Benign vascular tumors and tumor-like proliferations

A Rare Instance of Chronic Masson's Tumor Presenting in the External Auditory Meatus and Surgical Plan: A Case Report

Intravascular papillary endothelial hyperplasia (IPEH), or Masson's tumor, is a rare and benign proliferation of endothelial cells typically of vascular origin. Common locations of Masson's tumor include the head, neck, orbit, lip, pharynx, and mandible. It is typically seen in middle-aged adult life and females. Possible differential diagnoses include hemangioma, benign vascular formation, angiosarcoma, and neurofibromatosis. The exact pathophysiology of Masson's tumor is currently unknown. We present the case of a middle-aged 47-year-old male with a pure type of Masson's tumor presenting with pedunculated, malleable lesions across the posterior scalp and circumferential neck, on the pinna of the right ear, and within the right external auditory meatus. The lesions within the right external auditory meatus caused conductive hearing loss. The plan is a complete surgical excision without wide margins. The patient was referred to an ear, nose, and throat (ENT) surgeon due to the complicated location of the lesion within the external auditory meatus. This case serves as a differential diagnosis of conductive hearing loss complicated by Masson's tumor.

Cutaneous vascular tumors: an updated review

Cutaneous vascular tumors constitute a heterogeneous group of entities that share overlapping morphologic and immunohistochemical features, which can be diagnostically challenging for pathologists and dermatopathologists. Our understanding and knowledge of vascular neoplasms have improved over time, resulting in both a refinement of their classification by the International Society for the Study of Vascular Anomalies (ISSVA) and an improvement in the accurate diagnosis and clinical management of vascular neoplasms. This review article aims to summarize the updated clinical, histopathological, and immunohistochemical characteristics of cutaneous vascular tumors, as well as to highlight their associated genetic mutations. Such entities include infantile hemangioma, congenital hemangioma, tufted angioma, spindle cell hemangioma, epithelioid hemangioma, pyogenic granuloma, Kaposiform hemangioendothelioma, retiform hemangioendothelioma, pseudomyogenic hemangioendothelioma, Kaposi sarcoma, angiosarcoma, and epithelioid hemangioendothelioma.

Myopericytoma-like tumors of the lung: Report of two cases

Myopericytoma is a benign neoplasm presenting cells with different shapes, from oval to spindle, and myoid showing with perivascular growth, which frequently originates from the skin and soft tissues of distal extremities, trunk, head, and neck regions. These tumors rarely have been reported to occur in visceral sites. There is only one case of myopericytoma showing pulmonary involvement with multiple nodules. Although most myopericytomas behave in a benign manner, some cases of malignant myopericytoma arising in both superficial soft tissue and visceral locations have been described. We describe two cases of pulmonary tumors with myopericytoma-like features.

Cauda equina intradural extramedullary cavernous haemangioma: case report and review of the literature

Cavernous haemangioma (cavernoma) is a benign vascular lesion, exceptionally located in cauda equina. We report a case, diagnosed and operated in the Department of Neurosurgery from Pitesti County Emergency Hospital, of a 60-year-old woman with history of lumbar region distress, who presented with low back pain, paravertebral muscle contracture, and bilateral lumbar radiculopathy, with sudden onset after lifting effort. The preoperative diagnosis was done using computed tomography (CT) and magnetic resonance imaging (MRI), and the patient underwent surgery-two level laminectomy, dural incision, and tumor dissection from the cauda equina nerve roots under operatory microscope. Histopathological examination confirmed the positive diagnosis of cavernoma of cauda equina. The patient's outcome was favorable, without postoperative neurological deficits.

Down-regulation of mir-424 contributes to the abnormal angiogenesis via MEK1 and cyclin E1 in senile hemangioma: its implications to therapy

Background

Senile hemangioma, so-called cherry angioma, is known as the most common vascular anomalies specifically seen in the aged skin. The pathogenesis of its abnormal angiogenesis is still unclear.

Methodology/Principal Findings

In this study, we found that senile hemangioma consisted of clusters of proliferated small vascular channels in upper dermis, indicating that this tumor is categorized as a vascular tumor. We then investigated the mechanism of endothelial proliferation in senile hemangioma, focusing on microRNA (miRNA). miRNA PCR array analysis revealed the mir-424 level in senile hemangioma was lower than in other vascular anomalies. Protein expression of MEK1 and cyclin E1, the predicted target genes of mir-424, was increased in senile hemangioma compared to normal skin or other anomalies, but their mRNA levels were not. The inhibition of mir-424 in normal human dermal microvascular ECs (HDMECs) using specific inhibitor in vitro resulted in the increase of protein expression of MEK1 or cyclin E1, while mRNA levels were not affected by the inhibitor. Specific inhibitor of mir-424 also induced the cell proliferation of HDMECs significantly, while the cell number was decreased by the transfection of siRNA for MEK1 or cyclin E1.

Conclusions/Significance

Taken together, decreased mir-424 expression and increased levels of MEK1 or cyclin E1 in senile hemangioma may cause abnormal cell proliferation in the tumor. Senile hemangioma may be the good model for cutaneous angiogenesis. Investigation of senile hemangioma and the regulatory mechanisms of angiogenesis by miRNA in the aged skin may lead to new treatments using miRNA by the transfection into senile hemangioma.