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Ye Z, Li C, Liu Y, You M. Intraosseous venous malformation of the zygoma: Case report and pooled analysis. J Craniomaxillofac Surg 2023; 51:490-496. [PMID: 37574385 DOI: 10.1016/j.jcms.2023.07.001] [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: 02/20/2023] [Revised: 05/29/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023] Open
Abstract
The objective of this study is to provide a comprehensive summary of the clinical and radiological features of zygomatic intraosseous venous malformations (IVM), as well as its treatment strategies. The aim is to establish preoperative diagnostic bases that will aid in the identification of zygomatic IVM and facilitate the implementation of effective treatment. Four cases of pathologically diagnosed zygomatic IVM with typical clinical and radiological features were reported. They exhibited comparable clinical and radiological features, and the En bloc excision and reconstruction yielded satisfactory outcome. Pooled data analysis was performed with additional 74 cases collected from 63 previous studies. The results revealed a higher incidence of zygomatic IVMs in middle-aged females, with swelling, pain and ocular dysfunction being the typical clinical manifestations. The characteristic radiological features of these lesions were well-defined, round bony structures with specific internal trabecular patterns. A diagnostic flow-chart assisting the differential diagnosis of IVM was established. En bloc excision was deemed the most advantageous treatment option, as it presented minimal risk of haemorrhaging and no instances of recurrence. The decision to pursue reconstruction was contingent upon the extent of the defect. Alloplastic material has emerged as the most frequently employed reconstruction material in recent reports. The summarized characteristics of zygomatic IVM and the proposed diagnostic and treatment strategies, derived from the pooled analysis of reported cases, may help to improve diagnosis and management in further clinical practice.
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Affiliation(s)
- Zelin Ye
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Chenyang Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - YuanYuan Liu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Meng You
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Antúnez-Conde R, Navarro Cuéllar C, Salmerón Escobar JI, Díez-Montiel A, Navarro Cuéllar I, Dell’Aversana Orabona G, del Castillo Pardo de Vera JL, Navarro Vila C, Cebrián Carretero JL. Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature. J Clin Med 2021; 10:jcm10194565. [PMID: 34640581 PMCID: PMC8509390 DOI: 10.3390/jcm10194565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023] Open
Abstract
Intraosseous venous malformations affecting the zygomatic bone are infrequent. Primary reconstruction is usually accomplished with calvarial grafts, although the use of virtual surgical planning, cutting guides and patient-specific implants (PSI) have had a major development in recent years. A retrospective study was designed and implemented in patients diagnosed with intraosseous venous malformation during 2006–2021, and a review of the scientific literature was also performed to clarify diagnostic terms. Eight patients were treated, differentiating two groups according to the technique: four patients were treated through standard surgery with resection and primary reconstruction of the defect with calvarial graft, and four patients underwent resection and primary reconstruction through virtual surgical planning (VSP), cutting guides, STL models developed with CAD-CAM technology and PSI (titanium or Polyether-ether-ketone). In the group treated with standard surgery, 75% of the patients developed sequelae or morbidity associated with this technique. The operation time ranged from 175 min to 210 min (average 188.7 min), the length of hospital ranged from 4 days to 6 days (average 4.75 days) and the postoperative CT scan showed a defect surface coverage of 79.75%. The aesthetic results were “excellent” in 25% of the patients, “good” in 50% and “poor” in 25%. In the VSP group, 25% presented sequelae associated with surgical treatment. The operation time ranged from 99 min to 143 min (average 121 min), the length of hospital stay ranged from 1 to 2 days (average of 1.75 days) and 75% of the patients reported “excellent” results. Postoperative CT scan showed 100% coverage of the defect surface in the VSP group. The multi-stage implementation of virtual surgical planning with cutting guides, STL models and patient-specific implants increases the reconstructive accuracy in the treatment of patients diagnosed with intraosseous venous malformation of the zygomatic bone, reducing sequelae, operation time and average hospital stay, providing a better cover of the defect, and improving the precision of the reconstruction and the aesthetic results compared to standard technique.
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Affiliation(s)
- Raúl Antúnez-Conde
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Carlos Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
- Correspondence:
| | - José Ignacio Salmerón Escobar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Alberto Díez-Montiel
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Ignacio Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | | | | | - Carlos Navarro Vila
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - José Luis Cebrián Carretero
- Maxilofacial Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.L.d.C.P.d.V.); (J.L.C.C.)
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Park SM, Lee JH. Recurrence of intraosseous cavernous hemangioma in the maxilla: A case report. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Temerek AT, Ali S, Shehab MF. Computer guided resection and reconstruction of intra-osseous zygomatic hemangioma: Case report and systematic review of literature. Int J Surg Case Rep 2019; 66:240-256. [PMID: 31874384 PMCID: PMC6931065 DOI: 10.1016/j.ijscr.2019.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/30/2019] [Accepted: 12/10/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES to systemically integrate the available data on various published treatment strategies for intraosseous hemangioma of the zygoma in an updated comprehensive systematic review, and to present a new case of treated resection and immediate reconstruction using computer guided patient specific composite graft. CASE PRESENTATION A 29 years old female patient with intraosseos zygomatic hemangioma treated using computer guided resection and immediate reconstruction. The resection was performed using a resection template constructed based on preoperative 3D planning. The reconstruction was performed using ramus bone graft and titanium mesh. The patient was followed up for 3 years with no complications. METHODS An electronic search was performed on 3 data bases; additional hand search of bibliographies of selected articles was performed. Eligibility criteria include human studies presenting intraosseous zygomatico-orbital hemangioma with clearly reported therapeutic strategies. RESULTS 53 articles with 73 cases were included. The lesion was highly prevalent in females compared to males (2.28:1). Fifth decade represents the highest prevalence with mean age of 44.1 ± 1.8 years. The main patient concern was swelling and facial deformity. Total tumor resection can assure no recurrence, while partial resection and curettage are associated with high recurrence rate.
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Affiliation(s)
- Ahmed Talaat Temerek
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, South Valley University, Qena, Egypt.
| | - Sherif Ali
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Mohamed Farid Shehab
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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An Algorithm for Managing Intraosseous Vascular Anomalies of the Craniofacial Skeleton. J Craniofac Surg 2018; 29:622-627. [PMID: 29068964 DOI: 10.1097/scs.0000000000004014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Intraosseous vascular anomalies (IOVA) are rare in the craniofacial skeleton and present a diagnostic and therapeutic challenge. This study aims to describe the clinical management based on a large case series. METHODS A retrospective chart review was performed and 9 IOVA were identified over a 15-year period. Data on demographics, diagnostic features, clinical management, and outcomes were reviewed. RESULTS Five frontal bone IOVA and 4 orbital IOVA were identified. The postoperative follow-up ranged from 4 months to 4 years. All 9 lesions were diagnosed with computed tomography (CT) imaging. Magnetic resonance imaging (MRI) was used to delineate soft tissue involvement in 2 patients presenting with oculo-orbital dystopia and ophthalmoplegia. En bloc excision was performed in all patients. Preoperative interventional embolization was critical in the successful resection of an orbital IOVA following 2 previously failed attempts that were aborted secondary to hemorrhage. Intraoperative 3-dimensional stereotactic navigation was used for the accurate en bloc excision of a frontal IOVA to prevent injury to the frontal sinus. Reconstruction of esthetic and functional deformities was successfully accomplished. CONCLUSION The diagnosis of IOVA relies primarily on clinical assessment and CT imaging. Further interpretation of the involvement of periorbital, facial, and intracranial soft tissue is best defined by MRI. Multidisciplinary care with interventional radiology and neurosurgery must be considered for ensuring the safe and adequate en bloc excision of craniofacial IOVA.
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Powers DB, Fisher E, Erdmann D. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review. Craniomaxillofac Trauma Reconstr 2016; 10:1-10. [PMID: 28210401 DOI: 10.1055/s-0036-1592087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/10/2016] [Indexed: 10/20/2022] Open
Abstract
Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.
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Affiliation(s)
- David B Powers
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Elda Fisher
- Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Detlev Erdmann
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Correction of Facial Deformity in Sturge-Weber Syndrome. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e843. [PMID: 27622111 PMCID: PMC5010334 DOI: 10.1097/gox.0000000000000843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/29/2016] [Indexed: 01/06/2023]
Abstract
Background: Although previous studies have reported soft-tissue management in surgical treatment of Sturge–Weber syndrome (SWS), there are few reports describing facial bone surgery in this patient group. The purpose of this study is to examine the validity of our multidisciplinary algorithm for correcting facial deformities associated with SWS. To the best of our knowledge, this is the first study on orthognathic surgery for SWS patients. Methods: A retrospective chart review included 2 SWS patients who completed the surgical treatment algorithm. Radiographic and clinical data were recorded, and a treatment algorithm was derived. Results: According to the Roach classification, the first patient was classified as type I presenting with both facial and leptomeningeal vascular anomalies without glaucoma and the second patient as type II presenting only with a hemifacial capillary malformation. Considering positive findings in seizure history and intracranial vascular anomalies in the first case, the anesthetic management was modified to omit hypotensive anesthesia because of the potential risk of intracranial pressure elevation. Primarily, both patients underwent 2-jaw orthognathic surgery and facial bone contouring including genioplasty, zygomatic reduction, buccal fat pad removal, and masseter reduction without major complications. In the second step, the volume and distribution of facial soft tissues were altered by surgical resection and reposition. Both patients were satisfied with the surgical result. Conclusions: Our multidisciplinary algorithm can systematically detect potential risk factors. Correction of the asymmetric face by successive bone and soft-tissue surgery enables the patients to reduce their psychosocial burden and increase their quality of life.
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Kadlub N, Dainese L, Coulomb-L'Hermine A, Galmiche L, Soupre V, Lepointe HD, Vazquez MP, Picard A. Intraosseous haemangioma: semantic and medical confusion. Int J Oral Maxillofac Surg 2015; 44:718-24. [PMID: 25703595 DOI: 10.1016/j.ijom.2015.01.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 01/18/2023]
Abstract
The literature is rich in case reports of intraosseous haemangioma, although most of these are actually cases of venous or capillary malformations. To illustrate this confusion in terminology, we present three cases of slow-flow vascular malformations misnamed as intraosseous haemangioma. A retrospective study of children diagnosed with intraosseous haemangioma was conducted. Clinical and radiological data were evaluated. Histopathological examinations and immunohistochemical studies were redone by three independent pathologists to classify the lesions according to the International Society for the Study of Vascular Anomalies (ISSVA) and World Health Organization (WHO) classifications. Three children who had presented with jaw haemangiomas were identified. Computed tomography scan patterns were not specific. All tumours were GLUT-1-negative and D2-40-negative. The lesions were classified as central haemangiomas according to the WHO, and as slow-flow malformations according to the ISSVA. The classification of vascular anomalies is based on clinical, radiological, and histological differences between vascular tumours and malformations. Based on this classification, the evolution of the lesion can be predicted and adequate treatment applied. The binary ISSVA classification is widely accepted and should be applied for all vascular lesions.
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Affiliation(s)
- N Kadlub
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France.
| | - L Dainese
- APHP, Hôpital d'Enfants Armand Trousseau, Service de Cytologie et Pathologie, Paris, France; Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - A Coulomb-L'Hermine
- APHP, Hôpital d'Enfants Armand Trousseau, Service de Cytologie et Pathologie, Paris, France; Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - L Galmiche
- Université Paris Descartes, Paris, France; APHP, Hôpital Necker Enfants Malades, Service de Cytologie et Pathologie, Paris, France
| | - V Soupre
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - H Ducou Lepointe
- Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France; APHP, Hôpital d'Enfants Armand Trousseau, Service d'Imagerie Médicale, Paris, France
| | - M-P Vazquez
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - A Picard
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
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10
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Cranio-orbital primary intraosseous haemangioma. Eye (Lond) 2013; 27:1320-3. [PMID: 23989119 DOI: 10.1038/eye.2013.162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/19/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date. PATIENTS AND METHODS Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described. RESULTS Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells. DISCUSSION IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.
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Marcinow AM, Provenzano MJ, Gurgel RK, Chang KE. Primary Intraosseous Cavernous hemangioma of the Zygoma: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2012; 91:210, 212, 214-5. [DOI: 10.1177/014556131209100512] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intraosseous hemangiomas are rare. We report the case of a 47-year-old man who presented with a gradually enlarging left zygomatic mass that had caused pain, deformity, and superficial soft-tissue swelling. Computed tomography revealed a well-circumscribed 2.0 × 2.5-cm mass with a ground-glass matrix in the left zygoma. Following surgical excision, the patient's symptoms resolved. Findings on pathologic examination of the excised tissue were consistent with an intraosseous cavernous hemangioma. We describe the features of this rare case, we discuss the pertinent radiologic features and pathophysiology of intraosseous hemangiomas, and we review the available literature.
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Affiliation(s)
- Anna M. Marcinow
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University School of Medicine, Columbus
| | - Matthew J. Provenzano
- Division of Pediatric Otolaryngology–Head and Neck Surgery Cincinnati Children's Hospital Medical Center
| | - Richard K. Gurgel
- Department of Otolaryngology (Head and Neck Surgery), Stanford University Medical Center, Stanford, Calif
| | - Kristi E. Chang
- Department of Otolaryngology–Head and Neck Surgery, University of Iowa College of Medicine, Iowa City
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13
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Yu MS, Kim HC, Jang YJ. Removal of a nasal bone intraosseous venous malformation and primary reconstruction of the surgical defect using open rhinoplasty. Int J Oral Maxillofac Surg 2010; 39:394-6. [PMID: 20097542 DOI: 10.1016/j.ijom.2009.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 06/19/2009] [Accepted: 12/22/2009] [Indexed: 11/25/2022]
Abstract
Primary intraosseous venous malformations are rare benign tumors that account for approximately 1% of all primary osseous tumors. They are rarely found in the midface. The authors report a case of an intraosseous venous malformation in a 28-year-old woman who presented with a bony lesion in the nasal bone. Treatment involved surgical excision via open rhinoplasty. Histopathology indicated an intraosseous venous malformation. 16 months postoperatively, there was no evidence of recurrence, the functional and cosmetic results were good, and the patient was satisfied with the treatment outcome.
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Affiliation(s)
- M S Yu
- Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea
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Satoh K, Ohtsuka T, Abe T, Yokota K, Kunii K. Haemangioma of the forehead: Radiographic diagnosis and definitive surgical treatment in a Japanese series. ACTA ACUST UNITED AC 2009; 43:75-81. [DOI: 10.1080/02844310802602358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Srinivasan B, Ethunandan M, Van der Horst C, Markus AF. Intraosseous 'haemangioma' of the zygoma: more appropriately termed a venous malformation. Int J Oral Maxillofac Surg 2009; 38:1066-70. [PMID: 19574025 DOI: 10.1016/j.ijom.2009.05.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 11/29/2008] [Accepted: 05/28/2009] [Indexed: 11/28/2022]
Abstract
Vascular anomalies often affect the soft tissues and primary intraosseous lesions are uncommon, with only 33 cases reported in the zygoma. Intraosseous vascular anomalies of the zygoma have traditionally been designated 'haemangiomas' with little attempt to clarify the specific type of the lesion. Recently, specific immunohistochemical markers such as erythrocyte type glucose transporter protein 1 (GLUT-1) have been described to differentiate haemangiomas and vascular malformations. The authors report a case of intraosseous venous malformation of the zygoma and provide supporting evidence to justify the nomenclature. The literature on zygomatic 'haemangiomas' is critically reviewed and the basis for their proper designation as venous malformations highlighted.
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Affiliation(s)
- B Srinivasan
- Department of Oral and Maxillofacial Surgery, Poole, Dorset, UK
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Torres-Carranza E, García-Perla A, Infante-Cossío P, Acosta-Feria M, Belmonte-Caro R, Gutiérrez-Pérez J. Hemangioma intraóseo primario de la órbita: a propósito de dos casos. Neurocirugia (Astur) 2007. [DOI: 10.1016/s1130-1473(07)70276-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Clauser L, Mandrioli S, Polito J, Galiè M. Surgical techniques for the removal of forehead hemangioma. J Craniofac Surg 2006; 17:702-4. [PMID: 16877918 DOI: 10.1097/00001665-200607000-00017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Hemangiomas of the bone are rare tumors, accounting for 0.5-1% of all benign skeletal tumors. Most of these tumors are found in the vertebral bodies and they are rarely seen in the cranial bones, where their frequency is 0.2% of all bone neoplasms. The authors, after reviewing the literature, describe their experience with a case of frontal bone hemangioma.
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Affiliation(s)
- Luigi Clauser
- Department of Cranio Maxillo Facial Surgery, Center of Orbital Pathology and Surgery, St. Anna Hospital and University, Ferrara, Italy.
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Abstract
BACKGROUND Hemangiomas arising in the soft tissue are common in the head and neck region, but intraosseous hemangiomas of the facial bone are rare. METHODS The authors conducted a retrospective study investigating the clinical features, management, and outcomes for seven patients with facial bone hemangiomas. RESULTS Three of the hemangiomas arose in the orbital bones, two arose in the mandible, one arose in the frontal bone, and one arose in the zygoma. The mean follow-up was 3 years 9 months. During the first operation, total tumor resection was performed for two symptomatic patients, and partial resection with superficial osteotomy was performed for the remaining five individuals with facial contour deformity. Three patients who underwent partial resection achieved long-term aesthetically satisfactory results without recurrence; the other two developed recurrent tumors and underwent subsequent en bloc resection. No evidence of recurrence was observed in cases where primary or secondary complete tumor resections were performed. CONCLUSIONS Although complete tumor resection represents a definitive treatment for facial bone hemangiomas, conservative partial resection offers a simple method of restoring facial contour with minimal side effects. Although it appears that recurrence cannot be avoided entirely, partial resection should be considered for patients who seek surgery for cosmetic reasons.
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Affiliation(s)
- Nai-Chen Cheng
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei
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Zins JE, Türegün MC, Hosn W, Bauer TW. Reconstruction of intraosseous hemangiomas of the midface using split calvarial bone grafts. Plast Reconstr Surg 2006; 117:948-53; discussion 954. [PMID: 16525289 DOI: 10.1097/01.prs.0000204768.82643.0c] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Intraosseous hemangiomas are benign lesions that usually occur in the vertebral column and the calvaria. They are rare in the midface, with only 22 zygomatic and 26 nasal bone hemangioma cases described in the literature. Methods of reconstruction of craniofacial defects after surgical removal of these tumors have been inconsistent. METHODS The authors report long-term follow-up in three cases of midface intraosseous hemangiomas all treated in a similar fashion: surgical excision of the tumor with a small margin of normal bone and primary reconstruction using split calvarial bone grafts. RESULTS Clinical, photographic, and computed tomographic assessment (cases 1 and 2) documents no recurrence and maintenance of the result with a mean 5-year follow-up. To the authors' knowledge, this represents the longest follow-up of a patient series with hemangiomas of bone treated with primary reconstruction in the plastic surgery literature (Wolfe and Berkowitz did report on a single case with 4-year follow-up without recurrence). We recommend replacing like with like. Primary bone grafting with autogenous cranial bone was used to replace areas where original bone was thin, but full-thickness bone was used in areas where original bone was thick. Full-thickness cranial bone grafts may be superior to split cranial bone with regard to long-term volume maintenance. CONCLUSIONS Preoperative computed tomographic scanning should lead to the appropriate diagnosis. Proper diagnosis should lead to appropriate treatment, which includes total excision and primary bone grafting of the defect to prevent soft-tissue contraction.
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Affiliation(s)
- James E Zins
- Department of Plastic Surgery and Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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Perugini M, Renzi G, Gasparini G, Cerulli G, Becelli R. Intraosseous Hemangioma of the Maxillofacial District: Clinical Analysis and Surgical Treatment in 10 Consecutive Patients. J Craniofac Surg 2004; 15:980-5. [PMID: 15547387 DOI: 10.1097/00001665-200411000-00018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aims of this study are to illustrate functional and esthetic results obtained with different surgical strategies and to report a review of the relevant literature. There were 6 female patients and 4 male patients included in this study, with an average age of 35.7 years. Zygomatic bone was affected in six cases, the mandible in two cases, the medial orbital wall in one case, and the upper jaw in one case. In all 10 patients, surgery consisted of a wide excision of the intraosseous hemangioma with margins of 3 mm at least to ensure complete removal. Immediate reconstruction was carried out in 5 of the 10 patients. An analysis indicates that intraosseous hemangiomas of the maxillofacial area are rare; diagnosis can be difficult and is mainly based on computed tomography scans. Surgical excision, with previous angiography and embolization in cases of intraosseous hemangioma with a larger dimension or abnormal blood supply, is the treatment of choice.
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Affiliation(s)
- Maurizio Perugini
- Department of Maxillofacial Surgery, University of Rome, Umberto I Hospital, Rome, Italy.
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21
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Abstract
Zygomatic hemangioma is an extremely rare, benign, slow-growing tumor occurring mostly in adult women. The radiologic findings are diagnostic. Total excision of the tumor with primary reconstruction of the defect is the preferred treatment modality. We present a case of zygomatic hemangioma and a brief review of the literature.
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Affiliation(s)
- Serap Koybasi
- Department of Otolaryngology Head & Neck Surgery, Abant Izzet Baysak University, Bolu, Turkey
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22
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Pneumatisationen des Jochbogens ("zygomatic air cell defect") auf Panoramaschichtaufnahmen von Kindern und Jugendlichen als Hilfsmittel zur Identitätsbestimmung und Altersschätzung. Rechtsmedizin (Berl) 2003. [DOI: 10.1007/s00194-003-0192-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Vargel I, Cil BE, Er N, Ruacan S, Akarsu AN, Erk Y. Hereditary intraosseous vascular malformation of the craniofacial region: an apparently novel disorder. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 109:22-35. [PMID: 11932989 DOI: 10.1002/ajmg.10282] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Primary intraosseous vascular anomaly, previously called intraosseous hemangioma, is a very rare malformation that is usually seen in the vertebral column and in the skull. It is exclusively described in sporadic cases and no hereditary component has yet been reported. The most commonly affected bones in the skull are the mandible and the maxilla, and life-threatening bleeding after a simple tooth extraction is frequently observed. Here, we report two consanguineous families containing a total of four affected patients manifesting primary intraosseous vascular malformation (VMOS (vascular malformation osseous)) of the craniofacial region. The phenotypic expression is remarkably similar in both families. The characteristic findings include severe blood vessel expansions within the craniofacial bones and midline abnormalities such as diastasis recti, supraumbilical raphe, and hiatus hernia. Malformation is restricted to the mandibular and maxillary area in the prepubertal age, and rapid expansion starts after age 12 or 13. A 15-year follow-up of one of the patients demonstrated that the vascular malformation did not extend beyond the craniofacial region despite severe involvement of almost all bones in the skull. Detailed clinical and radiological evaluation provided neither evidence of soft-tissue involvement nor any sign of gross arterial, venous, or combined malformations, indicating that bone changes are a primary rather than a secondary effect due to any other vascular anomaly in the craniofacial region. An antibody against a universal proliferation marker, Ki-67, detected nonproliferative, single-layered endothelial cells, suggesting that this abnormality is a vascular malformation rather than a hemangioma. alpha-actin staining (antibody against perivascular tissue such as smooth muscle cells (SMCs) and/or pericytes) demonstrated that pathologic vessels lost their surrounding supportive tissues, as was previously seen in other types of vascular anomaly. Homozygosity mapping excluded the following loci and/or genes: multiple cutaneous venous malformation (VMCM1; gene, TIE2) on chromosome 9p21; venous malformation with glomus cells (VMGLOM) on chromosome 1p22-p21; hereditary hemorrhagic telangiectasia type 1 (HHT1; gene, endoglin) and type 2 (HHT2; gene, activin) on chromosomes 9q34.1 and 12q11-q14, respectively; and cerebral cavernous malformation type 1 (CCM1; gene, KRIT1), type 2 (CCM2), and type 3 (CCM3) on chromosomes 7q11.2-q21, 7p15-p13, and 3q35.2-q27, respectively. To the best of our knowledge, this is a new disorder, which we call hereditary intraosseous vascular malformation of the craniofacial region.
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Affiliation(s)
- Ibrahim Vargel
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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24
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25
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Khanam H, Lipper MH, Wolff CL, Lopes MB. Calvarial hemangiomas: report of two cases and review of the literature. SURGICAL NEUROLOGY 2001; 55:63-7; discussion 67. [PMID: 11248320 DOI: 10.1016/s0090-3019(00)00268-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Primary hemangiomas of the bone are uncommon tumors, accounting for less than 1.0% of all bone neoplasms. These tumors are mostly found in vertebral bodies. Hemangiomas are rarely seen in the calvarium, where their frequency is 0.2% of all bone neoplasms. Because of their infrequent appearance in the skull, vague symptoms, and absence of prototypical radiological findings, these tumors can be missed in many cases or may be misinterpreted as more ominous lesions like multiple myeloma or osteosarcoma. CASE DESCRIPTION We report two cases of calvarial hemangiomas: one with a single mass on the right sphenoid wing, and another with two similar lesions on the right occipital and left parietal bones. The diagnoses could be established only by histopathologic analysis. CONCLUSION Histopathologic confirmation of the tumor is the definitive method for diagnosis of intraosseous hemangiomas. Radiological findings are not always characteristic for calvarial hemangiomas. Due to possible complications and the possibility of effective treatment, this lesion should always be considered in the differential diagnosis of skull lesions.
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Affiliation(s)
- H Khanam
- University of Virginia Health Sciences Center, Department of Pathology, Box 800-214, Charlottesville, VA 22908-0214, USA
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26
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Orsini G, Fioroni M, Rubini C, Piattelli A. Hemangioma of the mandible presenting as a periapical radiolucency. J Endod 2000; 26:621-2. [PMID: 11199807 DOI: 10.1097/00004770-200010000-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A case of an hemangioma of the mandible in a 53-yr-old female patient is presented. The lesion was removed, and no atypia or mitotic cells were found. The excision was curative, and the overall prognosis was excellent. A differential diagnosis of radiolucent periapical lesions of the mandibular symphysis is presented.
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Affiliation(s)
- G Orsini
- Dental School, University of Chieti, Chieti, Italy
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