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Huang YT, Ou CY, Lee WT, Hsu HJ. Three Cases of Parotid Hemangiomas in Adults. EAR, NOSE & THROAT JOURNAL 2024; 103:NP422-NP426. [PMID: 34904445 DOI: 10.1177/01455613211067834] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hemangiomas account for only 0.4% to 0.6% of all parotid tumors, making them extremely rare in adults. Unlike pediatric parotid hemangiomas, those in adults typically present as asymptomatic swellings of the parotid, have no skin discoloration, and usually do not regress spontaneously. Therefore, an accurate diagnosis of parotid hemangiomas in adults before surgical excision is generally challenging. Herein, we present 3 cases of adult parotid hemangiomas. The patients all received parotidectomies with tumor resection. Histopathological analysis of the resected specimens revealed numerous dilated, thin- or thick-walled (small, large, or variably sized) vessels lined with flattened endothelial cells. A diagnosis of cavernous hemangioma of the parotid gland was established only after the histopathological analysis. Parotid cavernous hemangiomas in adults are rare and often misdiagnosed before surgical resection. Clinical presentation and imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and angiography may support an accurate preoperative diagnosis. Surgical resection proved a suitable treatment approach for our 3 cases.
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Affiliation(s)
- Yi-Ting Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ting Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Heng-Jui Hsu
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Leyman B, Govaerts D, Dormaar JT, Meeus J, Bila M, Coropciuc R, Willaert R, Politis C. A 16-year retrospective study of vascular anomalies in the head and neck region. Head Face Med 2023; 19:32. [PMID: 37528467 PMCID: PMC10391867 DOI: 10.1186/s13005-023-00376-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
Depending on the diagnostic modality, the classification of vascular anomalies varies and so does the nomenclature. The 'International Society for the Study of Vascular Anomalies' (ISSVA) is the most widely accepted classification in the literature and is mainly based on the radiologic and clinical presentation. The aim of this article is to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special focus on the nomenclature. All patients with a vascular anomaly presenting to the department of oral and maxillofacial surgery were reviewed in a retrospective manner. Nomenclature, diagnostic process, lesion characteristics, treatment and outcome were examined. The lesions were (re)classified according to the ISSVA classification. A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. After reclassification, the most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). A group of 39 anomalies could not be further specified. One hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of treated patients). Endovascular treatment was considered in 41 patients but applied in only eight. This strict selection led to a low a complication rate. We provide an overview of the clinical practice in the management of vascular anomalies in a university hospital. The histology report is a source of miscommunication because clinicians use the ISSVA classification, while pathologists use the WHO classification. Every professional involved should be aware of the differences in classification and nomenclature.
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Affiliation(s)
- Bernard Leyman
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Dries Govaerts
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Jakob Titiaan Dormaar
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
- Present Address: Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands
| | - Jan Meeus
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Michel Bila
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ruxandra Coropciuc
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Robin Willaert
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
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Finisanti R, Perkasa MF, Prawira AM, Faruk M. Orbital hemangioma extirpation via a transnasal endoscopic surgical approach: A case report. Int J Surg Case Rep 2023; 103:107898. [PMID: 36640470 PMCID: PMC9846022 DOI: 10.1016/j.ijscr.2023.107898] [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: 09/26/2022] [Revised: 12/26/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Orbital tumors are heterogeneous lesions originating from various structures in the eyeball, including the extraconal, conal, and intraconal spaces. One orbital tumor type is a vascular tumor, such as a hemangioma. Hemangiomas are most common in women aged 20-64 years. They are painless and slow-growing, leading to proptosis. The diagnosis can generally be established by clinical examination and computed tomography (CT) or magnetic resonance imaging scans. Orbital hemangioma management can involve regular observation of small and asymptomatic tumors or surgery for large symptomatic tumors. PRESENTATION OF CASE We report a 20-year-old Asian woman who presented with swelling on the medial side of her right eyelid that had increased over the last three months. A non-contrast head CT scan showed a mass in the right eye's medial wall. The patient underwent a joint operation with an ophthalmologist to remove the median orbital tumor by transnasal endoscopic orbital surgery. Anatomical pathology examination of the tumor tissue identified hemangiomas. CONCLUSION An endoscopic transnasal approach is a safe and effective way to access and manage an orbital tumor medial to the optic nerve. It is essential to have a multidisciplinary team with experience in endoscopic procedures. This patient had satisfactory results at their three-month postoperative follow-up. They reported no symptoms, and their CT scan did not show a relapsed mass in the right oculi region.
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Affiliation(s)
- Ratih Finisanti
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Muhammad Fadjar Perkasa
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Adi Matra Prawira
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Muhammad Faruk
- Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
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da Silva TJ, de Oliveira DHIP, Nonaka CFW, da Silveira ÉJD, Queiroz LMG. Immunoexpression of proliferation and apoptosis markers in oral vascular anomalies. Braz Dent J 2022; 33:65-70. [PMID: 36477966 PMCID: PMC9733364 DOI: 10.1590/0103-6440202205010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/13/2022] [Indexed: 12/12/2022] Open
Abstract
The biological behavior of lesions is highly dependent on the imbalance between their proliferative and apoptotic capacity. This study evaluated a correlation between the proliferative and apoptotic rates of different oral vascular anomalies (VAs) by analyzing the immunoexpression of proliferation (Ki-67) and apoptosis (Bcl-2 and Bax) markers in endothelial cells of 20 cases of GLUT-1 positive infantile hemangiomas (IHs), 20 cases of pyogenic granulomas (PGs) and 20 cases of vascular malformations (VMs). Immunoexpression analysis of Ki-67, Bcl-2 and Bax revealed a lower median percentage of positive cells in VMs cases compared to IHs and PGs cases (P <0.001). The Wilcoxon signed-rank test showed significantly higher percentages of immunostaining for Bax than for Bcl-2 in IHs (P = 0.048). In the group of PGs, a positive correlation was observed between the immunoexpressions of Ki-67 and Bax (r = 0.476; P = 0.034). Although oral IHs, PGs and VMs present similar clinical and histopathological features, each of these lesions has its etiopathogenic particularities. The results of this study suggest that different biological behaviors of VAs may be related to differences in the proliferative and apoptotic profiles of their endothelial cells.
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Affiliation(s)
- Tiago João da Silva
- School of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil.
| | | | | | | | - Lélia Maria Guedes Queiroz
- Postgraduate Program in Oral Pathology, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Tawfik HA, Dutton JJ. Orbital Vascular Anomalies: A Nomenclatorial, Etiological, and Nosologic Conundrum. Ophthalmic Plast Reconstr Surg 2022; 38:108-121. [PMID: 34238823 DOI: 10.1097/iop.0000000000002029] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Vascular anomalies are a heterogeneous group of disorders that frequently present in the periorbital region. They encompass 2 broad entities: vascular tumors, which possess a proliferative endothelium, and vascular malformations, which are basically localized defects of vascular morphogenesis. The primary goal of this review was to address inaccurate or controversial terminology in the oculoplastic literature concerning orbital and periorbital vascular anomalies and to categorize these lesions in an abridged and simplified hierarchical list that adheres as much as possible to the most recent (2018) iteration for the classification of vascular lesions proposed by the International Society for the Study of Vascular Anomalies (ISSVA). The secondary goal of this review was to review and update information regarding the genetic underpinnings of vascular anomalies and the downstream signaling pathways that are subsequently affected as a result of these genetic errors. METHODS A literature review was conducted in PubMed, MEDLINE, PubMed Central, National Center for Biotechnology Information Bookshelf, and Embase for several related keywords including "vascular anomalies, vascular malformations, vascular tumors, and cavernous venous malformation," both with and without adding the keywords "eyelid," "orbital," and "periorbital." In addition, a detailed search was conducted for controversial or obsolete keywords like "cavernous hemangioma," "lymphangioma," and "varices," again in their systemic and orbital/periorbital context. RESULTS Crucial issues in the 2018 ISSVA classification regarding the proper categorization of orbital vascular anomalies, particularly venous lesions, were critically evaluated and revised, and a regional, simplified, and abridged modification of the ISSVA 2018 classification was proposed. CONCLUSIONS Interdisciplinary and intradisciplinary dialogue concerning orbital vascular anomalies is seriously compromised due to the lack of a unanimous agreement on terminology and the absence of a unified classification concept system. The authors recommend that oculoplastic surgeons adopt ISSVA terminology whenever technically possible and scientifically sound. However, they also propose modifying the ISSVA 2018 classification specifically to adapt to the peculiarities of vascular anomalies in the periorbital region. At present, the simplified classification proposed here is a preliminary first step towards managing patients with orbital vascular anomalies with greater diagnostic and therapeutic precision, until such time in the future when the entire genetic makeup of orbital vascular anomalies is more completely elucidated. Optimistically, this could pave the way for a more robust classification and the ultimate therapeutic cure.
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Affiliation(s)
- Hatem A Tawfik
- Department of Ophthalmology, Ain Shams University, Cairo, Egypt
| | - Jonathan J Dutton
- Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A
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Bhattacharjee K, Medhi N, Mohapatra SSD. Orbital Venous Malformations (VM): Nondistensible. ATLAS OF ORBITAL IMAGING 2022:507-511. [DOI: 10.1007/978-3-030-62426-2_56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2023]
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Li Y, Yang J, Huang Y, Ge S, Song X, Jia R, Wang Y. Cellular heterogeneity and immune microenvironment revealed by single-cell transcriptome in venous malformation and cavernous venous malformation. J Mol Cell Cardiol 2021; 162:130-143. [PMID: 34536440 DOI: 10.1016/j.yjmcc.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/12/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022]
Abstract
Venous malformation (VM) and cavernous venous malformation (CVM) are two types of vascular malformations. Even if the two diseases are similar in appearance and imaging, the distinct cellular components and signaling pathways between them might help distinguish the two from a molecular perspective. Here, we performed single-cell profiling of 35,245 cells from two VM samples and three CVM samples, with a focus on endothelial cells (ECs), smooth muscle cells (SMCs) and immune microenvironment (IME). Clustering analysis based on differential gene expression unveiled 11 specific cell types, and determined CVM had more SMCs. Re-clustering of ECs and SMCs indicated CVM was dominated by arterial components, while VM is dominated by venous components. Gene set variation analysis suggested the activation of inflammation-related pathways in VM ECs, and upregulation of myogenesis pathway in CVM SMCs. In IME analysis, immune cells were identified to accounted for nearly 30% of the total cell number, including macrophages, monocytes, NK cells, T cells and B cells. Notably, more macrophages and monocytes were discovered in VM, indicating innate immune responses might be more closely related to VM pathogenesis. In addition, angiogenesis pathway was highlighted among the significant pathways of macrophages & monocytes between CVM and VM. In VM, VEGFA was highly expressed in macrophages & monocytes, while its receptors were all abundantly present in ECs. The close interaction of VEGFA on macrophages with its receptors on ECs was also predicted by CellPhoneDB analysis. Our results document cellular composition, significant pathways, and critical IME in CVM and VM development.
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Affiliation(s)
- Yongyun Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jie Yang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yazhuo Huang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Shengfang Ge
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xin Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yefei Wang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Atallah M, Edison N, Levi E, Elmalah I, Briscoe D. C-KIT Expression in Orbital Cavernous Venous Hemangiomas. Biomolecules 2021; 11:biom11081199. [PMID: 34439864 PMCID: PMC8392613 DOI: 10.3390/biom11081199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
Orbital (slow flow) cavernous venous hemangiomas (OCVH) are the most common benign orbital tumors in adults. The c-KIT is a tyrosine kinase receptor, which is expressed on several types of cells, is thought to play a key role in tumor pathogenesis. The purpose of this study was to evaluate the presence of the receptor c-KIT in OCVH. Our retrospective study examined 16 orbital cavernous venous hemangiomas from 16 cases operated on between 2006–2016 at Emek Medical Center. The mean tumor size was 18.4 mm. Symptoms appeared between 6 months and 22 years before operation. All specimens were analyzed for the c-KIT receptor through immunohistochemistry. The c-KIT was expressed by the endothelium in all 16 preparates. Staining was strong in two cases, moderate in six, and weak in eight cases, with no statistically significant correlation between staining and tumor size (p = 0.69) or the symptom duration (p = 0.15). We conclude that c-KIT may play an important role in the pathogenesis of OCVH. This pilot study is significant in that tumor-targeted therapy such as Imatinib Mesylate and Sunitinib may have a role in treating surgically complicated cases located in the orbital apex. A large multicenter collaborative study is necessary to examine the role of c-KIT in OCVH.
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Affiliation(s)
- Mizhir Atallah
- Ophthalmology Department, Emek Medical Center, Afula 18101, Israel;
- Laboratory of Ophthalmic Research, Emek Medical Center, Afula 18101, Israel;
| | - Natalia Edison
- The Tissue Diagnostics and Cancer Research Institute, Emek Medical Center, Afula 18101, Israel; (N.E.); (I.E.)
| | - Esther Levi
- Laboratory of Ophthalmic Research, Emek Medical Center, Afula 18101, Israel;
| | - Irit Elmalah
- The Tissue Diagnostics and Cancer Research Institute, Emek Medical Center, Afula 18101, Israel; (N.E.); (I.E.)
| | - Daniel Briscoe
- Ophthalmology Department, Emek Medical Center, Afula 18101, Israel;
- Laboratory of Ophthalmic Research, Emek Medical Center, Afula 18101, Israel;
- Correspondence: ; Tel.: +972-4-6494344
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9
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Glut 1, S-100, and Nerve Bundle Study in Vascular Anomalies. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02972-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Vascular anomalies grouped into vascular tumors (hemangioma) (HI) and vascular malformation (VM) are benign vascular lesions that are difficult to distinguish from one another clinically and often confused with each other at histopathology. This confusing terminology leads to improper diagnosis, illogical treatment, and misdirected research. This study aimed to study GLUT 1, S-100, and nerve bundle to differentiate hemangioma and vascular malformation. Thirty two cases of vascular lesions (26 vascular malformations and 6 hemangiomas) were taken into the study. For histological evaluation and immunohistochemistry (IHC), samples of vascular lesions were collected in formalin. All the hematoxylin and eosin-stained slides were evaluated under light microscope for histology and nerve bundles. Immunohistochemical staining was performed by streptavidin–biotin method for GLUT 1 and S-100. GLUT 1 was positive in all 6 cases of hemangiomas (100%) and only in 1 case of vascular malformation. Nerve bundle was present in 24 cases of vascular malformation (92.3%) out of 26 cases but not in any cases of hemangioma and S-100 was found positive in all vascular malformation cases (100%) but not in hemangioma. So GLUT 1 expression, S-100, and presence of nerve bundle in vascular lesions can help to differentiate hemangioma and vascular malformation.
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Risks and Benefits of Surgical Excision of Orbital Cavernous Venous Malformations (So-Called Cavernous Hemangioma): Factors Influencing the Outcome. Ophthalmic Plast Reconstr Surg 2021; 37:248-254. [PMID: 32826827 DOI: 10.1097/iop.0000000000001767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess risks and benefits associated with surgical excision of orbital cavernous venous malformation and analyze factors influencing the outcome. METHODS Design: cohort study. Participants: 164 consecutive patients undergoing surgical removal of orbital cavernous venous malformation. Intervention: lateral or anterior orbitotomy. Outcome measures: visual acuity, visual field, pupillary function, ocular motility, and fundus examination. Influence of the mass volume and tumor location on the outcome was evaluated. The threshold value and risk group for the volume were evaluated using the receiver operating characteristic analysis; 8 orbital different quadrants, extraconal/intraconal position, and orbital apex extension were considered as variables to evaluate the location. RESULTS Postoperatively overall visual acuity (p = 0.0084), visual field (p < 0.0001), diplopia (p < 0.0001), proptosis (p < 0.0001), ocular motility (p = 0.02), ptosis (p = 0.033), choroidal fold (p < 0.0001), disk edema (p = 0.0004) were significantly improved. The commonest location was the lateral quadrant (28%). Choroidal folds were associated with tumor greater than 1100 mm3 (p = 0.001). Visual loss occurred in 2 patients (1.2%) and tonic pupil in 5 (3%,) Visual deterioration was associated with the apical extension (p = 0.001). Pupil efferent defect was associated with lateral quadrant location (p = 0.011) and apical extension (p = 0.05). CONCLUSIONS Surgical removal of orbital cavernous venous malformation is a useful treatment modality, particularly for large size tumors. Removal of cavernous venous malformations located at the lateral aspect of the orbit carries an increased risk of permanent tonic pupil. Postoperative blindness is rarely seen and is often associated with the apical extension. Tailoring the surgical approach, depending on the relative position to the optic nerve, may have an important bearing on outcome.
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Mace T, Baldini N, Rousseau A, Haution D, Kün-Darbois JD. Cavernous venous malformation of the lacrimal gland. J Fr Ophtalmol 2021; 44:799-803. [PMID: 34020812 DOI: 10.1016/j.jfo.2020.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cavernous venous malformation (CVM) is a common benign vascular lesion of the orbit. It was previously known as "orbital cavernous hemangioma". Localization within the lacrimal gland is extremely rare. CASE PRESENTATION We describe the case of a 76-year-old man with an asymptomatic CVM of the left lacrimal gland incidentally discovered on a routine MRI. A curative and diagnostic en bloc surgical resection was performed, allowing for histological diagnosis. CONCLUSIONS CVM of the lacrimal gland is extremely rare and usually asymptomatic. Proptosis is the main symptom. On MRI, the lesion appears hypointense with heterogeneous enhancement after Gadolinium injection on T1-weighted imaging and hyperintense on T2 STIR-weighted imaging. Histological examination is mandatory for the diagnosis. Surgical resection is usually performed.
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Affiliation(s)
- T Mace
- Department of maxillofacial surgery, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France; Department of ophthalmology, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France.
| | - N Baldini
- Department of maxillofacial surgery, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France
| | - A Rousseau
- Department of pathology, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France; Faculty of medicine, Angers university, 28, rue Roger-Amsler, 49045 Angers cedex 01, France
| | - D Haution
- Department of ophthalmology, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France
| | - J-D Kün-Darbois
- Department of maxillofacial surgery, Angers university hospital, 4, rue Larrey, 49933 Angers cedex, France; Faculty of medicine, Angers university, 28, rue Roger-Amsler, 49045 Angers cedex 01, France
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Luca AC, Miron IC, Trandafir LM, Cojocaru E, Pădureţ IA, Trandafirescu MF, Iordache AC, Ţarcă E. Morphological, genetic and clinical correlations in infantile hemangiomas and their mimics. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:687-695. [PMID: 33817710 PMCID: PMC8112746 DOI: 10.47162/rjme.61.3.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Infantile hemangiomas (IHs) are the most frequent pediatric benign vascular tumors, with a reported incidence of 5% to 10%. They have self-limiting evolution pattern divided into a growth phase in the first 12 months and a regression one, that may take up to 10 years. Occasionally, hemangiomas might lead to local or systemic complications, depending on their morphological characteristics. The first line of treatment is β-blockers, such as Propranolol, Timolol, Nadolol, administered either locally or systemically. Newer therapeutic strategies involving laser therapy and angiotensin-converting enzyme inhibitors are being studied, while older treatment modalities like corticosteroids, Imiquimod, Vincristine, Bleomycin and Interferon-α have become second line therapy options. Before establishing the appropriate treatment, clinical, histological, and imaging investigations are required.
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Affiliation(s)
- Alina Costina Luca
- Department of Morphofunctional Sciences I - Pathology, Department of Mother and Child Medicine - Pediatrics, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania; ,
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Adult Primary Capillary Hemangioma of the Sclera: A Previously Undescribed Entity With a Review of Epibulbar Vascular Lesions. Ophthalmic Plast Reconstr Surg 2021; 36:327-333. [PMID: 31895731 DOI: 10.1097/iop.0000000000001582] [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]
Abstract
PURPOSE The objective of this article is to document a unique case of a primary hemangioma and review epibulbar vascular tumors of the conjunctiva and episclera. METHODS A case report with detailed histopathologic, histochemical, and immunohistochemical studies coupled with a comprehensive review of the relevant literature with a tabulation of previously reported epibulbar vascular lesions was performed. RESULTS A vascular tumor developed in a 46-year-old woman over 2-3 months that histopathologically was located in the superficial third of the normally avascular sclera and was composed of capillary caliber vessels. CD31 and CD34 positivity established the vascular nature of the lesion. Despite its adult onset, the tumor was also glut-1 positive, a vascular characteristic of childhood capillary hemangiomas that will ultimately involute. Smooth muscle actin was positive in the endothelial cells and associated pericytes. An ectatic muscular vessel identified in the midst of the lesion was interpreted as an anomalous intrascleral branch of an epibulbar anterior ciliary artery, where it perforated the sclera in the vicinity of the insertion of an extraocular rectus muscle. It was deduced to be the source of the capillary proliferation. A literature review failed to identify any previously reported epibulbar vascular tumor that originated primarily in the sclera or secondarily infiltrated this ocular tunic. CONCLUSION An adult primary capillary intrascleral neoplasm is described as the rarest of all epibulbar vascular tumors and in keeping with the exceptional status of the ocular endothelium was glut-1 positive. This lesion must be distinguished from an array of other common and esoteric epibulbar vascular conditions.
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14
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Moore RJ, Dave M, Stocker J, Aggarwal VR. Simplifying differential diagnoses of orofacial conditions - a guide to surgical sieves and red flags. Br Dent J 2021; 230:289-293. [PMID: 33712778 DOI: 10.1038/s41415-021-2717-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/21/2020] [Indexed: 11/09/2022]
Abstract
Formulation of a differential diagnosis with appropriate diagnostic tests is critical in day-to-day clinical practice. Many specialists or hospital-based practitioners in specialties such as oral medicine and oral surgery will be familiar with the use of surgical sieves and the term 'red flags' in their practice. However, it is the authors' experience that general dental practitioners may not be as familiar with such tools. Primary care practitioners are often the first port of call for patients with uncommon symptoms; therefore, it is essential that appropriate and timely referrals are made. The use of a surgical sieve and heightened awareness of red flags will assist practitioners significantly.
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Affiliation(s)
- Richard J Moore
- Division of Oral Surgery & Oral Medicine, University of Leeds, UK.
| | - Manas Dave
- Division of Dentistry, University of Manchester, UK
| | - Judith Stocker
- Department of Oral & Maxillofacial Surgery, University Hospitals Coventry & Warwickshire, UK
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15
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Azad AD, Sears CM, Hwang PH, Mohyeldin A, Fernandez-Miranda J, Kossler AL. Multi-compartment skull base orbital cavernous venous malformation: A rare presentation of a common orbital mass. Am J Ophthalmol Case Rep 2021; 21:101020. [PMID: 33598587 PMCID: PMC7868709 DOI: 10.1016/j.ajoc.2021.101020] [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: 07/24/2020] [Revised: 11/09/2020] [Accepted: 01/14/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose We present a unique case of an orbital intraconal cavernous venous malformation that extended along the trigeminal nerve to the pterygopalatine and middle cranial fossa. Our aim is to describe an atypical presentation of this common orbital vascular mass. Observations A 57-year-old female presented with right eye proptosis. Orbital magnetic resonance imaging demonstrated a lobulated contrast-enhancing mass involving the right intraconal orbital space, pterygopalatine fossa, and right middle cranial fossa, radiographically presumed to be a schwannoma. Intraoperative and histopathologic evaluation confirmed a cavernous venous malformation that extended along the trigeminal nerve. The mass, including its attachments to the cranial nerves and dura, was successfully removed via a combined transorbital and endoscopic endonasal approach. The patient recovered well with 20/20 vision, full extraocular movements, and resolution of proptosis. Conclusions This a rare presentation of an orbital cavernous venous malformation not previously described. Cavernous venous malformations typically present as ovoid well-circumscribed lesions; however, they can also extend outside the orbit along the path of cranial nerves, as was observed in this case. These types of lesions should be included in the differential diagnosis of masses arising from or extending along cranial nerves, even when involving the orbit.
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Affiliation(s)
- Amee D Azad
- Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Connie M Sears
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Ahmed Mohyeldin
- Department of Neurosurgery, Stanford Neuroscience Health Center, Stanford University, Palo Alto, CA, USA
| | - Juan Fernandez-Miranda
- Department of Neurosurgery, Stanford Neuroscience Health Center, Stanford University, Palo Alto, CA, USA
| | - Andrea L Kossler
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
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16
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Abstract
Orbital hemangiomas are the most common primary neoplasm of the orbit and manifest as two distinct pathologic entities: infantile hemangiomas and cavernous hemangiomas. In this article, both infantile and cavernous hemangiomas are reviewed, with special attention paid to the natural history, clinical presentation, and management teams and approaches involved. An example case of each type of hemangioma is presented along with pearls and tips a reader can take away after reading this article.
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Affiliation(s)
- Christopher M Low
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Janalee K Stokken
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
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17
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Mimura H, Akita S, Fujino A, Jinnin M, Ozaki M, Osuga K, Nakaoka H, Morii E, Kuramochi A, Aoki Y, Arai Y, Aramaki N, Inoue M, Iwashina Y, Iwanaka T, Ueno S, Umezawa A, Ozeki M, Ochi J, Kinoshita Y, Kurita M, Seike S, Takakura N, Takahashi M, Tachibana T, Chuman K, Nagata S, Narushima M, Niimi Y, Nosaka S, Nozaki T, Hashimoto K, Hayashi A, Hirakawa S, Fujikawa A, Hori Y, Matsuoka K, Mori H, Yamamoto Y, Yuzuriha S, Rikihisa N, Watanabe S, Watanabe S, Kuroda T, Sugawara S, Ishikawa K, Sasaki S. Japanese clinical practice guidelines for vascular anomalies 2017. Jpn J Radiol 2020; 38:287-342. [PMID: 32207066 PMCID: PMC7150662 DOI: 10.1007/s11604-019-00885-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.
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Affiliation(s)
- Hidefumi Mimura
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511 Japan
| | - Sadanori Akita
- Department of Plastic Surgery, Wound Repair and Regeneration, Fukuoka University, School of Medicine, Fukuoka, Japan
| | - Akihiro Fujino
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Mine Ozaki
- Department of Plastic and Reconstructive, Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Keigo Osuga
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroki Nakaoka
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akira Kuramochi
- Department of Dermatology, Saitama Medical University, Irumagun, Japan
| | - Yoko Aoki
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
| | - Yasunori Arai
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511 Japan
| | - Noriko Aramaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masanori Inoue
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Iwashina
- Department of Plastic and Reconstructive, Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Tadashi Iwanaka
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shigeru Ueno
- Department of Pediatric Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Umezawa
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junko Ochi
- Department of Diagnostic Radiology, Tohoku University, Sendai, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masakazu Kurita
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shien Seike
- Department of Plastic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuyuki Takakura
- Department of Signal Transduction, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Masataka Takahashi
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Kumiko Chuman
- Department of Dermatology, Kanto Central Hospital, Tokyo, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St. Luke’s International Hospital, Tokyo, Japan
| | - Shunsuke Nosaka
- Division of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Taiki Nozaki
- Department of Radiology, St Luke’s International Hospital, Tokyo, Japan
| | - Kazuki Hashimoto
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511 Japan
| | - Ayato Hayashi
- Department of Plastic and Reconstructive Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Satoshi Hirakawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsuko Fujikawa
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511 Japan
| | - Yumiko Hori
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Matsuoka
- Department of Pathology, Dokkyo Medical University, Saitama Medical Center, Koshigaya, Japan
| | - Hideki Mori
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Yuki Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoaki Rikihisa
- Department of Plastic and Reconstructive Surgery, Oyumino Central Hospital, Chiba, Japan
| | - Shoji Watanabe
- Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
| | - Shinichi Watanabe
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shunsuke Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Kosuke Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoru Sasaki
- Department of Plastic and Reconstructive Surgery, Center for Vascular Anomalies, Tonan Hospital, Sapporo, Japan
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18
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Li Y, Yang L, Yang J, Shi J, Chai P, Ge S, Wang Y, Fan X, Jia R. A novel variant in GPAA1, encoding a GPI transamidase complex protein, causes inherited vascular anomalies with various phenotypes. Hum Genet 2020; 139:1499-1511. [PMID: 32533362 DOI: 10.1007/s00439-020-02192-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
Vascular anomalies (VAs), comprising wide subtypes of tumors and malformations, are often caused by variants in multiple tyrosine kinase (TK) receptor signaling pathways including TIE2, PIK3CA and GNAQ/11. Yet, a portion of individuals with clinical features of VA do not have variants in these genes, suggesting that there are undiscovered pathogenic factors underlying these patients and possibly with overlapping phenotypes. Here, we identified one rare non-synonymous variant (c.968A > G) in the seventh exon of GPAA1 (Glycosylphosphatidylinositol Anchor Attachment Protein 1), shared by the four affected members of a large pedigree with multiple types of VA using whole-exome sequencing. GPAA1 encodes a glycosylphosphatidylinositol (GPI) transamidase complex protein. This complex orchestrates the attachment of the GPI anchor to the C terminus of precursor proteins in the endoplasmic reticulum (ER). We showed such variant led to scarce expression of GPAA1 protein in vascular endothelium and induced a localization change from ER membrane to cytoplasm and nucleus. In addition, expressing wild-type GPAA1 in endothelial cells had an effect to inhibit cell proliferation and migration, while expressing variant GPAA1 led to overgrowth and overmigration, indicating a loss of the quiescent status. Finally, a gpaa1-deficient zebrafish model displayed several types of developmental defects as well as vascular dysplasia, demonstrating that GPAA1 is involved in angiogenesis and vascular remodeling. Altogether, our results indicate that the rare coding variant in GPAA1 (c.968A > G) is causally related to familial forms of VAs.
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Affiliation(s)
- Yongyun Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Liu Yang
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Yang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jiahao Shi
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Peiwei Chai
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Shengfang Ge
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yefei Wang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200001, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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19
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Mimura H, Akita S, Fujino A, Jinnin M, Ozaki M, Osuga K, Nakaoka H, Morii E, Kuramochi A, Aoki Y, Arai Y, Aramaki N, Inoue M, Iwashina Y, Iwanaka T, Ueno S, Umezawa A, Ozeki M, Ochi J, Kinoshita Y, Kurita M, Seike S, Takakura N, Takahashi M, Tachibana T, Chuman K, Nagata S, Narushima M, Niimi Y, Nosaka S, Nozaki T, Hashimoto K, Hayashi A, Hirakawa S, Fujikawa A, Hori Y, Matsuoka K, Mori H, Yamamoto Y, Yuzuriha S, Rikihisa N, Watanabe S, Watanabe S, Kuroda T, Sugawara S, Ishikawa K, Sasaki S. Japanese Clinical Practice Guidelines for Vascular Anomalies 2017. J Dermatol 2020; 47:e138-e183. [PMID: 32200557 PMCID: PMC7317503 DOI: 10.1111/1346-8138.15189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/19/2023]
Abstract
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety and systematizing treatment, employing evidence‐based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQ) were decided based on the important clinical issues. For document retrieval, key words for published work searches were set for each CQ, and work published from 1980 to the end of September 2014 was searched in PubMed, Cochrane Library and Japana Centra Revuo Medicina databases. The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System technique. A total of 33 CQ were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies.
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Affiliation(s)
- Hidefumi Mimura
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Sadanori Akita
- Department of Plastic Surgery, Wound Repair and Regeneration, Fukuoka University, School of Medicine, Fukuoka, Japan
| | - Akihiro Fujino
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Mine Ozaki
- Department of Plastic, Reconstructive and Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Keigo Osuga
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroki Nakaoka
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akira Kuramochi
- Department of Dermatology, Saitama Medical University, Iruma-gun, Japan
| | - Yoko Aoki
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
| | - Yasunori Arai
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Noriko Aramaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masanori Inoue
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Iwashina
- Department of Plastic, Reconstructive and Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Tadashi Iwanaka
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shigeru Ueno
- Department of Pediatric Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Umezawa
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junko Ochi
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masakazu Kurita
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shien Seike
- Department of Plastic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuyuki Takakura
- Department of Signal Transduction, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Masataka Takahashi
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Kumiko Chuman
- Department of Dermatology, Kanto Central Hospital, Tokyo, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan
| | - Shunsuke Nosaka
- Division of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Taiki Nozaki
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Kazuki Hashimoto
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Ayato Hayashi
- Department of Plastic and Reconstructive Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Satoshi Hirakawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsuko Fujikawa
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yumiko Hori
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Matsuoka
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Hideki Mori
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Yuki Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoaki Rikihisa
- Department of Plastic and Reconstructive Surgery, Oyumino Central Hospital, Chiba, Japan
| | - Shoji Watanabe
- Department of Plastic and Reconstructive Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Shinichi Watanabe
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shunsuke Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Kosuke Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoru Sasaki
- Department of Plastic and Reconstructive Surgery, Center for Vascular Anomalies, Tonan Hospital, Sapporo, Japan
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20
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Mimura H, Akita S, Fujino A, Jinnin M, Ozaki M, Osuga K, Nakaoka H, Morii E, Kuramochi A, Aoki Y, Arai Y, Aramaki N, Inoue M, Iwashina Y, Iwanaka T, Ueno S, Umezawa A, Ozeki M, Ochi J, Kinoshita Y, Kurita M, Seike S, Takakura N, Takahashi M, Tachibana T, Chuman K, Nagata S, Narushima M, Niimi Y, Nosaka S, Nozaki T, Hashimoto K, Hayashi A, Hirakawa S, Fujikawa A, Hori Y, Matsuoka K, Mori H, Yamamoto Y, Yuzuriha S, Rikihisa N, Watanabe S, Watanabe S, Kuroda T, Sugawara S, Ishikawa K, Sasaki S. Japanese clinical practice guidelines for vascular anomalies 2017. Pediatr Int 2020; 62:257-304. [PMID: 32202048 PMCID: PMC7232443 DOI: 10.1111/ped.14077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/19/2023]
Abstract
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.
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Affiliation(s)
- Hidefumi Mimura
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Sadanori Akita
- Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akihiro Fujino
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Mine Ozaki
- Department of Plastic and Reconstructive, Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Keigo Osuga
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroki Nakaoka
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akira Kuramochi
- Department of Dermatology, Saitama Medical University, Irumagun, Japan
| | - Yoko Aoki
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
| | - Yasunori Arai
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Noriko Aramaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masanori Inoue
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Iwashina
- Department of Plastic and Reconstructive, Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Tadashi Iwanaka
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shigeru Ueno
- Department of Pediatric Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Umezawa
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junko Ochi
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiaki Kinoshita
- Department of Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masakazu Kurita
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shien Seike
- Department of Plastic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuyuki Takakura
- Department of Signal Transduction, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Masataka Takahashi
- Department of Reproductive Biology, Center for Regenerative Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Kumiko Chuman
- Department of Dermatology, Kanto Central Hospital, Tokyo, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St Luke's International Hospital, Tokyo, Japan
| | - Shunsuke Nosaka
- Division of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Taiki Nozaki
- Department of Radiology, St Luke's International Hospital, Tokyo, Japan
| | - Kazuki Hashimoto
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Ayato Hayashi
- Department of Plastic and Reconstructive Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Satoshi Hirakawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsuko Fujikawa
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Yumiko Hori
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Matsuoka
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Hideki Mori
- Department of Plastic Surgery, Ehime University Hospital, Toon, Japan
| | - Yuki Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoaki Rikihisa
- Department of Plastic and Reconstructive Surgery, Oyumino Central Hospital, Chiba, Japan
| | - Shoji Watanabe
- Department of Plastic and Reconstructive Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Shinichi Watanabe
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shunsuke Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Kosuke Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoru Sasaki
- Department of Plastic and Reconstructive Surgery, Center for Vascular Anomalies, Tonan Hospital, Sapporo, Japan
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Chai P, Yu J, Li Y, Shi Y, Fan X, Jia R. High-throughput transcriptional profiling combined with angiogenesis antibody array analysis in an orbital venous malformation cohort. Exp Eye Res 2020; 191:107916. [PMID: 31926133 DOI: 10.1016/j.exer.2020.107916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 12/15/2022]
Abstract
Orbital venous malformations (OVMs) are the most common benign orbital vascular disorders in adults and are characterized as enlarging encapsulated vascular neoplasms. These painless lesions grow slowly and become symptomatic with proptosis or visual disturbance. However, the pathogenic mechanism and diagnostic markers of OVMs remain poorly understood. To identify potential pathways involved in OVM formation, a cDNA microarray analysis was conducted with OVM samples and normal vascular tissues. These data were deposited in the National Omics Data Encyclopedia (NODE) database (accession number: OER033009). These pathway expression data were further confirmed by reverse transcription qPCR (RT-qPCR) in an OVM cohort. To explore the diagnostic markers in OVM, an angiogenesis antibody array was analyzed. The altered factors were further validated by enzyme-linked immunosorbent assay (ELISA) in the OVM cohort. Transcriptome screening revealed upregulated autophagy and VEGF pathways and downregulated Hippo, Wnt, hedgehog and vascular smooth muscle contraction signaling pathways in OVM samples. Furthermore, plasma EGF (p < 0.001) and Leptin (p < 0.01) levels were significantly elevated in OVM patients. Here, for the first time, we revealed the transcriptional background and plasma diagnostic markers in OVM, providing a novel understanding of OVM pathogenesis and facilitating the early diagnosis of OVM.
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Affiliation(s)
- Peiwei Chai
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Jie Yu
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Yongyun Li
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Yingyun Shi
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
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22
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Ratnayake GS, McNab AA, Dally MJ, Zajarski C, Senthi S, Ruben JD. Fractionated Stereotactic Radiotherapy for Cavernous Venous Malformations of the Orbital Apex. Ophthalmic Plast Reconstr Surg 2019; 35:322-325. [PMID: 30365476 DOI: 10.1097/iop.0000000000001239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The objective of this study was to investigate the efficacy and safety of fractionated stereotactic radiotherapy in the treatment of cavernous venous malformation of the orbital apex. METHODS The authors reviewed a prospective database from a single center of patients with cavernous venous malformation of the orbital apex who had treatment with fractionated stereotactic radiotherapy. The authors compared the symptoms, visual function and the size of the tumor pre- and posttreatment as well as reviewed the treatment details and the incidence of complications. RESULTS Six patients received treatment with fractionated stereotactic radiotherapy for cavernous venous malformation involving the orbital apex. The median age was 48 (range, 32-63), and 50% were female. Patients received a dose of 45 to 50.4 Gy in 1.8 to 2 Gy fractions. Median follow up was 33 months (range, 18-66 months). The average tumor volume reduction at posttreatment imaging after 12 months was 63%. All lesions reduced in size postradiotherapy and remained controlled for the duration of follow up. All patients who had proptosis or a visual field defect had an improvement in the symptoms posttreatment. There were no complications of the treatment. CONCLUSION Fractionated stereotactic radiotherapy appears to be a safe and effective management option for cavernous venous malformation of the orbital apex and leads to a sustained reduction of the volume of the lesion with associated improvement in symptoms and visual function.
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Affiliation(s)
| | - Alan A McNab
- Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital
| | | | | | - Sashendra Senthi
- Alfred Health Radiation Oncology, The Alfred Hospital.,Monash University, Melbourne, Australia
| | - Jeremy D Ruben
- Alfred Health Radiation Oncology, The Alfred Hospital.,Monash University, Melbourne, Australia
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23
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Shchurova IN, Pronin IN, Mel'nikova-Pitskhelauri TV, Serova NK, Grigor'eva NN, Fadeeva LM, Shishkina LV. [Orbital hemangiomas: capabilities of modern neuroradiological diagnostics]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2019; 82:57-69. [PMID: 30137039 DOI: 10.17116/neiro201882457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
MATERIAL AND METHODS In the period from 2010 to 2016. 14 patients with cavernous hemangioma (CH) and 2 patients with capillary hemangioma (CapH) of the orbit were examined. The age of CH patients varied from 17 to 67 years (median, 53 years); 8 females and 6 males. The age of CapH patients was 35 and 54 years. All patients underwent surgery with subsequent histological verification. CT-perfusion was performed in 10 CH patients and 2 CapH patients according to a developed low-dose protocol (80 kV, 200 mAs, tscan=40 s) with allowance for a target localizer (80 kV, 120 mAs) and at a maximum radiation dose of not more than 4.0 mZv. Neoplasm microcirculation was quantitatively assessed by calculating hemodynamic parameters: blood flow velocity (BFV), blood volume (BV), and mean transit time (MTT). MRI without and with contrast enhancement was performed in 11 CH patients and 2 CapH patients according to the ophthalmologic protocol (Signa GE, 3.0 T) accepted at the Institute: without contrast enhancement - T1, T2, and T2-FLAIR modes, T1 and T2 with a Fat Sat technique at a scan thickness of 3 mm, and DWI MRI; contrast enhancement - T1 (three projections) mode, including the Fat Sat technique. SWAN (n=2) and non-contrast MR perfusion ASL (n=3) were also used. Diffusion-weighted images (DWI) were processed with calculation of the apparent diffusion coefficient (ACD). RESULTS In all CH patients, CT-perfusion revealed low perfusion parameters of blood flow: BVCH=0.86±0.37 mL/100 g, BFVCH= 4.89±2.01 mL/100 g/min with a high mean transit time MTTCH=10.13±3.05 s compared to the same parameters of blood flow in the normal white matter: CBVNormWM=1.63±2.22 mL/100 g, CBFVNormWM=9.72±3.13 mL/100 g/min, and MTTNormWM=6.76±2.78 s. In CapH cases, significantly increased blood flow velocity and volume values and a low MTT value in the tumor were observed: BVCapH=10.30±4.10 mL/100 g, BFVCapH=119.72±53.13 mL/100 g/min, and MTTCapH=4.35±1.79 s. In the case of orbital hemangiomas, optimal MRI modes were T1 and T2 with the Fat Sat technique, a scan thickness of 3 mm, and intravenous contrast enhancement. The revealed pattern of contrast agent accumulation by CH, initially in the central part and then in the periphery, may be a useful radiographic sign in the differential diagnosis with other orbital tumors. CONCLUSION Modern CT- and MRI-based diagnostics of orbital hemangiomas provides not only the exact location, size, and spread of the lesion but also reveals the characteristic structural features of these tumors, and the use of perfusion techniques visualizes hemodynamics of the tumors. CT-perfusion-based hemodynamic parameters of cavernous hemangiomas typical of this type of hemangiomas may be used in the differential diagnosis with other tumors of this location. The use of contrast enhancement and the Fat Sat technique with a scan thickness of not more than 3 mm is optimal for MRI diagnostics of orbital hemangiomas.
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Affiliation(s)
| | - I N Pronin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - N K Serova
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - L M Fadeeva
- Burdenko Neurosurgical Institute, Moscow, Russia
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24
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Abstract
The recent International Society for the Study of Vascular Anomalies (ISSVA) classification of vascular anomalies can be applied to orbital lesions, dividing them into vascular tumors and vascular malformations. Orbital cavernous hemangiomas are probably best considered cavernous venous malformations under this classification. Management of symptomatic lesions can be with surgical excision or stereotactic fractionated radiotherapy in selected cases. Beta-blockers including propranolol and topical timolol maleate represent first-line therapy for infantile hemangiomas, although surgery has a role in selected cases. Orbital venous-lymphatic malformations are problematic but with improved imaging, neuroradiological intervention, and a multidisciplinary approach to management, outcomes are improving.
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Affiliation(s)
- Timothy John Sullivan
- Department of Ophthalmology, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Department of Ophthalmology, Lady Cilento Children's Hospital, Brisbane, Australia
- University of Queensland, Brisbane, Australia
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25
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Ford JR, Gonzalez-Barlatay J, Valenzuela AA. Early orbital infantile hemangioma that emphasizes the importance of glucose-transporter-1 (GLUT-1). CANADIAN JOURNAL OF OPHTHALMOLOGY 2018; 53:e58-e60. [PMID: 29631842 DOI: 10.1016/j.jcjo.2017.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/24/2017] [Accepted: 07/04/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Joshua R Ford
- Tulane University Department of Ophthalmology, New Orleans, LA
| | - Joaquín Gonzalez-Barlatay
- Tulane University Department of Ophthalmology, New Orleans, LA; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Jayaram A, Cohen LM, Lissner GS, Karagianis AG. A retrospective review of cases preoperatively diagnosed by radiologic imaging as cavernous venous malformations. Orbit 2017; 36:128-134. [PMID: 28368723 DOI: 10.1080/01676830.2017.1279666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study is to examine orbital lesions identified on preoperative radiologic imaging as cavernous venous malformations (CVMs), identify their imaging characteristics, and determine if these may help differentiate CVMs from other intraorbital masses. An IRB-approved retrospective chart review over 30 years was undertaken identifying lesions "consistent with cavernous hemangioma" on radiologic studies, which were subsequently surgically resected with a tissue diagnosis. All radiologic images (CT and MRI) obtained preoperatively were re-reviewed by a single masked neuroradiologist. The pattern of contrast enhancement on sequential MRI views was used to determine whether the enhancing characteristics helped identify CVMs compared to other intraorbital masses. Fifty-seven orbital lesions consistent with a CVM were identified on imaging. Fourteen (25%) of them were resected, of which nine (64%) were found to be CVMs on pathologic examination. Five (36%) were found to be a different lesion, most commonly schwannoma (21%). On imaging, CVMs tended to display heterogeneous progressive enhancement, whereas other tumors, in particular schwannomas, enhanced at their maximum level immediately. Based on these characteristics, on re-review, the masked neuroradiologist was able to differentiate a CVM versus other tumors for all 14 imaging cases. This study suggests that examining the pattern of contrast enhancement may help to correctly differentiate a CVM from other isolated, encapsulated orbital lesions on CT/MR imaging.
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Affiliation(s)
- Anupam Jayaram
- a Department of Ophthalmology , Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA
| | - Liza M Cohen
- a Department of Ophthalmology , Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA
| | - Gary S Lissner
- a Department of Ophthalmology , Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA
| | - Achilles G Karagianis
- b Department of Radiology , Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA
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27
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da Silva Filho TJ, de Oliveira DHIP, Brasil VLM, Nonaka CFW, da Silveira ÉJD, Queiroz LMG. An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity. Exp Mol Pathol 2017; 103:9-13. [PMID: 28545938 DOI: 10.1016/j.yexmp.2017.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 04/15/2017] [Accepted: 05/20/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate cases diagnosed as "oral hemangiomas" based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. MATERIAL AND METHODS All cases stored in the archives of an Oral Pathology Service and diagnosed as "oral hemangiomas" were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(-) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. RESULTS Only 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(-) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as "hemangiomas" were IHs. In the group of "capillary hemangiomas", most cases (56.2%) were PGs. Among the three "cellular hemangiomas", two were PGs and one was IH. Most (88.8%) "cavernous hemangiomas" were vascular malformations. CONCLUSION Careful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. CLINICAL RELEVANCE Accurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis.
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28
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Tobouti PL, Olegário I, de Sousa SCOM. Benign vascular lesions of the lips: Diagnostic approach. J Cutan Pathol 2017; 44:451-455. [PMID: 28111788 DOI: 10.1111/cup.12911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/13/2017] [Accepted: 01/18/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although not rare, vascular lesions occurring in the lips sometimes poses a difficult in properly diagnosing and handling them. In this study, vascular lesions occurring in the lips were retrieved from an Oral Pathology Service. METHODS Among 5600 biopsies, 131 cases were found. The following diagnoses were attributed: caliber-persistent artery, infantile hemangioma, vascular malformation, venous lake, thrombus, papillary endothelial hyperplasia and pyogenic granuloma. Clinical data were obtained from patients' records. RESULTS The lesions' frequency were: pyogenic granuloma (48%), followed by venous lake (17.5%), thrombus (14.5%), papillary endothelial hyperplasia (9.1%), infantile hemangioma (6.1%), caliber-persistent artery (3%) and vascular malformation (1.5%). Glucose transporter protein of the erythrocyte type was positive only in infantile hemangioma. The other markers (CD34 and smooth muscle action) were positive in all lesions, except for podoplanin, which was negative. CONCLUSION It is important to be aware of the occurrence of different vascular lip lesions and their histomorphologies in order to properly handle them. Despite most lesions do not represent any risk to the patient, some of them can reach large dimensions and thus cause aesthetical trouble. Immunohistochemistry may help when the vascular character of the lesion is not promptly determined and to differentiate among some lesions.
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Affiliation(s)
- Priscila L Tobouti
- School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Isabel Olegário
- School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
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29
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Calandriello L, Grimaldi G, Petrone G, Rigante M, Petroni S, Riso M, Savino G. Cavernous venous malformation (cavernous hemangioma) of the orbit: Current concepts and a review of the literature. Surv Ophthalmol 2017; 62:393-403. [PMID: 28131871 DOI: 10.1016/j.survophthal.2017.01.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 12/14/2022]
Abstract
The cavernous venous malformation of the orbit, previously called cavernous hemangioma, is the most common primary orbital lesion of adults. Cavernous venous malformation occurs more often in women and typically presents in the fourth and fifth decades of life. It is a benign vascular malformation characterized by a well-defined capsule and numerous large vascular channels. The most common sign of cavernous venous malformation is progressive axial proptosis from the preferential involvement of the intraconal orbital space. Optic nerve damage and other signs of orbital pathology may be present, with a variable degree of visual impairment. The combination of ultrasound, computed tomography, and magnetic resonance imaging leads to an accurate diagnosis in the vast majority of cases. Surgical and nonsurgical treatments are required in case of symptomatic lesions, with a characteristic multidisciplinary management influencing optimal outcome. Orbitotomy represents the traditional surgical approach. Recently, the endoscopic transnasal approach to the orbital cavity has gained interest, representing a feasible and safe, less-invasive surgical technique for the management of cavernous venous malformation.
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Affiliation(s)
- Luigi Calandriello
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy; Ophthalmology, Fondazione G. B. Bietti-IRCCS, Rome, Italy
| | - Gabriela Grimaldi
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Petrone
- Department of Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Rigante
- Department of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sergio Petroni
- Department of Pediatrics, Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Monica Riso
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gustavo Savino
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy.
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30
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Abstract
PURPOSE To review the treatment modalities available to clinicians who treat orbital and periocular vascular anomalies, with a focus on newer approaches. METHODS The authors' experience, along with a literature review, was used to provide a concise summary of the available approaches to the treatment of periocular vascular anomalies. Emerging diagnostic tools and therapies are highlighted. RESULTS The treatment of orbital and periocular vascular anomalies, including vascular malformations and tumors, increasingly utilizes a multidisciplinary team and a combination of endovascular, percutaneous, and open surgical techniques. CONCLUSIONS A growing reliance on new instrumentation and tools in a team-oriented approach to treatment may lead to better results with improved visual function and cosmesis and with reduced risk of complications.
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31
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Stagner AM, Jakobiec FA. A Critical Analysis of Eleven Periocular Lobular Capillary Hemangiomas in Adults. Am J Ophthalmol 2016; 165:164-73. [PMID: 26973052 DOI: 10.1016/j.ajo.2016.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide a critical analysis of a series of periocular lobular capillary hemangiomas in adults, outlining characteristic clinical and histopathologic patterns in comparison with those of other vascular tumors of adults and children. DESIGN Retrospective observational case series. METHODS Review of clinical data, hematoxylin-eosin-stained sections, and immunohistochemical studies of smooth muscle actin (SMA), D2-40, CD34, and glucose transporter 1 (GLUT-1). RESULTS The 7 female and 4 male patients were diagnosed with periocular lobular capillary hemangioma at a median age of 39 years (range, 17-82 years). The tumors were small (3-14 mm, median size 6 mm) and well circumscribed, arose over the course of weeks to months, and developed most commonly in the canthal region, followed by the upper eyelid skin. The tumors were all composed microscopically of repeating units of various sizes (lobules) consisting of CD34-postive, GLUT-1-negative endothelial cells and SMA-positive pericytes arranged in macro- or microlobules. Some foci also exhibited ectatic vessels or diffuse, nonlobular capillary proliferations. Excision was curative without recurrence. CONCLUSION Although capillary hemangiomas are more common in children, lobular capillary hemangiomas can also arise in the periocular region of adults. Some histopathologic features of these lesions are shared with those of infantile hemangioma and tufted angioma of children, but features of the clinical presentation and the results of immunohistochemical staining patterns are distinctive.
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Affiliation(s)
- Anna M Stagner
- David G. Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye & Ear Infirmary; and the Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Frederick A Jakobiec
- David G. Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye & Ear Infirmary; and the Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
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32
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Potential correlation between menopausal status and the clinical course of orbital cavernous hemangiomas. Ophthalmic Plast Reconstr Surg 2016; 31:187-90. [PMID: 25162412 DOI: 10.1097/iop.0000000000000240] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the clinical course of radiologically diagnosed orbital cavernous hemangiomas in the setting of presumed changes in estrogen/progesterone levels. METHODS An institutional review board-approved retrospective cohort chart review of patients from January 1, 1983, to January 1, 2013, was undertaken searching both outpatient ophthalmology diagnoses and radiologic diagnoses, identifying 32 orbital cavernous hemangiomas, which were subsequently divided into group 1, presumed to have stable levels of estrogen/progesterone, and group 2, presumed to have decreasing levels of estrogen/progesterone. Patients were then categorized as having short-term, mid-range, or long-term follow up. Serial imaging studies were evaluated and graded as having increased, decreased, or remained stable in size. RESULTS In group 1, no lesions decreased in size, 69% remained stable, and 31% increased in size. In group 2, no lesions increased in size, 45% remained stable, and 55% decreased in size. When evaluating only those patients with long-term follow up, many masses in group 1 increased in size, while the majority in group 2 decreased in size. CONCLUSIONS In this study evaluating orbital cavernous hemangiomas over a span of 30 years, the authors found that in postmenopausal women with assumed decreasing levels of circulating estrogen/progesterone, the vast majority of lesions either remained stable or decreased in size, suggesting the effect of hormone levels on such vascular lesions and supporting the role for observation in asymptomatic individuals in this patient population.
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González-Arriagada WA, Dias MA, Dias PDS, Martínez-Martínez M, Sena-Filho M, de Almeida OP. Oral encapsulated vascular malformation: An undescribed presentation in the mouth. J Clin Exp Dent 2016; 8:e84-8. [PMID: 26855712 PMCID: PMC4739374 DOI: 10.4317/jced.52698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/05/2015] [Indexed: 01/03/2023] Open
Abstract
Vascular lesions have been classified in two broad categories, hemangiomas and malformations. Encapsulated vascular lesions have not been reported in the oral cavity, but they were described in other sites, mainly in the orbit. Herein, we present a case of an oral encapsulated vascular lesion located in the right buccal mucosa of a 69-year-old male, including histological and immunohistochemical description and a literature review.
Key words:Buccal mucosa, hemangioma, vascular malformation, oral cavity.
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Affiliation(s)
| | - Márcio-Américo Dias
- DDS. Stomatology, Faculdade de Odontologia do INAPOS, Pouso Alegre, Minas Gerais, Brazil
| | | | - Marisol Martínez-Martínez
- DDS, MSc, PhD. Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Marcondes Sena-Filho
- DDS, MSc, PhD. Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Oslei-Paes de Almeida
- DDS, MSc, PhD. Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
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Silva Filho TJD, Oliveira DHIPD, Moura IDS, Medeiros LKDS, Gonzaga AKG, Brasil VLM, Queiroz LMG. Importance of GLUT1 in differential diagnosis of vascular anomalies. J Vasc Bras 2015. [DOI: 10.1590/1677-5449.0069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Vascular anomalies (VAs) include a group of distinct lesions, such as vascular system congenital malformations, as well as benign and malignant vascular tumors. These lesions may present similar clinical and histopathological features, leading to mistaken diagnoses and incorrect treatment choices. It is important that professionals responsible for monitoring the development of VAs conduct precise investigations and use the appropriate terminology. The human glucose transporter protein isoform 1 (GLUT1) has been proposed as a tool to aid in differential diagnosis between different VAs, given that it is a sensitive and specific marker for identification of infantile hemangiomas (HIs) in any organ. This article presents a review of the literature on this protein as an effective tool for identification and possible differential diagnosis between several VAs.
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Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. J Lipids 2015; 2015:971453. [PMID: 25949827 PMCID: PMC4407625 DOI: 10.1155/2015/971453] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 12/16/2022] Open
Abstract
Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.
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Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, DDU Gorakhpur University, Gorakhpur 273009, India
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Jakobiec FA, Callahan AB, Stagner AM, Lee NG, Rashid A, Mendoza P, Grove A, Freitag SK. Malignant rhabdoid transformation of a longstanding, aggressive, and recurrent orbital angiomyxoma. Surv Ophthalmol 2015; 60:166-76. [DOI: 10.1016/j.survophthal.2014.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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Werdich XQ, Jakobiec FA, Curtin HD, Fay A. A clinical, radiologic, and immunopathologic study of five periorbital intraosseous cavernous vascular malformations. Am J Ophthalmol 2014; 158:816-826.e1. [PMID: 25034115 DOI: 10.1016/j.ajo.2014.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To correlate the clinical, radiographic, histopathologic, and immunohistochemical features of 5 primary periorbital intraosseous cavernous vascular malformations. DESIGN Retrospective interventional case series. METHODS Clinical and operative records and radiographic images were reviewed. Histopathologic slides were evaluated with hematoxylin-eosin, trichrome, and elastin stains. Immunohistochemical studies were performed with a spectrum of monoclonal antibodies directed at antigens of vascular cells. RESULTS Three men and 2 women ranged in age from 36 to 64 years. Vision was unaffected and there was no proptosis or globe displacement. The slow-growing lesions measured 13-25 mm in greatest diameter (mean 16.4 mm). Computed tomographic studies revealed that 2 lesions were situated in the maxillary bone, 2 in the frontal, and 1 in the zygoma, all anteriorly and with circumscribed, lucent, honeycombed, or sunburst characteristics. Histopathologically the lesions were composed of cavernous or telangiectatic channels; 1 showed advanced fibrotic vascular involution. Immunohistochemistry demonstrated CD31/34 positivity for vascular endothelium and D2-40 negativity for lymphatic endothelium. A typically thin mural myofibroblastic cuff was smooth muscle actin positive, weakly calponin positive, and desmin negative. Glucose transporter-1 and Ki-67 were negative in the endothelium. CONCLUSIONS Intraosseous vascular lesions resemble orbital cavernous venous malformations (not true hemangiomas), except that their vascular walls are thinner owing to the constraints imposed by neighboring bone spicules, which limit the amount of interstitium from which mural myofibroblasts can be recruited. The bony trabeculae conferred the honeycomb or sunburst appearances observed radiographically. En bloc excision of these lesions was successful and avoided complications (mean follow-up, 46 months).
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Affiliation(s)
- Xiang Q Werdich
- David G. Cogan Laboratory of Ophthalmic Pathology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Frederick A Jakobiec
- David G. Cogan Laboratory of Ophthalmic Pathology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Hugh D Curtin
- Department of Radiology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Aaron Fay
- Ophthalmic Plastic Surgery, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Rootman DB, Heran MKS, Rootman J, White VA, Luemsamran P, Yucel YH. Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature. Br J Ophthalmol 2014; 98:880-8. [DOI: 10.1136/bjophthalmol-2013-304460] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jakobiec FA, Werdich XQ, Chodosh J, Freitag SK. An analysis of conjunctival and periocular venous malformations: clinicopathologic and immunohistochemical features with a comparison of racemose and cirsoid lesions. Surv Ophthalmol 2014; 59:236-44. [DOI: 10.1016/j.survophthal.2013.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/24/2013] [Accepted: 06/04/2013] [Indexed: 11/15/2022]
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Blei F. Update December 2013. Lymphat Res Biol 2013. [DOI: 10.1089/lrb.2013.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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