1
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Gong X, Chang SJ, Xiong P, Lin X, Wang L. Usefulness of Ultrasound in Verrucous Venous Malformation: a Series of 103 Cases. Dermatol Surg 2023; 49:1006-1011. [PMID: 37738289 DOI: 10.1097/dss.0000000000003922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
BACKGROUND Verrucous venous malformation (VVM), previously called "verrucous hemangioma," is a rare type of vascular malformation. OBJECTIVE Little is known about the ultrasonographic characteristics of VVM. The present study aimed to show the conventional US and elastographic features of a VVM. MATERIALS AND METHODS The US findings in 103 patients with VVMs were retrospectively evaluated. RESULTS On gray-scale ultrasound images, 98 (95.1%) lesions showed subcutaneous fat infiltration from skin across muscle to deep fascia. The other 5 (4.9%) sat in the subcutaneous layer with no skin involvement. Most (96.1%) lesions were hyperechoic. Furthermore, 71.8% of lesions were heterogeneous, 68.9% of which were with ill-defined margins. Calcifications and visible vessels were present in 5.7% and 10.7% of the VVM cases, respectively. By color Doppler ultrasound, all lesions were found with low vascular density and 4.9% showed enhanced blood flow after compression. Venous spectrum was observed in 67.0% of lesions. The elasticity score was 2.66 ± 0.48. CONCLUSION Diagnosis of a VVM is challenging in the clinic. However, we found that most VVM lesions present distinctive ultrasound imaging characteristics. These ultrasound findings may well contribute to the accuracy of VVM diagnosis, especially in those with the absence of epidermal changes and the lack of dermal involvement.
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Affiliation(s)
- Xia Gong
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Shih-Jen Chang
- Department of Plastic and Reconstruction Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Xiaoxi Lin
- Department of Plastic and Reconstruction Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Lizhen Wang
- Department of Pathology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
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2
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Cai R, Gu H, Yu Z, Yang X, Chen H, Lin X. Topical rapamycin in superficial lymphatic malformation: Microcystic lymphatic malformation or verrucous venous malformation? J Am Acad Dermatol 2023; 88:e267-e268. [PMID: 30710605 DOI: 10.1016/j.jaad.2019.01.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/10/2019] [Accepted: 01/17/2019] [Indexed: 11/23/2022]
Affiliation(s)
- Ren Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China
| | - Hao Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China
| | - Zhang Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China
| | - Xi Yang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China
| | - Hui Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China
| | - Xiaoxi Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China.
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3
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Diaz-Perez JA, Kerr DA. Benign and low-grade superficial endothelial cell neoplasms in the molecular era. Semin Diagn Pathol 2023:S0740-2570(23)00041-2. [PMID: 37149395 DOI: 10.1053/j.semdp.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
Vascular tumors are the most common mesenchymal neoplasms of the skin and subcutis, and they encompass a heterogeneous group with diverse clinical, histological, and molecular features, as well as biological behavior. Over the past two decades, molecular studies have enabled the identification of pathogenic recurrent genetic alterations that can be used as additional data points to support the correct classification of these lesions. The purpose of this review is to summarize the available data related to superficially located benign and low-grade vascular neoplasms and to highlight recent molecular advances with the role of surrogate immunohistochemistry to target pathogenic proteins as diagnostic biomarkers.
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Affiliation(s)
- Julio A Diaz-Perez
- Departments of Dermatology and Pathology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Darcy A Kerr
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
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4
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Chen H, Zhang G. Reply to "Comment on 'Sirolimus for the treatment of verrucous venous malformation: A retrospective cohort study': Are we missing the lymphatic malformation component?". J Am Acad Dermatol 2023; 88:e135-e136. [PMID: 30240777 DOI: 10.1016/j.jaad.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Beijing, China.
| | - Gaolei Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China
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5
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Cai R, Yang X, Gu H, Chen H, Lin X. Comment on "Sirolimus for the treatment of verrucous venous malformation: A retrospective cohort study": Are we missing the lymphatic malformation component? J Am Acad Dermatol 2023; 88:e133-e134. [PMID: 30240774 DOI: 10.1016/j.jaad.2018.08.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 08/16/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Ren Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Wellman Center of Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Xi Yang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hao Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoxi Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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6
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Phung TL. Histopathology of Vascular Malformations. Dermatol Clin 2022; 40:345-355. [DOI: 10.1016/j.det.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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7
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Hatfield J, Preston AK, Hendrick SJ. A solitary angiokeratoma on the toe of a teenaged girl. Proc (Bayl Univ Med Cent) 2022; 35:560-561. [DOI: 10.1080/08998280.2022.2068945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Jess Hatfield
- Texas A&M Health Science Center School of Medicine, Temple, Texas
| | - Allie K. Preston
- Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas
| | - Sophia J. Hendrick
- Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas
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8
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Schmidt BAR, El Zein S, Cuoto J, Al-Ibraheemi A, Liang MG, Paltiel HJ, Anderson ME, Labow BI, Upton J, Fishman SJ, Mulliken JB, Greene AK, Warman ML, Kozakewich H. Verrucous Venous Malformation-Subcutaneous Variant. Am J Dermatopathol 2021; 43:e181-e184. [PMID: 33899768 DOI: 10.1097/dad.0000000000001963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Verrucous venous malformation (VVM), previously called "verrucous hemangioma," typically involves the dermis and the subcutaneous fat. We have encountered patients with VVM confined to the hypodermis. MATERIALS AND METHODS During a nearly 20-year period, 13 patients, aged 2-17 years, presented with a subcutaneous mass in the limb without clinically obvious epidermal alterations. Consequently, operative excisions did not include the skin. RESULTS Histopathologically, the specimens were composed of blood-filled channels with morphologic characteristics of capillaries and veins that infiltrated adipose tissue. Aggregates often formed nodules with variable fibrosis and a component of large and radially oriented vessels. A diagnosis of VVM was supported by endothelial immunopositivity for GLUT-1 (25%-75% immunopositive channels in 16/16 specimens); D2-40 (1%-25% channels in 14/15 specimens); and Prox-1 (1%-50% of channels in 14/16 specimens). A MAP3K3 mutation was identified by droplet digital PCR in 3 of the 6 specimens. CONCLUSIONS Diagnosis of VVM in this uncommon location is challenging because of absence of epidermal changes and lack of dermal involvement. Imaging is not pathognomonic, and mimickers are many. Appropriate immunohistochemical stains and molecular analysis contribute to the correct diagnosis.
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Affiliation(s)
- Birgitta A R Schmidt
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Javier Cuoto
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Marilyn G Liang
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Megan E Anderson
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA
| | - Brian I Labow
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Joseph Upton
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Steven J Fishman
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA; and
| | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Arin K Greene
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Mathew L Warman
- Department of Orthopedics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harry Kozakewich
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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9
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Reyes-Hadsall SC, Fayiga FF, Duarte AM. Verrucous venous malformation with thrombocytopenia in a neonate. Pediatr Dermatol 2021; 38:1553-1557. [PMID: 34749432 DOI: 10.1111/pde.14857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Verrucous venous malformations (VVM) are rare, congenital, slow-flow vascular anomalies that have been historically difficult to characterize due to clinical mimics and unclear histological evaluation. A life-threatening complication of VVMs is localized intravascular coagulation. Herein, we describe a male neonate who presented with a congenital VVM on the left lower extremity with associated severe thrombocytopenia. We discuss the multifaceted diagnostic approach used to identify this VVM, while highlighting the use of WT-1 as a negative predictive marker; we additionally outline novel treatment options and management beyond cutaneous involvement.
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Affiliation(s)
- Sophia C Reyes-Hadsall
- University of Miami Miller School of Medicine, Miami, FL, USA.,Children's Skin Center, Miami, FL, USA
| | - Folasade F Fayiga
- Children's Skin Center, Miami, FL, USA.,Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL, USA.,The Dr. Philip Frost Department of Dermatology and Cutaneous Surgery at The University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ana M Duarte
- Children's Skin Center, Miami, FL, USA.,Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL, USA.,The Dr. Philip Frost Department of Dermatology and Cutaneous Surgery at The University of Miami Miller School of Medicine, Miami, FL, USA
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10
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Liu L, Zhou L, Zhao Q, Wei D, Jiang X. Eccrine angiomatous hamartoma with verrucous hemangioma-like features - an unusual combination. Indian J Dermatol Venereol Leprol 2021; 87:842-844. [PMID: 34379948 DOI: 10.25259/ijdvl_195_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/01/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Lian Liu
- Department of Dermatology, West China Hospital, Sichuan University, Sichuan, China
| | - Li Zhou
- Department of Core Facility, West China Hospital, Sichuan University, Sichuan, China
| | - Qian Zhao
- Department of Dermatology, West China Hospital, Sichuan University, Sichuan, China
| | - Danfeng Wei
- Department of Dermatology, West China Hospital, Sichuan University, Sichuan, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Sichuan, China
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11
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Leeds DR, Reddy S, Mamlouk MD, Lee P, McCullough WP. MRI in verrucous venous malformation: role in diagnosis and treatment. Clin Imaging 2021; 76:156-159. [PMID: 33607419 DOI: 10.1016/j.clinimag.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
Verrucous venous malformation (VVM), recently reclassified from verrucous hemangioma, is a rare congenital vascular anomaly that is traditionally diagnosed on histopathologic analysis of deep tissue biopsy. This case report documents the utility of magnetic resonance imaging in confirming VVM diagnosis, characterizing lesion extent and guiding therapy.
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Affiliation(s)
- David R Leeds
- Kaiser Permanente Santa Clara Medical Center, Department of Radiology, 700 Lawrence Expwy, Santa Clara, CA 95051, United States of America; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, United States of America
| | - Shriya Reddy
- Kaiser Permanente Santa Clara Medical Center, Department of Radiology, 700 Lawrence Expwy, Santa Clara, CA 95051, United States of America; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, United States of America
| | - Mark D Mamlouk
- Kaiser Permanente Santa Clara Medical Center, Department of Radiology, 700 Lawrence Expwy, Santa Clara, CA 95051, United States of America
| | - Pristine Lee
- Kaiser Permanente Santa Clara Medical Center, Department of Dermatology, 700 Lawrence Expwy, Santa Clara, CA 95051, United States of America
| | - William P McCullough
- Kaiser Permanente Santa Clara Medical Center, Department of Radiology, 700 Lawrence Expwy, Santa Clara, CA 95051, United States of America.
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12
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Beijnen UEA, Saldanha F, Ganske I, Upton J, Taghinia AH. Verrucous venous malformations of the hand. J Hand Surg Eur Vol 2019; 44:850-855. [PMID: 31042103 DOI: 10.1177/1753193419845271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Verrucous venous malformation is a rare vascular anomaly that presents as a deep purple skin stain and evolves into a larger scaly, keratotic lesion that can bleed and cause pain. Because of its similarity to other vascular lesions, it is often misdiagnosed and treated incorrectly. Ten patients with hand verrucous venous malformations evaluated between 1990 and 2017 were reviewed. Diagnosis was confirmed with histopathology. Six patients were initially misdiagnosed and two patients were incorrectly treated. Eight patients had excision procedures. Immunostaining for glucose transporter 1 protein was positive in all specimens that underwent staining. Most (three of four) of the patients with isolated small lesions remained disease free postoperatively, but those with larger lesions experienced recurrence or continued growth. Early recognition of verrucous venous malformation is important because nonsurgical ablative techniques are ineffective; the optimal treatment is surgery. Level of evidence: IV.
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Affiliation(s)
- Usha E A Beijnen
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, USA
| | - Francesca Saldanha
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, USA
| | - Ingrid Ganske
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, USA
| | - Joseph Upton
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, USA
| | - Amir H Taghinia
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, USA
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13
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Zhang G, Chen H, Zhen Z, Chen J, Zhang S, Qin Q, Liu X. Sirolimus for treatment of verrucous venous malformation: A retrospective cohort study. J Am Acad Dermatol 2019; 80:556-558. [PMID: 30048660 DOI: 10.1016/j.jaad.2018.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Gaolei Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China.
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhen Zhen
- Department of Otolaryngology, Peking University First Hospital, Beijing, China
| | - Jianyou Chen
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China
| | - Sheng Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China
| | - Qin Qin
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyan Liu
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Beijing, China
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14
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Boccara O, Ariche-Maman S, Hadj-Rabia S, Chrétien-Marquet B, Frassati-Biaggi A, Zazurca F, Brunelle F, Soupre V, Bodemer C, Fraitag S. Verrucous hemangioma (also known as verrucous venous malformation): A vascular anomaly frequently misdiagnosed as a lymphatic malformation. Pediatr Dermatol 2018; 35:e378-e381. [PMID: 30216519 DOI: 10.1111/pde.13671] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Verrucous hemangioma or verrucous venous malformation is a superficial venous malformation frequently misdiagnosed as a lymphatic malformation because of its classical hyperkeratotic appearance. Clinical characteristics of VVM were studied in patients with a histologically confirmed VVM, and validated in a prospective study of 18 patients. VVM was made of separated vascular elements with irregular shape, in a linear disposition, with variable thickness and keratosis. Its specific vascular pattern consisting of an erythematous patch with scattered small red to violet dots was easily identified using dermoscopy. In many cases, the typical clinical presentation of verrucous hemangioma is sufficient to establish the diagnosis and a biopsy may not be required.
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Affiliation(s)
- Olivia Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Sonia Ariche-Maman
- Department of Pediatric Radiology, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Smail Hadj-Rabia
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Bertrand Chrétien-Marquet
- Department of plastic and maxillo-facial surgery, Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Annonciade Frassati-Biaggi
- Department of Pathology, Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Frédéric Zazurca
- Department of plastic and maxillo-facial surgery, Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Francis Brunelle
- Department of Pediatric Radiology, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Veronique Soupre
- Department of plastic and maxillo-facial surgery, Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Christine Bodemer
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Sylvie Fraitag
- Department of Pathology, Institut Imagine, APHP, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Sorbonne Paris Cité, Paris, France
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15
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Abstract
This overview of mesenchymal tumors presenting in the skin and/or subcutis in children brings together the range of neoplasms and hamartomas which are seen in this age-group. It is not surprising from the perspective of the pediatric or general surgical pathologist that vascular anomalies, including true neoplasms and vascular malformations, are the common phenotypic category. Since there is considerable morphologic overlap among these lesions, clinicopathologic correlation may be more important than for many of the other mesenchymal tumors. The skin and subcutis are the most common sites of clinical presentation for the infantile myofibroma which is the most common of fibrous mesenchymal tumors in children. Several of the other mesenchymal tumors are more common adults-like dermatofibrosarcoma protuberans, but nonetheless have an important presence in children, even as a congenital neoplasm. A lipomatous tumor in a young child should be considered as a possible manifestation of an overgrowth syndrome.
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Affiliation(s)
- Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri.,2 Dermatopathology Center and Division of Dermatology, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 3 Department of Pathology, University of Virginia, Charlottesville, Virginia.,4 Department of Dermatology, University of Virginia, Charlottesville, Virginia
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16
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Tokat F, Lehman JS, Sezer E, Cetin ED, Ince U, Durmaz EO. Immunoreactivity of Wilms tumor 1 (WT1) as an additional evidence supporting hemangiomatous rather than inflammatory origin in the etiopathogenesis of angiolymphoid hyperplasia with eosinophilia. Dermatol Pract Concept 2018; 8:28-32. [PMID: 29445571 PMCID: PMC5808368 DOI: 10.5826/dpc.0801a06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/14/2017] [Indexed: 11/21/2022] Open
Abstract
Background Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferative disorder mainly located in the periauricular region. The etiopathogenesis of ALHE is unknown, and it is still controversial as to whether the entity represents a benign vascular neoplasm or an inflammatory process. Aim Recently, the intracytoplasmic staining pattern of Wilms tumor 1 (WT1) on immunohistochemistry has highlighted true vascular neoplasms, such as microvenular hemangioma, tufted angioma, and spindle cell hemangioma, which has made it helpful to distinguish ALHE from vascular malformations, as there is a negative staining pattern in the other entities. We aimed to investigate the immunoreactivity of ALHE specimens for WT1 as well as glucose transporter protein 1 (GLUT1) immunohistochemistry, an important and sensitive marker for the diagnosis of infantile hemangioma, which recently has been described to label other hemangiomas, such as verrucous hemangioma. Material and methods Clinical data and histopathological specimens from patients diagnosed with ALHE were reviewed, and immunohistochemical staining and microscopic analysis for WT-1 and GLUT1 were performed. Results Intracytoplasmic endothelial staining of WT1 was detected in 19 of 20 ALHE specimens. GLUT1 was not detected in any ALHE specimen. Conclusions We conclude that ALHE may represent a true hemangioma (i.e., benign vascular neoplasia) characterized by an eosinophil- and lymphocyte-rich inflammatory component as opposed to the reactive inflammatory dermatosis with a positive intracytoplasmic staining pattern for WT1. As far as we are aware, WT1 staining for ALHE has not been described to date.
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Affiliation(s)
- Fatma Tokat
- Department of Pathology Acibadem University School of Medicine, Istanbul, Turkey
| | - Julia S Lehman
- Department of Dermatopathology Mayo Clinic, Rochester, MN, USA
| | - Engin Sezer
- Department of Dermatology Acibadem University School of Medicine, Istanbul, Turkey
| | | | - Umit Ince
- Department of Pathology Acibadem University School of Medicine, Istanbul, Turkey
| | - Emel Ozturk Durmaz
- Department of Dermatology Acibadem University School of Medicine, Istanbul, Turkey
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17
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The utility of GLUT1 as a diagnostic marker in cutaneous vascular anomalies: A review of literature and recommendations for daily practice. Pathol Res Pract 2017; 213:591-597. [DOI: 10.1016/j.prp.2017.04.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/08/2017] [Accepted: 04/09/2017] [Indexed: 11/20/2022]
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Putra J, Gupta A. Kaposiform haemangioendothelioma: a review with emphasis on histological differential diagnosis. Pathology 2017; 49:356-362. [PMID: 28438388 DOI: 10.1016/j.pathol.2017.03.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/03/2017] [Accepted: 03/21/2017] [Indexed: 12/25/2022]
Abstract
Kaposiform haemangioendothelioma (KHE) is a rare, locally aggressive/borderline vascular tumour primarily seen in neonates and children. KHE is occasionally associated with Kasabach-Merritt phenomenon and tends to have a poor clinical prognosis. While the histological features of tufted angiomas and KHE overlap, some believe tufted angiomas are a milder, benign, more localised counterpart of KHE. The other histological differential diagnoses of KHE include infantile haemangioma, congenital haemangioma, spindle cell haemangioma, verrucous malformation/haemangioma, and Kaposi sarcoma. Microscopically, KHE is characterised by confluent nodules of neoplastic spindled endothelial cells involving multiple planes of tissue which are positive for endothelial, lymphatic, and smooth muscle markers. Resection, once thought to be the definitive treatment for KHE, is often unattainable due to the extent of the lesion; thus, single or combination chemotherapies have been used to treat these patients. Sirolimus has recently been reported to be a successful agent to treat refractory and complicated cases of KHE.
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Affiliation(s)
- Juan Putra
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States.
| | - Anita Gupta
- Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Prindaville B, Lawrence H, Singh V, Nopper AJ, Horii KA. Immunohistochemical Staining of Pediatric Solitary Angiokeratomas. Pediatr Dermatol 2017; 34:211-213. [PMID: 28297141 DOI: 10.1111/pde.13089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The precise etiology and subtype of vessels constituting angiokeratomas is poorly understood. We sought to characterize the vessels by studying prospero-related homeobox gene-1 and D2-40 expression in 22 pediatric solitary angiokeratomas. Routine histologic examination demonstrated a mix of lymph-containing vessels and erythrocyte-filled small vessels. Our results suggest that angiokeratomas may in part be comprised of vessels with lymphatic differentiation.
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Affiliation(s)
- Brea Prindaville
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Hillary Lawrence
- Department of Dermatology, College of Medicine, University of Oklahoma, Oklahoma City, Oklahoma
| | - Vivekanand Singh
- Department of Pathology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Amy J Nopper
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Kimberly A Horii
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
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20
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Reactive Eccrine Glands Hyperplasia in Vascular Proliferations. Am J Dermatopathol 2016; 39:416-417. [PMID: 27655117 DOI: 10.1097/dad.0000000000000665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Fatani M, Al Otaibi H, Mohammed M, Hegazy O. Verrucous Hemangioma Treated with Electrocautery. Case Rep Dermatol 2016; 8:112-7. [PMID: 27462218 PMCID: PMC4943306 DOI: 10.1159/000446100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/12/2016] [Indexed: 11/27/2022] Open
Abstract
Verrucous hemangioma is a rare vascular malformation consisting of a proliferation of dilated blood vessels of different sizes that occupy the dermis and hypodermis. The epidermis of the affected area shows a strong proliferative reaction that presents as a warty appearance. Here, we report the case of a 17-year-old male who presented with an asymptomatic warty growth above the lateral malleolus on the right leg, which healed after electrocautery.
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Affiliation(s)
- Mohammad Fatani
- Department of Dermatology, Hera General Hospital, Makkah, Saudi Arabia
| | | | | | - Osama Hegazy
- Department of Pathology, Hera General Hospital, Makkah, Saudi Arabia
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22
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Histopathology and Pathogenesis of Vascular Tumors and Malformations. VASCULAR TUMORS AND DEVELOPMENTAL MALFORMATIONS 2016. [DOI: 10.1007/978-1-4939-3240-5_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Couto JA, Vivero MP, Kozakewich HPW, Taghinia AH, Mulliken JB, Warman ML, Greene AK. A somatic MAP3K3 mutation is associated with verrucous venous malformation. Am J Hum Genet 2015; 96:480-6. [PMID: 25728774 DOI: 10.1016/j.ajhg.2015.01.007] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/09/2015] [Indexed: 11/30/2022] Open
Abstract
Verrucous venous malformation (VVM), also called "verrucous hemangioma," is a non-hereditary, congenital, vascular anomaly comprised of aberrant clusters of malformed dermal venule-like channels underlying hyperkeratotic skin. We tested the hypothesis that VVM lesions arise as a consequence of a somatic mutation. We performed whole-exome sequencing (WES) on VVM tissue from six unrelated individuals and looked for somatic mutations affecting the same gene in specimens from multiple persons. We observed mosaicism for a missense mutation (NM_002401.3, c.1323C>G; NP_002392, p.Iso441Met) in mitogen-activated protein kinase kinase kinase 3 (MAP3K3) in three of six individuals. We confirmed the presence of this mutation via droplet digital PCR (ddPCR) in the three subjects and found the mutation in three additional specimens from another four participants. Mutant allele frequencies ranged from 6% to 19% in affected tissue. We did not observe this mutant allele in unaffected tissue or in affected tissue from individuals with other types of vascular anomalies. Studies using global and conditional Map3k3 knockout mice have previously implicated MAP3K3 in vascular development. MAP3K3 dysfunction probably causes VVM in humans.
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Affiliation(s)
- Javier A Couto
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Matthew P Vivero
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Harry P W Kozakewich
- Vascular Anomalies Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Amir H Taghinia
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Vascular Anomalies Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Vascular Anomalies Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Matthew L Warman
- Vascular Anomalies Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Genetics, Harvard Medical School, Boston, MA 02115, USA; Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA 02115, USA
| | - Arin K Greene
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Vascular Anomalies Center, Boston Children's Hospital, Boston, MA 02115, USA.
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