lymphangiomas usually occur during the early postsurgical period and 80% of them within the first 3 to 5 years. However, in a new onset of clinical manifestations affecting the head and neck, even many years after the successful surgical treatment, a recurrent lymphangioma should be considered in the differential diagnosis. We present herein the second reported case, to our knowledge, of a recurrent left-sided neck lymphangioma in a young man, 23 years after a successful surgical treatment that initially took place 6 weeks after his birth.
Collapse
Affiliation(s)
- Thomas Kotsis
- 1 Vascular Unit-2nd Clinic of Surgery-Medical School, National and Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece
| | - Georgios Exarchos
- 2 2nd Clinic of Surgery-Medical School, National and Kapodistrian University of Athens Aretaieion University Hospital, Athens, Greece
| | - Linda Metaxa
- 3 Radiology Department, St Bartholomew's Hospital, London, United Kingdom
| | | |
Collapse
|
15
|
Blei F. Update February 2018. Lymphat Res Biol 2018. [DOI: 10.1089/lrb.2018.29035.fb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|