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Ma C, Su X, Liu Y, Liu Y. A retrospective study: Clinicopathological and immunohistochemical analysis of 54 cases of tufted angioma. Indian J Dermatol Venereol Leprol 2020; 86:24-32. [DOI: 10.4103/ijdvl.ijdvl_777_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Tufted angiomas (TAs) are uncommon benign vascular tumors mostly located cutaneously or subcutaneously in the skin of the neck and upper trunk, which appear during childhood and grow slowly. TAs are a variant of lobular capillary hemangiomas. This is the first study to provide an overview of the current literature in combination with the authors' own clinical experience on this rare entity in the head and neck area with non-dermatological localization. METHODS A selective Medline and Google Scholar database search was performed. Additionally, we conducted an ICD-10-based database search on hemangiomas (D18.0) in the Charité SAP patient records. RESULTS We identified 13 reports in the literature consisting of 16 cases of TA of the head and neck. Males were predominantly affected by TAs (70.6%). The mean age of the patients at the time of surgery was 31.5 years; the mean maximum diameter of the tumors was 16.3 mm. Additionally, we report on one case of TA in our Department of Head and Neck Surgery. A male patient presented with swelling and redness of the left upper eyelid. Radiological examination with computed tomography showed a suprabulbar tumor with a diameter of 13 mm. The tumor was surgically removed via a transcutaneous blepharoplasty approach with the patient under general anesthesia. DISCUSSION There is only one other case report on the surgical excision of an intra-orbital TA described to date. Here, we present an epidemiological overview, therapeutic considerations, and differential diagnoses.
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Affiliation(s)
- S M Häußler
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medical Center Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - F C Uecker
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medical Center Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Knopke
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medical Center Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - F Roßner
- Institute of Pathology, Charité - University Medical Center Berlin, Campus Charité Mitte, Berlin, Germany
| | - H Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medical Center Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Böttcher
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Escudero-Góngora M, Corral-Magaña O, Gómez C, Martín-Santiago A. Topical Rapamycin: An Additional Therapeutic Option for Tufted Angioma in Adults. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2017.12.022] [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
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Escudero-Góngora M, Corral-Magaña O, Gómez C, Martín-Santiago A. Rapamicina tópica: otra opción terapéutica del angioma en penacho en el adulto. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:192-194. [DOI: 10.1016/j.ad.2017.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/21/2017] [Accepted: 04/21/2017] [Indexed: 11/16/2022] Open
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Häußler SM, Uecker FC, Knopke S, Roßner F, Olze H, Böttcher A. [Tufted angiomas of the head and neck. German version]. HNO 2017; 65:981-986. [PMID: 28761971 DOI: 10.1007/s00106-017-0379-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tufted angiomas (TAs) are uncommon benign vascular tumors mostly located cutaneously or subcutaneously in the skin of the neck and upper trunk, which appear during childhood and grow slowly. TAs are a variant of lobular capillary hemangiomas. This is the first study to provide an overview of the current literature in combination with the authors' own clinical experience on this rare entity in the head and neck area with non-dermatological localization. METHODS A selective Medline and Google Scholar database search was performed. Additionally, we conducted an ICD-10-based database search on hemangiomas (D18.0) in the Charité SAP patient records. RESULTS We identified 13 reports in the literature consisting of 16 cases of TA of the head and neck. Males were predominantly affected by TAs (70.6%). The mean age of the patients at the time of surgery was 31.5 years; the mean maximum diameter of the tumors was 16.3 mm. Additionally, we report on one case of TA in our Department of Head and Neck Surgery. A male patient presented with swelling and redness of the left upper eyelid. Radiological examination with computed tomography showed a suprabulbar tumor with a diameter of 13 mm. The tumor was surgically removed via a transcutaneous blepharoplasty approach with the patient under general anesthesia. DISCUSSION There is only one other case report on the surgical excision of an intra- orbital TA described to date. Here, we present an epidemiological overview, therapeutic considerations, and differential diagnoses.
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Affiliation(s)
- S M Häußler
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - F C Uecker
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - S Knopke
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - F Roßner
- Institut für Pathologie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Deutschland
| | - H Olze
- Klinik für Hals-Nasen-Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - A Böttcher
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Kimura R, Yoshida Y, Wakumoto K, Yamada N, Yamamoto O. Successful treatment of tufted angioma with low-dose electron beam radiation therapy: Report of two cases. J Dermatol 2017. [PMID: 28623854 DOI: 10.1111/1346-8138.13936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Ryoko Kimura
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yuichi Yoshida
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Keiko Wakumoto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Nanako Yamada
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Osamu Yamamoto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan
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D'Amico RS, Zanazzi G, Hargus G, Dyster T, Chan S, Lignelli-Dipple A, Wang TJC, Faust PL, McKhann GM. Intracranial intraaxial cerebral tufted angioma: case report. J Neurosurg 2017; 128:524-529. [PMID: 28298028 DOI: 10.3171/2016.10.jns162207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Tufted angioma (TA) is a rare, slow-growing, vascular lesion that commonly presents as a solitary macule, papule, or nodule arising in the soft tissues of the torso, extremities, and head and neck in children and young adults. Adult-onset cases have been infrequently reported. While typically benign, TAs may be locally aggressive. Complete physical examination and hematological workup are recommended in patients with TA to exclude the presence of Kasabach-Merritt phenomenon (KMP). The authors describe the case of a 69-year-old man with a contrast-enhancing frontal lobe lesion, with surrounding vasogenic edema, which was treated by gross-total resection. Characteristic histological features of a TA were demonstrated, with multiple cannonball-like tufts of densely packed capillaries emanating from intraparenchymal vessels in cerebral cortex and adjacent white matter. Tumor recurrence was detected after 4 months and treated with adjuvant Gamma Knife radiosurgery. To the extent of the authors' knowledge, this case illustrates the first report of TA presenting in an adult as an intracranial intraaxial tumor without associated KMP. The fairly rapid regrowth of this tumor, requiring adjuvant treatment after resection, is consistent with a potential for locally aggressive growth in a TA occurring in the brain.
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Affiliation(s)
| | | | | | | | | | | | - Tony J C Wang
- 4Radiation Oncology, Columbia University Medical Center, New York, New York
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O'Rafferty C, O'Regan GM, Irvine AD, Smith OP. Recent advances in the pathobiology and management of Kasabach-Merritt phenomenon. Br J Haematol 2015; 171:38-51. [PMID: 26123689 DOI: 10.1111/bjh.13557] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Kasabach-Merritt Phenomenon (KMP) refers to the clinical constellation of thrombocytopenia, consumptive coagulopathy and purpura associated with Kaposiform haemangioedothelioma or tufted angioma, but not the more common infantile haemangioma. It shows a variable and unpredictable response to traditional pharmacological agents, such as steroids, vincristine or interferon alpha 2a or 2b. More recently, the interaction between platelets and endothelial cells and the proangiogenic phenotype that results has been recognized to underly the pathogenesis of this disorder. Recent efforts have attempted to target the platelet by using antiplatelet agents and by the withholding of platelet transfusions even in those patients who have significant thrombocytopenia and laboratory evidence of coagulopathy. Excellent response rates and prompt results have been achieved by combining antiplatelet therapy with vincristine, without the need for steroid use. This synergistic approach moves away from the conventional wisdom of treating the underlying lesion to control the coagulopathy. Sirolimus, which is directed against the PI3/AKT/mTOR downstream signalling pathway involved in lymphangiogenesis, has also shown promising results, although further study is needed.
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Affiliation(s)
- Ciara O'Rafferty
- Department of Haematology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Grainne M O'Regan
- Department of Dermatology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Alan D Irvine
- Department of Dermatology, Our Lady's Children's Hospital, Dublin, Ireland.,Trinity College, Dublin, Dublin, Ireland
| | - Owen P Smith
- Department of Haematology, Our Lady's Children's Hospital, Dublin, Ireland.,Trinity College, Dublin, Dublin, Ireland
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