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Izumi T, Osawa M, Tsuru I, Ono A, Kume H, Shiga Y, Nakamura M. A giant pelvic arteriovenous malformation. IJU Case Rep 2024; 7:399-403. [PMID: 39224686 PMCID: PMC11366434 DOI: 10.1002/iju5.12767] [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: 05/24/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Pelvic arteriovenous malformations are rare in male patients. We present a case of pelvic arteriovenous malformation involving the seminal vesicle. Case presentation A 58-year-old man was diagnosed with pelvic arteriovenous malformation that involved the left seminal vesicle by angiography. The patient underwent three embolization procedures and made favorable progress after the embolizations. Conclusion Herein, we report a rare case of pelvic arteriovenous malformation involving the seminal vesicle treated by embolizations with good outcome.
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Affiliation(s)
- Taro Izumi
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Marie Osawa
- Department of RadiologyNTT Medical Center TokyoTokyoJapan
| | - Ibuki Tsuru
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Akihiro Ono
- Department of UrologyNTT Medical Center TokyoTokyoJapan
| | - Haruki Kume
- Department of UrologyThe University of Tokyo HospitalTokyoJapan
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2
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Ibáñez-Mancera NG, Partida-Rodríguez E, Partida-Rodríguez O. Phleboliths of venous malformation studied with scan electron microscopy. Case report and literature review. J Clin Exp Dent 2024; 16:e921-e925. [PMID: 39219821 PMCID: PMC11360459 DOI: 10.4317/jced.61738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 05/25/2024] [Indexed: 09/04/2024] Open
Abstract
Vascular anomalies are classified in two categories, vascular tumors and vascular malformations. Among the latter, venous malformations are the second most common vascular anomalies. In addition to pain and/or increase of volume, venous malformations can lead to phlebolith formation with time. We present the case of a female patient of 17 years of age, with a tumoration of four centimeters of diameter, located in the submentonian region, with nine calcified foci identified by three-dimension reconstruction. The calcifications were studied with scanning electron microscopy, detecting mainly the presence of carbon, oxygen and calcium. Regarding the tissue organization, it was possible to observe the development of filamentous aggregates of carbon macroparticles. As an important part of the evaluation for diagnostics and for the treatment of vascular anomalies, it is necessary to do a complete clinical history, and the clinic evaluation of the lesion should be complemented with imagenology studies. This will allow identification of the size and extension of the lesion and the presence of calcifications, which must be considered as a presumptuous diagnosis to vascular lesion. Key words:Vascular anomalies, vascular tumors, vascular malformations, phlebolith.
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Affiliation(s)
| | - Eric Partida-Rodríguez
- Servicio de Cirugía Maxilofacial del Centro Médico "Lic. Adolfo López Mateos" ISEM, México. Facultad de Odontología Universidad Autónoma del Estado de México, México
| | - Oswaldo Partida-Rodríguez
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, México. Hospital General de México, CDMX México
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3
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Ku L, Ma X. Congenital giant pelvic arteriovenous malformation. Am J Med Sci 2024:S0002-9629(24)01319-3. [PMID: 38909901 DOI: 10.1016/j.amjms.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024]
Affiliation(s)
- Leizhi Ku
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, PR China
| | - Xiaojing Ma
- Department of Echocardiography, Wuhan Asia Heart Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, PR China.
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4
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Gullabzada M, Brito Y, Gonzalez AI, Zena D, Jabri MN. Infantile Hemangioma in Infancy: A Case Study on the Natural Course and Therapeutic Management. Cureus 2024; 16:e63156. [PMID: 39070329 PMCID: PMC11272419 DOI: 10.7759/cureus.63156] [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] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Infantile hemangiomas (IHs) are common benign vascular tumors that affect infants. In this case report, we detail the natural course of an IH in an infant monitored over four months without medical intervention, illustrating the benign progression and potential for spontaneous stabilization of such lesions. The aim was to observe changes in the size and morphology of the hemangioma, alongside the infant's overall health and developmental milestones, through regular clinical assessments. This case presented a challenge as the patient's parents lacked English fluency, lacked healthcare access, and had low socioeconomic status. It highlights the importance of individualized patient care, advocating for careful observation and restraint in the application of pharmacological treatments when clinically unnecessary. The report contributes to existing pediatric dermatology knowledge by emphasizing the natural benign behavior of IH and the need for a balanced approach to treatment decisions, ensuring safe and favorable long-term outcomes for patients.
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Affiliation(s)
| | - Yesenia Brito
- Surgery, St. George's University School of Medicine, True Blue, GRD
| | - Ana I Gonzalez
- Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Dawit Zena
- Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Mohamed N Jabri
- Pediatrics, Jabri Medical Ltd., Bloomingdale, USA
- Pediatrics, Alexian Brothers Hospital, Elk Grove Village, USA
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5
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Mahajan A, Nagpal T, Shah A, Daithankar S. Excision of arteriovenous malformation in an emergency situation - A case report. Natl J Maxillofac Surg 2024; 15:319-322. [PMID: 39234118 PMCID: PMC11371296 DOI: 10.4103/njms.njms_159_23] [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: 09/06/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 09/06/2024] Open
Abstract
An arteriovenous malformation (AVM) is an infrequent congenital vascular anomaly that can affect the vasculature and involve the endothelium and neighboring cells of any anatomical structure. AVMs are characterized histologically by abnormal AV shunts with atypical interconnecting capillary beds. AVM can cause functional and esthetic issues like face asymmetry, pain, osteolytic changes, and unanticipated hemorrhage or squeeze and tear of the surrounding tissue without causing any symptoms. The literature search yielded limited case reports on AVMs in the facial region. Insufficient diagnosis, limited knowledge, and a lack of literature can lead to severe bleeding and potentially fatal hemorrhagic incidents following dental procedures like tooth extraction, surgery, puncture wounds, or blunt injuries in the affected area. In this manuscript, we report a case of AV malformation involving the left cheek and buccal mucosa region in a 37-year-old male patient who reported uncontrolled bleeding after trauma. This report highlights the management of AV malformation in an emergency by facial artery ligation and surgical excision.
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Affiliation(s)
- Amit Mahajan
- Department of Oral and Maxillofacial Surgery, K. M. Shah Dental College and Hospital, Gujarat, India
| | - Tapan Nagpal
- Department of ENT, SBKS Institute of Medical Sciences, Sumandeep Vidyapeeth Deemed to be University, Gujarat, India
| | - Aditya Shah
- Department of Oral and Maxillofacial Surgery, K. M. Shah Dental College and Hospital, Gujarat, India
| | - Sharvari Daithankar
- Department of Oral and Maxillofacial Surgery, K. M. Shah Dental College and Hospital, Gujarat, India
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6
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Hartman E, Balkin DM, See AP. A Review of the Current State and Future Directions for Management of Scalp and Facial Vascular Malformations. J Korean Neurosurg Soc 2024; 67:315-325. [PMID: 38720545 PMCID: PMC11079557 DOI: 10.3340/jkns.2024.0032] [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: 02/06/2024] [Revised: 04/06/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
Vascular malformations are structural abnormalities that are thought to result from errors in vasculogenesis and angiogenesis during embryogenesis. Vascular malformations of the scalp present unique management challenges due to aesthetic and functional implications. This review examines the pathophysiology, clinical presentation, and management techniques for six common types of vascular malformations of the face and scalp : infantile hemangioma, capillary malformations, venous malformations, lymphatic malformations, arteriovenous malformations, and arteriovenous fistulas. These lesions range from common to rare, and have very different natural histories and management paradigms. There has been increasing understanding of the molecular pathways that are altered in association with these vascular lesions and these molecular targets may represent novel strategies of treating lesions that have historically been approached from a structural perspective only.
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Affiliation(s)
- Emma Hartman
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel M. Balkin
- Department of Plastic & Oral Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alfred Pokmeng See
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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7
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Khalil A, Laguna A, I Mehta T, Gowda PC, Gong AJ, Weinstein RM, Garg T, Ring NY, England RW, George Linguraru M, Jones CK, Weiss CR. Whole-lesion assessment of volume and signal changes after sclerotherapy of extremity venous malformations. Eur J Radiol 2024; 174:111397. [PMID: 38452733 DOI: 10.1016/j.ejrad.2024.111397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/12/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To investigate quantitative changes in MRI signal intensity (SI) and lesion volume that indicate treatment response and correlate these changes with clinical outcomes after percutaneous sclerotherapy (PS) of extremity venous malformations (VMs). METHODS VMs were segmented manually on pre- and post-treatment T2-weighted MRI using 3D Slicer to assess changes in lesion volume and SI. Clinical outcomes were scored on a 7-point Likert scale according to patient perception of symptom improvement; treatment response (success or failure) was determined accordingly. RESULTS Eighty-one patients with VMs underwent 125 PS sessions. Treatment success occurred in 77 patients (95 %). Mean (±SD) changes were -7.9 ± 24 cm3 in lesion volume and -123 ± 162 in SI (both, P <.001). Mean reduction in lesion volume was greater in the success group (-9.4 ± 24 cm3) than in the failure group (21 ± 20 cm3) (P =.006). Overall, lesion volume correlated with treatment response (ρ = -0.3, P =.004). On subgroup analysis, volume change correlated with clinical outcomes in children (ρ = -0.3, P =.03), in sodium tetradecyl sulfate-treated lesions (ρ = -0.5, P =.02), and in foot lesions (ρ = -0.6, P =.04). SI change correlated with clinical outcomes in VMs treated in 1 PS session (ρ = -0.3, P =.01) and in bleomycin-treated lesions (ρ = -0.4, P =.04). CONCLUSIONS Change in lesion volume is a reliable indicator of treatment response. Lesion volume and SI correlate with clinical outcomes in specific subgroups.
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Affiliation(s)
- Adham Khalil
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Surgery, Medstar Georgetown University Hospital, Washington, DC
| | - Amanda Laguna
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Tej I Mehta
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA; United States Air Force Medical Corps, Falls Church, VA, USA
| | - Prateek C Gowda
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anna J Gong
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Tushar Garg
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Natalie Y Ring
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ryan W England
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Craig K Jones
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Computer Science, The Johns Hopkins University, Baltimore, MD, USA; The Malone Center for Engineering in Healthcare, The Johns Hopkins University, Baltimore, MD, USA.
| | - Clifford R Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA; The Malone Center for Engineering in Healthcare, The Johns Hopkins University, Baltimore, MD, USA
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8
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Suphonkhan J, Klaymongkol C, Khomsiri W, Wanprom J, Jeamsripong S, Chimnakboon N, Rungsipipat A, Radtanakatikanon A. Retrospective Study of Clinicopathological Changes and Prediction Model for Canine Vascular Neoplasms. Vet Sci 2024; 11:189. [PMID: 38787161 PMCID: PMC11125596 DOI: 10.3390/vetsci11050189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/06/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Vascular neoplasms, including hemangiosarcoma (HSA) and hemangioma (HMA), are more common in dogs than other domestic animal species; however, comprehensive laboratory screening tests for early diagnosis are currently limited. The aims of this study were to investigate general signalments, anatomic locations, and clinicopathological abnormalities of dogs diagnosed with vascular neoplasms and to determine the diagnostic significance of these abnormalities. Retrospective data of dogs with HMA, HSA, and healthy dogs were analyzed. Dogs with HMA and HSA were seniors, with mixed breeds being most affected. HMA affected predominantly non-visceral sites, while HSA was more common in visceral sites, particularly the spleen. In multivariate model analyses, the odds of HMA diagnosis were 5.5 times higher in anemic dogs and 33.0 times higher in lymphopenic dogs compared to dogs without the abnormalities. The odds of HSA diagnosis were 42.5 times higher in anemic dogs, 343 times higher in lymphopenic dogs and 92.7 times higher in dogs with hyperfibrinogenemia compared to dogs without the abnormalities. The study suggested that these identified abnormalities were nonspecific and commonly observed in various chronic diseases, and hence their combination with clinical information, such as diagnostic imaging and histopathology, is important to facilitate a more precise diagnosis of canine vascular neoplasms.
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Affiliation(s)
- Jidapa Suphonkhan
- Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | | | - Wijittra Khomsiri
- Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Jedsada Wanprom
- Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Saharuetai Jeamsripong
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Narisara Chimnakboon
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (N.C.); (A.R.)
| | - Anudep Rungsipipat
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (N.C.); (A.R.)
- Center of Excellence for Companion Animal Cancer, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Araya Radtanakatikanon
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (N.C.); (A.R.)
- Center of Excellence for Companion Animal Cancer, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
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9
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Bancroft A, Santa Cruz J, Levett K, Nguyen QD. Incidental Breast Hemangioma on Breast MRI: A Case Report. Cureus 2024; 16:e57903. [PMID: 38725792 PMCID: PMC11079714 DOI: 10.7759/cureus.57903] [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] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Vascular tumors of the breast are rare, but benign hemangiomas are the most common type. Capillary hemangiomas are a subset of benign vascular tumors that involve smaller vessel sizes. They are difficult to diagnose with mammography and ultrasound, as they lack pathognomonic features and are frequently not seen. MRI is the most sensitive imaging tool. The lesions appear similar to angiosarcoma or ductal carcinoma in situ on imaging, which further complicates the diagnosis. A biopsy of the lesions is required for a definitive diagnosis. In this report, a 49-year-old female with newly diagnosed breast cancer is incidentally found to have a capillary hemangioma on staging breast MRI that was confirmed with a biopsy and excised along with the primary breast cancer with a partial mastectomy. The imaging findings of breast hemangioma on mammography, ultrasound, and MRI are also reviewed and described in this report.
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Affiliation(s)
| | | | - Kaitlyn Levett
- Pathology and Immunology, Baylor College of Medicine, Houston, USA
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10
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Ghosn Y, Jabbour Y, Zeid FA, Jurdi N, Khouzami R, Moukaddam H. Massive spinal epidural infantile hemangioma, image findings, and treatment: a case report and review of literature. Skeletal Radiol 2024:10.1007/s00256-024-04570-1. [PMID: 38512366 DOI: 10.1007/s00256-024-04570-1] [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: 08/15/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 03/23/2024]
Abstract
Spinal involvement of infantile hemangiomas is rare with the predilection to involve the epidural space. A proper diagnosis might be challenging due to the atypical location and variable/inconsistent use of the International Society for the Study of Vascular Anomalies (ISSVA) classification by radiologists, pathologists, and clinicians. A proper diagnosis of epidural infantile hemangioma is key due to the different aggressiveness of the treatment options with inconstant literature regarding the best available treatment. Herein, we present a case of a massive epidural infantile hemangioma successfully treated with only beta-blocker. We discuss the clinical, MRI, CT, ultrasound, and histological features of this lesion as we review the literature with the objective of addressing some of the confusion surrounding the subject.
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Affiliation(s)
- Youssef Ghosn
- Department of Diagnostic Radiology, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Yara Jabbour
- Department of Diagnostic Radiology, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Farah Abou Zeid
- Department of Diagnostic Radiology, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Nawaf Jurdi
- Department of Pathology, American University of Beirut, Beirut, Lebanon
| | - Riad Khouzami
- Department of Diagnostic Radiology, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Hicham Moukaddam
- Department of Diagnostic Radiology, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon.
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11
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Aslamzai M, Hakimi T, Mushoud M, Mukhlis AH. Noninvoluting congenital hemangiomas with hypovolemic shock, anemia and prolonged jaundice in a neonate: a case report. Oxf Med Case Reports 2024; 2024:omae019. [PMID: 38532750 PMCID: PMC10962241 DOI: 10.1093/omcr/omae019] [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: 07/08/2023] [Revised: 01/13/2024] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Abstract
Noninvoluting congenital hemangioma is an extremely rare congenital anomaly in newborn babies and may complicate life-threatening events, including hemorrhage. We present a very rare case of noninvoluting congenital hemangiomas in an Asian and Afghan six-day-old girl that was detected at birth. The noninvoluting congenital hemangiomas were accompanied by hypovolemic shock, anemia, and prolonged jaundice during the first two weeks of life. These diseases were diagnosed by medical history, physical examination, blood analysis, and doppler ultrasonography of the skin lesions. Her hypovolemic shock and hemorrhage were improved after supportive treatment, and she was discharged from the hospital in a good condition. After four weeks of life, the hemangiomas did not regress or progress, suggesting noninvoluting congenital hemangiomas. Hemangioma may complicate severe hemorrhage and shock, as well as there may be an association between congenital hemangioma and prolonged neonatal jaundice.
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Affiliation(s)
- Mansoor Aslamzai
- Department of Neonatology, Kabul University of Medical Sciences, 3rd district, Kabul, Afghanistan
| | - Turyalai Hakimi
- Department of Pediatrics Surgery, Kabul University of Medical Sciences, 3rd district, Kabul, Afghanistan
| | - Mesbahullah Mushoud
- Department of Pediatrics, Maiwand Teaching Hospital, 1st district, Kabul, Afghanistan
| | - Abdul Hakim Mukhlis
- Department of Neonatology, Kabul University of Medical Sciences, 3rd district, Kabul, Afghanistan
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12
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Chaulagain R, Chug A, Simre S, Pandey S, Shrestha S. Super-selective Embolisation and Surgical Excision of the Facial Arteriovenous Malformation. Cureus 2024; 16:e57240. [PMID: 38686263 PMCID: PMC11056801 DOI: 10.7759/cureus.57240] [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] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
Vascular anomalies broadly include vascular tumours and malformations. Arteriovenous malformations (AVM), though rare in the oral and maxillofacial regions, can present with swelling, facial asymmetry, ulceration, and bleeding tendencies, which can be life-threatening. Thus, to minimise the associated life-threatening consequences, prompt and appropriate diagnosis of the lesion is necessitated. The management of the AVM is a therapeutic challenge for maxillofacial surgeons; however, technological advances in interventional radiology have gained a foothold. Super-selective embolisation of the feeder vessels with subsequent resection of the lesion is the most widely accepted approach for management. The present report describes a unique case of a facial AVM managed through a trans-oral approach without any post-operative sequelae.
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Affiliation(s)
- Ramsundar Chaulagain
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashi Chug
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Saurabh Simre
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sameer Pandey
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sudarshan Shrestha
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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13
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de Souto Medeiros MR, da Silva Barros CC, Rolim LSA, Pinto LP, Miguel MCDC, da Silveira ÉJD. Hamartomas, choristomas, and teratomas of the oral cavity: A 49-years cross-sectional study in an oral diagnostic service. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101765. [PMID: 38218332 DOI: 10.1016/j.jormas.2024.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/06/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a Brazilian population over a 49 years-period. METHODS A retrospective cross-sectional study was performed, and data regarding demographic and clinical aspects were obtained from the medical records of a [removed for blind peer review] referral center (1970-2019). The collected data were submitted to descriptive analysis and Pearson's chi-square, Fisher's exact, and Kruskal-Wallis tests (p ≤ 0.05). RESULTS In a total of 16,412 medical records analyzed, 300 (1.83 %) were hamartomatous, 2 (0.01 %) choristomatous, and 1 (0.01 %) teratoid lesions. Hamartomas were most diagnosed in females and adults. Statistical significance was observed between hamartoma and age group (p < 0.001). Odontoma was the most frequent hamartomatous lesion. In choristomatous and teratoid lesions, there was no occurrence in males. The jaws were the most affected anatomical site by hamartoma. Choristomas were observed on the mandible and tongue, while a teratoid lesion was seen on the floor of the mouth. CONCLUSIONS Low occurrence of choristomatous and teratoid lesions over hamartomatous lesions and a heterogeneous occurrence profile regarding sex, age group, and anatomic site were observed. Hamartomas are relatively common and benign conditions that may cause damage and require special care during dental treatment. Thus, the dentist needs to be able to identify and treat them appropriately. Likewise, although choristomas and teratomas present no risk to patients and have a lower occurrence than hamartomas, they also require treatment.
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Affiliation(s)
- Maurília Raquel de Souto Medeiros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Caio César da Silva Barros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Larissa Santos Amaral Rolim
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Leão Pereira Pinto
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Márcia Cristina da Costa Miguel
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil.
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14
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Wong KPL, Tan TWX, Chan LWM, Mahadev A, Cheng MHW. Wide Resection for Pediatric Extremity Vascular Malformation-A Tertiary Hospital's Experience. J Pediatr Orthop 2024; 44:55-60. [PMID: 37807610 DOI: 10.1097/bpo.0000000000002546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND Vascular malformations of the extremities (VM) are common benign lesions that tend to grow throughout the patient's lifetime. They can cause various issues like pain, swelling, and even limb length discrepancies. Sclerotherapy was the preferred treatment choice in previous studies. However, sclerotherapy and many other treatments have the potential to result in higher recurrence rates. Surgical treatment has been shown to be effective and safe in many cases. Hence, this study aims to evaluate the suitability of wide resection surgery for VM to reduce recurrence. METHODS Fort-seven VM cases that underwent wide resection were identified retrospectively in the institution of study. Demographics, depth of malformation, whether malformations were local or diffuse, location and size of malformations, and histology records were taken note of. Records of recurrence and postoperative function were also gathered. We utilized self-reported questionnaires, QuickDASH and Lower Extremity Functional Scale, to determine patients' postsurgical physical function. RESULTS Out of 47 cases that underwent wide resection, we found a recurrence rate of 2.1%. No patients sustained any loss of function postsurgery, with few patients experiencing minor complications like tenderness, hypertrophic scars/keloids, as well as numbness. Good functionality posttreatment was also seen through self-reported questionnaires, with an average score of 2.12 for QuickDASH and 99.96% for LEFS. CONCLUSION Where margins can be obtained without functional impairment, surgical-wide resection for VM is a viable treatment option to minimize recurrence. LEVEL OF EVIDENCE Level-IV.
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15
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Emami A, Bahadoran E, SamieeRad F. Cavernous hemangioma of corpus imitating endometrial polyp in a young non-pregnant woman: A case report study. Clin Case Rep 2024; 12:e8413. [PMID: 38188844 PMCID: PMC10766558 DOI: 10.1002/ccr3.8413] [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: 08/17/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/09/2024] Open
Abstract
Key Clinical Message Cavernous hemangiomas are rare and have various non-specific clinical presentations, such as menorrhagia. It can mimic different diseases such as endometrial polyps. Pathologists and gynecologists should be aware of performing histopathological examinations of this neoplasm for accurate diagnosis and to avoid unwarranted therapeutic interventions. Abstract Internal genital tract hemangiomas are rare and can be divided into capillary and cavernous. We present a rare case of cavernous hemangioma (CH) of the corpus in a young, non-pregnant woman. The patient was a 28-year-old woman who had complained of menorrhagia for 2.5 years. Sonography showed a hypoechoic intramural area measuring 35 × 23 mm. Histomorphology revealed neoplastic proliferation of dilated thin-walled arteries of various sizes within the myometrium. Due to the variable clinical presentations of CH, histopathological examination should be performed for an accurate diagnosis. It is a rare entity and we recommend training pathologists and gynecologists on this neoplasm for accurate diagnosis and to avoid unwarranted therapeutic interventions.
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Affiliation(s)
- Ali Emami
- School of MedicineQazvin University of Medical SciencesQazvinIran
| | | | - Fatemeh SamieeRad
- Department of Pathobiology, Faculty of Medical SchoolQazvin University of Medical SciencesQazvinIran
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16
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Chrysouli K, Karamagkiolas S. Venous malformation phleboliths mimicking submandibular sialadenitis in children. BMJ Case Rep 2023; 16:e257971. [PMID: 38087492 PMCID: PMC10728921 DOI: 10.1136/bcr-2023-257971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
To report one paediatric patient who presented with a rare venous vascular malformation as a mass in the left submandibular region with a clinical picture compatible with sialadenitis. Phleboliths are a specific feature of venous malformations due to venous stasis and may mimic sialoliths on various imaging modalities. Thus venous malformations are often misdiagnosed as sialadenitis due to sialolithiasis. Sialoliths are extremely rare in paediatric patients. In an early adolescent presenting with a submandibular mass and suspected sialadenitis arising from sialoliths, a detailed history, clinical examination and careful review of the radiological findings will allow the diagnosis of venous vascular malformation and provide the complete surgical resection. Our patient was initially referred with a presumed diagnosis of submandibular sialadenitis, and instead a venous malformation with phlebolith was diagnosed.
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Affiliation(s)
| | - Sotirios Karamagkiolas
- Department of Otorhinolaryngology, Panepistemiako Geniko Nosokomeio Attikon, Athens, Attica, Greece
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17
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Goldman A, Wollina U. Cavernous hemangioma of the lip: combined treatment with intralesional laser and surgery. Wien Med Wochenschr 2023:10.1007/s10354-023-01028-2. [PMID: 37975966 DOI: 10.1007/s10354-023-01028-2] [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: 06/27/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
Infantile cavernous hemangioma is a benign vascular tumor in childhood. Cavernous hemangiomas have a tendency of slow enlargement with subsequent complications such as ulceration and bleeding. We report a case of a large cavernous hemangioma affecting the median upper lip in an 11-year-old girl. The lesion was growing and painful on pressure. The patient felt stigmatized. Treatment was wished for by patient and parents. After careful examination including Doppler ultrasound, we suggested a combined approach. In the first step the lesion was coagulated with an intralesional neodymium-YAG laser using a blunt tip. In the second step, immediately after the action of the laser, the lesion was removed completely by surgery. Defect closure was realized with bilateral tissue-expanding vermillion myocutaneous flaps. The patient was followed-up to 5 months. Disfigurement and functional impairment were eliminated. The result was satisfying for both patient and parents. Vascular lesions of the upper lip-particularly when close to Cupid's bow-can become disfiguring and cause functional impairment. We propose a combined approach with intralesional neodymium-YAG laser photocoagulation to avoid bleeding and to shrink the lesion before complete surgical removal. For defect closure, bilateral tissue-expanding vermillion myocutaneous flaps (Goldstein technique modified by Sawada) were used.
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Affiliation(s)
- Alberto Goldman
- Department of Plastic Surgery, Hospital São Lucas da PUCRS, 90610-001, Porto Alegre, Brazil
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital, Städtisches Klinikum Dresden, 01067, Dresden, Germany.
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18
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Lai KKH, Kwok YT, Lam SC, Lam MCW, Yuen HKL. Doxycycline sclerotherapy in patients with periorbital lymphatic malformation: A case series and literature review. Eur J Ophthalmol 2023; 33:2170-2177. [PMID: 36999219 DOI: 10.1177/11206721231163614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
PURPOSE To describe and report the outcomes of doxycycline sclerotherapy in patients with periorbital lymphatic malformations(LMs). BASIC PROCEDURES A retrospective review of consecutive patients diagnosed with periorbital LMs and who received doxycycline sclerotherapy at Hong Kong Eye Hospital and Queen Elizabeth Hospital, Hong Kong between January 2016 and June 2022. Doxycycline was prepared with a concentration of 100 mg diluted in 10 mL water for injection. A 23-gauge needle aiming at the center of the macrocyst was used to aspirate fluid from the lesion; this was then followed by an intralesional injection of 0.5 to 2 ml of doxycycline depending on the size of the cavity. MAIN FINDINGS A total of eight patients(six females) were included in this study. All of them received doxycycline sclerotherapy for periorbital LMs(five extraconal, three intraconal). The median age for receiving sclerotherapy was 29 years old. Seven patients had macrocystic LMs, and one had mixed macro- and microcystic LM. Two of the LMs had venous components radiologically. The average number of sclerotherapy treatment in one patient was 1.4 ± 0.7times. Seven of the eight patients had excellent response radiologically or clinically. One patient showed a satisfactory response after three cycles of sclerotherapy. No recurrence was experienced at median follow-up of 14 months. None of the patients experienced visual threatening or systemic complication. PRINCIPLE CONCLUSIONS Our preliminary experience with doxycycline sclerotherapy has shown encouraging results for the treatment of macrocystic or mixed-type periorbital LMs, with a favourable safety profile. Further clinical trials with longer follow-ups are warranted on this topic.
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Affiliation(s)
- Kenneth K H Lai
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong Special Administrative Region
| | - Yuen Ting Kwok
- Hong Kong Eye Hospital, Hong Kong Special Administrative Region
| | - Stacey C Lam
- Hong Kong Eye Hospital, Hong Kong Special Administrative Region
| | - Matthew C W Lam
- Hong Kong Eye Hospital, Hong Kong Special Administrative Region
| | - Hunter K L Yuen
- Hong Kong Eye Hospital, Hong Kong Special Administrative Region
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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19
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Kochaji N, Ajalyakeen H, Fakir A, Al-Mozaik AAS. Intraosseous hemangioma of the mandible: A rare case report. Int J Surg Case Rep 2023; 109:108496. [PMID: 37473620 PMCID: PMC10372736 DOI: 10.1016/j.ijscr.2023.108496] [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: 05/20/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Intraosseous hemangioma is a benign vascular tumour, it is mostly seen in long bones, vertebrae, and rarely on jaw bones, it usually occurs with its cavernous form. Medical literature is lacking a full description of capillary hemangioma of the jaws due to its rareness. CASE PRESENTATION A 68 year old male referred to the dentist for normal checking, without significant medical history nor presuming medications. The panoramic radiograph showed radiolucent lesion in the right mandibular body. Surgery was performed and the excisional biopsy was subjected to a private oral pathology lab for the definite diagnosis, which was capillary hemangioma. CLINICAL DISCUSSION Intraosseous hemangioma rarely occurs in the jaws. Normally it is asymptomatic and discovered accidently on radiographs. Radiological findings for intraosseous hemangiomas are not well documented. Treatment of intraosseous capillary hemangioma differs according to the dimension and size of the lesion. CONCLUSION This paper aims to guide the clinician to start including hemangioma in the differential diagnosis for translucent lesions located in the jawbones, when radiographs show the necessity of that, in order to avoid uncontrollable bleeding and even death during any surgical intervention.
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Affiliation(s)
- Nabil Kochaji
- Oral Histology & Pathology Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Haya Ajalyakeen
- Oral Histology & Pathology Department, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Anas Fakir
- Faculty of Dentistry, Damascus University, Damascus, Syria
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20
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Ota Y, Lee E, Sella E, Agarwal P. Vascular Malformations and Tumors: A Review of Classification and Imaging Features for Cardiothoracic Radiologists. Radiol Cardiothorac Imaging 2023; 5:e220328. [PMID: 37693195 PMCID: PMC10483253 DOI: 10.1148/ryct.220328] [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: 12/27/2022] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 09/12/2023]
Abstract
The International Society for the Study of Vascular Anomalies (ISSVA) classification is a comprehensive histology-based scheme that was updated in 2018. It is important for cardiothoracic imagers to understand this classification to ensure that accurate terminology is used and that archaic terms are avoided when vascular lesions are described. Knowledge of the various malformations (including common conditions, such as venous malformation, arteriovenous fistula, and arteriovenous malformation) and vascular tumors allows for timely diagnosis and appropriate management. This review describes various vascular anomalies, in accordance with ISSVA classification and terminology; highlights key imaging features associated with each; and discusses the role of different imaging modalities. Keywords: Pulmonary, Soft Tissues/Skin, Vascular, Arteriovenous Malformation © RSNA, 2023.
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Affiliation(s)
- Yoshiaki Ota
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Elizabeth Lee
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Edith Sella
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Prachi Agarwal
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
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21
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Lu AZ, Chandra D, Chandra SR, James AW, Ching-Yun Hsu G. Differential pericyte marker expression in craniofacial benign and malignant vascular tumors. J Oral Pathol Med 2023; 52:660-665. [PMID: 37336496 PMCID: PMC11042677 DOI: 10.1111/jop.13459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Vascular anomalies and tumors are common in the head, neck, and craniofacial areas and are associated with abnormalities in the angiomatous architecture. However, the etiology and molecular basis for the pathogenesis of most vascular lesions are still unknown. Pericytes are mural cells that surround endothelial cells. Besides angiogenesis and other physiological functions, pericytes play an important role in vascularized tissue repair and as resident mesenchymal stem/progenitor cells. Perivascular cells demonstrate a distinct immunohistochemical profile, including expression of alpha-smooth muscle actin (α-SMA), CD146, CD105, and PDGFRβ, without endothelial differentiation (absence of CD31 and CD34 immunoreactivity). These pericyte markers have been shown to be expressed in soft tissue hemangiomas. However, they have not been fully examined in intraosseous hemangiomas. METHODS In this study, we compared mesenchymal stem cell (MSC) expression of CD146 and α-SMA markers in pericytes from hemangiomas from different tissues and malignant vascular tumors. RESULTS The results demonstrated an increased expression of pericyte markers in perivascular cells of benign hemangiomas, especially intraosseous hemangiomas and a significantly reduced expression of pericyte markers in malignant angiosarcomas. CONCLUSION The evidence provides insight into the function of pericytes in vascular tumors and suggests their role in vascular tumor disease types.
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Affiliation(s)
- Amy Z. Lu
- Weill Cornell Medicine, New York, NY, 10021
| | - Dave Chandra
- Department of Oral Pathology, Oregon Health and Science University, 97201
| | - Srinivasa R. Chandra
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, 97201
| | - Aaron W. James
- Department of Pathology, Johns Hopkins University, 21205
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22
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Okuda H, Aoki M, Ueda N, Ogawa T, Mori H. A Rare Case of Adult Vocal Cord Hemangioma: A Case Report and Literature Review. Cureus 2023; 15:e44042. [PMID: 37746482 PMCID: PMC10517693 DOI: 10.7759/cureus.44042] [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] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Infantile laryngeal hemangiomas are relatively common. However, adult vocal cord hemangiomas are extremely rare. A 46-year-old woman was referred to our department for hoarseness, which continued for 18 months. A laryngeal fiberscope revealed a small protuberant tumor resembling a polyp on her right vocal cord, and the narrow-band imaging showed abundant vascularity. Laryngeal microsurgery with a cold instrument under general anesthesia completely resected the tumor on the vocal cord. Histopathologically, the resected tumor consisted of vessels with thick walls and was diagnosed as a cavernous hemangioma of the vocal cord. After the surgery, she has never complained of hoarseness and has had no local recurrence for six months.
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Affiliation(s)
- Hiroshi Okuda
- Otolaryngology - Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, JPN
- Otolaryngology, Ogaki Tokushukai Hospital, Ogaki, JPN
| | | | - Natsuko Ueda
- Otolaryngology - Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, JPN
| | - Takenori Ogawa
- Otolaryngology - Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, JPN
- Otolaryngology, Gifu University Graduate School of Medicine, Gifu, JPN
| | - Hideki Mori
- Pathology, Ogaki Tokushukai Hospital, Ogaki, JPN
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23
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Hasan S, Khan A, Banerjee A, Ramalingam K. Infantile Hemangioma of the Upper Lip: Report of a Rare Case With a Brief Review of Literature. Cureus 2023; 15:e42556. [PMID: 37637601 PMCID: PMC10460138 DOI: 10.7759/cureus.42556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Hamartomas are tumor-like abnormalities typified by the presence of cellular proliferation indigenous to the native site. However, hamartomas maintain growth cessation without the potential for further growth or malignant transformation. Hamartomas are commonly seen in the lungs, kidney, liver, and spleen and rarely occur in the orofacial region. Various hamartomatous oral lesions include hemangiomas, lymphangiomas, tori, exostosis, dens invaginatus, dens evaginatus, odontomas, nevi, and cherubism. Infantile hemangiomas are benign vascular tumors that emerge soon after birth and experience rapid growth within the first year. Oral hemangiomas affect up to 6.4% of infants and are more common on the ventral surface of the tongue, as opposed to oral vascular malformations, which are more prevalent on the lips. It also has a 3:1 female-to-male predominance. Afterward, their growth usually stabilizes and enters a prolonged, incomplete involution phase. Uncomplicated hemangiomas generally exhibit spontaneous resolution, whereas few can leave behind scars and telangiectasias on the external surface of the skin on which it occurs. Thus, lesions located in anatomically sensitive regions necessitate vigilant surveillance and treatment. This paper deals with an asymptomatic swelling of the upper lip in a four-year-old female child but with problems in aesthetics, speech, and feeding. A thorough history, clinical examination, positive diascopy, ultrasonography, and histopathology confirmed the diagnosis of infantile hemangioma.
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Affiliation(s)
- Shamimul Hasan
- Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, IND
| | - Ateeba Khan
- Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, IND
| | - Abhishek Banerjee
- Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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24
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Gasparella P, Flucher C, Beqo BP, Schmidt B, Spendel S, Arneitz C, Till H, Haxhija EQ, Singer G. Outcome after surgical treatment of venous malformations of the hand in childhood. J Vasc Surg Venous Lymphat Disord 2023; 11:793-800. [PMID: 36906103 DOI: 10.1016/j.jvsv.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE Surgical treatment of venous malformations (VMs) of the hand is challenging. The hand's small functional units, dense innervation, and terminal vasculature can be easily compromised during invasive interventions like surgery or sclerotherapy, leading to an increased risk of functional impairment, cosmetic consequences, and negative psychological effects. METHODS We have conducted a retrospective review of all surgically treated patients diagnosed with VMs of the hand between 2000 and 2019 and evaluated their symptoms, diagnostic investigations, complications, and recurrences. RESULTS Twenty-nine patients (females, n = 15) with a median age of 9.9 years (range, 0.6-18 years) were included. Eleven patients presented with VMs involving at least one of the fingers. In 16 patients, the palm and/or dorsum of the hand was affected. Two children presented with multifocal lesions. All patients presented with swelling. Preoperative imaging was done in 26 patients and consisted of magnetic resonance imaging in nine patients, ultrasound in eight patients, and both modalities in nine patients. Three patients underwent surgical resection of the lesions without any imaging. Indications for surgery were pain and restriction of function (n = 16), and when lesions were preoperatively evaluated as completely resectable (n = 11). In 17 patients, a complete surgical resection of the VMs was performed, whereas in 12 children, an incomplete resection of VM was deemed due to nerve sheath infiltration. At a median follow-up of 135 months (interquartile range, 136.5 months; range, 36-253 months), recurrence occurred in 11 patients (37.9%) after a median time of 22 months (range, 2-36 months). Eight patients (27.6%) were reoperated because of pain, whereas three patients were treated conservatively. The rate of recurrences did not significantly differ between patients presenting with (n = 7 of 12) or without (n = 4 of 17) local nerve infiltration (P = .119). All surgically treated patients who were diagnosed without preoperative imaging developed a relapse. CONCLUSIONS VMs in the region of the hand are difficult to treat, and surgery is associated with a high recurrence rate. Accurate diagnostic imaging and meticulous surgery may contribute to improve the outcome of the patients.
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Affiliation(s)
- Paolo Gasparella
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
| | - Christina Flucher
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
| | - Besiana P Beqo
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria; Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Barbara Schmidt
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
| | - Stephan Spendel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Christoph Arneitz
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
| | - Emir Q Haxhija
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria.
| | - Georg Singer
- Department of Paediatric and Adolescent Surgery, VASCERN VASCA European Reference Centre, Medical University of Graz, Graz, Austria
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25
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Saad Abdalla Al-Zawi A, Shah A, Asaad A, Jalilzadeh Afshari S, Alowami S. Unique Case of Parathyroid Adenoma With Arteriovenous Malformation. Cureus 2023; 15:e41206. [PMID: 37525819 PMCID: PMC10387323 DOI: 10.7759/cureus.41206] [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] [Accepted: 06/30/2023] [Indexed: 08/02/2023] Open
Abstract
Direct communication between dysmorphic arteries and veins without an interceding capillary segment is known as arteriovenous malformation (AVM). Its etiology is still unknown; however, it is commonly acknowledged that it could be related to trauma or is congenital in origin. Often, AVMs are found in the central nervous system or other sites such as under the skin or in the deep solid organs. They can be encountered as a solitary abnormality or associated with another pathology. If they are large enough, they can deprive the neighboring tissue of oxygen, eventually leading to tissue damage and compressing the surrounding organs, causing potentially more serious consequences. AVM in parathyroid adenoma is an unusual entity in the medical reports and known clinical practice. We herein report a unique case of a 49-year-old female patient who presented with a neck mass and associated symptoms of hyperparathyroidism (HPT) with no history of previous trauma or surgery. The imaging and laboratory tests were consistent with parathyroid neoplasm. Parathyroidectomy was performed and revealed parathyroid adenoma with AVM.
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Affiliation(s)
- Abdalla Saad Abdalla Al-Zawi
- General & Breast Surgery, Mid and South Essex University Hospital Group, Basildon, GBR
- General & Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
- General & Breast Surgery, Anglia Ruskin University, Chelmsford, GBR
| | - Ahmed Shah
- Pathology and Molecular Medicine, McMaster University, Hamilton, CAN
| | - Amira Asaad
- Surgery, University College Hospital, London, GBR
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26
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Zhang J, Croft J, Le A. Familial CCM Genes Might Not Be Main Drivers for Pathogenesis of Sporadic CCMs-Genetic Similarity between Cancers and Vascular Malformations. J Pers Med 2023; 13:jpm13040673. [PMID: 37109059 PMCID: PMC10143507 DOI: 10.3390/jpm13040673] [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: 03/20/2023] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Cerebral cavernous malformations (CCMs) are abnormally dilated intracranial capillaries that form cerebrovascular lesions with a high risk of hemorrhagic stroke. Recently, several somatic "activating" gain-of-function (GOF) point mutations in PIK3CA (phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit p110α) were discovered as a dominant mutation in the lesions of sporadic forms of cerebral cavernous malformation (sCCM), raising the possibility that CCMs, like other types of vascular malformations, fall in the PIK3CA-related overgrowth spectrum (PROS). However, this possibility has been challenged with different interpretations. In this review, we will continue our efforts to expound the phenomenon of the coexistence of gain-of-function (GOF) point mutations in the PIK3CA gene and loss-of-function (LOF) mutations in CCM genes in the CCM lesions of sCCM and try to delineate the relationship between mutagenic events with CCM lesions in a temporospatial manner. Since GOF PIK3CA point mutations have been well studied in reproductive cancers, especially breast cancer as a driver oncogene, we will perform a comparative meta-analysis for GOF PIK3CA point mutations in an attempt to demonstrate the genetic similarities shared by both cancers and vascular anomalies.
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Affiliation(s)
- Jun Zhang
- Departments of Molecular & Translational Medicine (MTM), Texas Tech University Health Science Center El Paso (TTUHSCEP), El Paso, TX 79905, USA
| | - Jacob Croft
- Departments of Molecular & Translational Medicine (MTM), Texas Tech University Health Science Center El Paso (TTUHSCEP), El Paso, TX 79905, USA
| | - Alexander Le
- Departments of Molecular & Translational Medicine (MTM), Texas Tech University Health Science Center El Paso (TTUHSCEP), El Paso, TX 79905, USA
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27
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Utami AM, Horbach SE, Meijer-Jorna LB, Waas IS, de Boer OJ, van der Wal AC, van der Horst CM. Microvascular proliferation in arteriovenous malformation of the hand worsens during pregnancy: a case report. Ann Med Surg (Lond) 2023; 85:1262-1269. [PMID: 37113922 PMCID: PMC10129217 DOI: 10.1097/ms9.0000000000000507] [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: 02/09/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
Arteriovenous malformations (AVMs) are rare congenital disorders characterized by episodes of disproportionate growth that can cause pain and severe bleeding, with microvascular proliferation (MVP) associated with these episodes. Hormonal influences can also worsen the symptoms in patients with AVM. Case presentation This case report presents a female patient with congenital vascular malformations of the left hand since birth, whose symptoms worsened during puberty and pregnancy, ultimately leading to amputation of the left hand due to unbearable pain and loss of function. Pathologic analysis revealed substantial MVP activity within the tissues of the AVM, with an expression of receptors for estrogen, growth hormone, and follicle-stimulating hormone in the vessels of the AVM, including MVP areas. Resected materials not related to pregnancy revealed chronic inflammation and fibrosis but hardly any MVP. Discussion and conclusion These findings suggest a role for MVP in the progressive growth of AVM during pregnancy, with a potential role for hormonal influences. The case highlights the relationship between AVM symptoms and size during pregnancy and the pathological findings of MVP areas within the AVM with hormone receptor expression on proliferating vessels in resected materials.
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Affiliation(s)
- Amalia M. Utami
- Department of Pathology
- Department of Pathology Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Corresponding author. Address: Department of Pathology Anatomy, Faculty of Medicine, Hasanuddin University, Jln. Perintis Kemerdekaan Km.10, Makassar 90245, Indonesia. Tel./fax: +62411-586010. E-mail address: (A.M. Utami)
| | - Sophie E.R. Horbach
- Department of Plastic Surgery, Amsterdam University Medical Center, AMC, University of Amsterdam, Amsterdam
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Briones RC, Cruz KS, Resoco DR, Briones MVA. Medusa's Wrath: Bleeding Giant Scalp Arteriovenous Malformation in an Adult: A Case Report. Vasc Endovascular Surg 2023:15385744231154990. [PMID: 36727411 DOI: 10.1177/15385744231154990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Scalp arteriovenous malformation (AVM) is a rare congenital disease that may present with massive bleeding. To date, surgical excision remains the definitive management. However, the procedure could lead to intraoperative bleeding due to the tumor's high blood flow and complex vascularity. CASE REPORT A 49-year old Filipino male presented with a bleeding giant scalp AVM. Computed tomographic scan and duplex studies showed multiple feeding vessels with turbulent flow arising primarily from the right superficial temporal, right posterior auricular, and occipital vessels. Prior to surgery, the patient underwent transfusion due to preoperative hemoglobin of 6 g/dL. Proximal control of the right external carotid artery was performed through a supine position and left in place to reduce the majority of blood flow to the AVM. The patient was turned to a prone position for surgical planning to achieve maximal skin-sparing dissection prior to excision. First, ligation of bilateral superficial temporal and posterior auricular arteries was performed. Next, excision above the periosteum with segmental ligation of feeding vessels around the AVM was carried out. Reconstruction of the defect was done via scalp advancement flap and split-thickness skin grafting. Intraoperative blood loss was 1.6 L. On the sixth postoperative day, the patient was discharged with 100% graft take. CONCLUSION Management of scalp AV malformation is challenging, and despite measures to decrease intraoperative bleeding, blood loss is still high. While preoperative embolization has been reported to decrease the risk of bleeding, this procedure is not currently available in our setting. Our case highlights the complexity of giant scalp AV malformation management in a limited-resource setting. Even in the absence of endovascular intervention, outright surgical excision of AVM can be performed, albeit with higher levels of blood loss.
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Affiliation(s)
- Richard C Briones
- Department of Surgery, 604409Bicol Medical Center, Naga City, Philippines
| | - Kathleen S Cruz
- Department of Surgery, 604409Bicol Medical Center, Naga City, Philippines
| | - Dave R Resoco
- Department of Surgery, 604409Bicol Medical Center, Naga City, Philippines
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29
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Badki SD, Lohe V, Bhowate R, Kadu RP, Sune R, Wanjari MB. Conventional Radiology in Deep Seated Facial Hemangioma: A Case Report. Cureus 2023; 15:e35186. [PMID: 36960270 PMCID: PMC10030065 DOI: 10.7759/cureus.35186] [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: 01/19/2023] [Accepted: 02/18/2023] [Indexed: 02/21/2023] Open
Abstract
Hemangioma is congenital or traumatic in origin, and it is caused due to atypical build-up of the blood vessel. It is a painless benign condition with typical characteristic clinical features. These generally occur in the first three decades of life with no gender predispositions. A plain soft tissue radiograph can demonstrate phleboliths and aid in diagnosing an intramuscular hemangioma. The present report is a rare deep-seated facial hemangioma involving various facial muscles with multiple phleboliths; characteristics clinical and radiological features. A 22-year-old male patient reported a complaint of swelling on the right side of the jaw. Conventional radiography showed the right cheek's soft tissue and multiple round, target-like radiopacities of variable sizes.
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Affiliation(s)
- Simran D Badki
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vidya Lohe
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ravindra P Kadu
- Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ravikant Sune
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur B Wanjari
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, Levi B. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle) 2023; 12:68-84. [PMID: 35951024 DOI: 10.1089/wound.2021.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.
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Affiliation(s)
- Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Comish
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoffrey E Hespe
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jalen Harvey
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Sorkin
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Mataro I, Di Franco L, Cavaliere A, Razzano S, Schonauer F, D'Andrea F, d'Alessio R. Extensive severe intraorbital arteriovenous malformations: report of a rare laser complication and successful management. J Wound Care 2023; 32:S4-S8. [PMID: 36630192 DOI: 10.12968/jowc.2023.32.sup1.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Arteriovenous malformations (AVMs) are rare congenital errors of vascular morphogenesis, characterised by abnormal direct communications between arteries and veins, bypassing the normal capillary bed. Apart from the central nervous system, typical locations include the head and neck, and less frequently limbs, trunk or internal organs. AVMs of the head and neck often become clinically evident and symptomatic only in later childhood and are characterised by a history of variable growth, sometimes leading to large, deforming, pulsating masses with a propensity to massive haemorrhage. Therapeutic strategy is based on selective embolisation, surgical excision, or a combination of both. Radical surgical excision of local AVMs is the only effective treatment but it may be mutilating, especially for AVMs of the head and neck. Laser therapy represents a good option to treat the cutaneous aspects of AVMs nevertheless, its efficacy is limited. To the date, pharmacological therapy for AVMs is still on debate due to its controversial outcomes as it seems not as effective as other treatments and usually requires a longer course of application. However, pharmacological therapy could be useful in selected patients and for AVMs nonresponsive to traditional treatment, allowing them to obtain acceptable results without serious complications. This paper reports the case of a serious laser complication of extensive intraorbital AVM successfully treated by local reconstruction and topical pharmacological treatment.
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Affiliation(s)
- Ilaria Mataro
- Plastic and Reconstructive Surgery and Burn Unit, Hospital 'A. Cardarelli', Naples, Italy
| | - Livia Di Franco
- Resident Doctor in General Surgery, Federico II University Hospital, Via Pansini 5, Naples, Italy
| | - Annachiara Cavaliere
- Department of Plastic and Reconstructive Surgery, Federico II University Hospital, Via Pansini 5, Naples, Italy
| | - Sergio Razzano
- Plastic and Reconstructive Surgery and Burn Unit, Hospital 'A. Cardarelli', Naples, Italy
| | - Fabrizio Schonauer
- Department of Plastic and Reconstructive Surgery, Federico II University Hospital, Via Pansini 5, Naples, Italy
| | - Francesco D'Andrea
- Department of Plastic and Reconstructive Surgery, Federico II University Hospital, Via Pansini 5, Naples, Italy
| | - Roberto d'Alessio
- Plastic and Reconstructive Surgery and Burn Unit, Hospital 'A. Cardarelli', Naples, Italy
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Mlv SK, Mittal R. Suprapatellar Fat Pad Impingement due to Vascular Lesion: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00071. [PMID: 36947643 DOI: 10.2106/jbjs.cc.22.00611] [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: 06/18/2023]
Abstract
CASE We present a fifteen-year-old adolescent boy with anterior knee pain and a palpable tender swelling in the suprapatellar region with painful terminal extension. Imaging was suggestive of a vascular lesion in the suprapatellar fat pad. He underwent arthroscopic debridement and postoperatively regained his terminal extension. CONCLUSION Suprapatellar fat pad impingement can rarely be due to vascular lesions or lipomatous tumors affecting the suprapatellar fat pad. If conservative treatment is unsuccessful, surgery can provide good pain relief. The tissue excised should always be sent for histopathological examination.
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Affiliation(s)
- Sai Krishna Mlv
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Altman I. Study of the changed level of angiogenesis activation factors after endovascular treatment of arteriovenous malformations depending on the type of embolizing material and the radicality of exclusion of the malformation from the blood flow. UKRAINIAN INTERVENTIONAL NEURORADIOLOGY AND SURGERY 2022. [DOI: 10.26683/2786-4855-2022-2(40)-72-82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective ‒ тo study changes in angiogenesis factors (VEGF-A, VEGFR-1, Great Endothelin-1) in the blood plasma of patients with arteriovenous malformation (AVM) of different localization before and after endovascular treatment depending on the type of embolizing material used and the results of AVM exclusion from the bloodstream.Materials and methods. The results of treatment in 2019–2022 were analyzed in 27 patients (11 (41.0 %) men and 16 (59.0 %) women) with AVMs of different localization who underwent endovascular treatment. The age of the patients ranged from 11 to 47 years, the average age was (32.8 ± 5.1) years. Patients with AVM were divided into two groups depending on the type of embolizing material: liquid substances (n=12) and emboli and coils (n=15). The control group was formed from 25 healthy people (10 men and 15 women) without AVM, in which the concentration of VEGF-A, VEGFR-1, Great Endothelin-1 in the blood plasma was determined for 3 months. The average age of the control group was (37.4 ± 4.8) years (from 16 to 57 years).Results. It was proved that the concentration of VEGF-A in blood plasma in patients with AVM before endovascular treatment was statistically significantly higher by 4.5 times than in the control group, VEGFR-1 by 3.0 times, Great Endothelin-1 by 2.12 times. Within 5‒7 days after embolization, a sharp increase in the level of angiogenesis induction factors was noted by 2.5–3.0 times compared to the initial indicator and a slow decrease during 3 months. However, with the use of liquid embolizing substances, no increase in VEGFR-1 concentration was registered. A comparison of the level of angiogenesis factors before and after endovascular surgical interventions revealed that the total exclusion of AVMs from the bloodstream contributes to the reduction or normalization of the content of angiogenesis factors, while the partial exclusion of AVMs from the bloodstream leads to an increase in their level due to the preservation of the source of production in the AVM structure.Conclusions. It was established that AVMs remain physiologically active during the life of the organism and undergo vascular remodeling as a result of constant pathological neoangiogenesis. Factors of angiogenesis actively respond to endovascular interventions by changing the expression of VEGF-A, VEGFR-1 and Great Endothelin-1 in the blood plasma, depending on the type of embolizing material and the radicality of AVM exclusion from the bloodstream. This is one of the main reasons for remission or further growth of AVMs and recurrences.
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34
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Shukla TS. Recurrence of Laryngeal Hemangioma in an Adult: A Case Report. Cureus 2022; 14:e31090. [DOI: 10.7759/cureus.31090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
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35
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Andrew MS, Poon C. A Rare Case of a Giant Vulval Fibroepithelial Stromal Polyp. J Pediatr Adolesc Gynecol 2022; 35:501-504. [PMID: 35123056 DOI: 10.1016/j.jpag.2022.01.012] [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: 10/15/2021] [Revised: 12/22/2021] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND A fibroepithelial stromal polyp is an uncommon benign pathology of the female genital tract. Rarely, these benign tumors present as a giant lesion and are clinically difficulty to distinguish from other pathologies. CASE A 19-year-old female presented with a vulval fibroepithelial stromal polyp measuring ∼8 × 8 × 3 cm that extended from the right labia majora. Present for 2 years, the lesion caused mild discomfort and aesthetic dissatisfaction due to its size but otherwise had no associated symptoms. It was diagnosed using a combination of imaging techniques including ultrasound and magnetic resonance imaging and histological analysis. It was removed surgically and has had no recurrence. SUMMARY AND CONCLUSION The consideration of both benign and malignant pathologies is paramount when differentiating vulval masses. Thorough clinical reasoning and appropriate use of imaging modalities and histological analysis are essential.
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Affiliation(s)
- Madison S Andrew
- Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia 3168.
| | - Carolin Poon
- Mercy Hospital for Women, Mercy Health, 163 Studley Road, Heidelberg 3084 Victoria, Australia
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Walter A, Calite E, Müller A, Kalff JC, Meyer C, Geipel A, Gembruch U, Schreiner C. Prenatal diagnosis and management of a giant intrahepatic arteriovenous malformation-Sonographic findings, clinical implications, and treatment. Clin Case Rep 2022; 10:e6175. [PMID: 35937027 PMCID: PMC9347331 DOI: 10.1002/ccr3.6175] [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: 04/04/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
Prenatal detection of complex giant hepatic arteriovenous malformation requires an examination of the affected fetal hemodynamic situation with emphasis on the affected arterial supply pattern. Early pediatric surgeon presentation is needed, as timely surgical intervention appears to be essential.
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Affiliation(s)
- Adeline Walter
- Department of Obstetrics and Prenatal MedicineUniversity Hospital BonnBonnGermany
| | - Elina Calite
- Department of Obstetrics and Prenatal MedicineUniversity Hospital BonnBonnGermany
| | - Andreas Müller
- Department of Neonatology and Pediatric Intensive Care MedicineUniversity Hospital BonnBonnGermany
| | - Jörg C. Kalff
- Department of SurgeryBonn University Hospital, University Hospital BonnBonnGermany
| | - Carsten Meyer
- Department of Diagnostic and Interventional RadiologyBonn University Hospital, University Hospital BonnBonnGermany
| | - Annegret Geipel
- Department of Obstetrics and Prenatal MedicineUniversity Hospital BonnBonnGermany
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal MedicineUniversity Hospital BonnBonnGermany
| | - Christine Schreiner
- Department of Neonatology and Pediatric Intensive Care MedicineUniversity Hospital BonnBonnGermany
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Sokolova R, Memeti S, Risteski T, Andonovska B, Lumani-Bakiji N, Stepanovski A, Kocevski B. Treatment of venous malformations in pediatric population – three- year experience. Arch Public Health 2022. [DOI: 10.3889/aph.2022.6052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Venous malformations (VMs) are a type of vascular malformations that result in abnormal development of veins that become extensible over time due to an error in vascular morphogenesis. They usually appear in newborns or in early adulthood as a bluish, soft, swollen and eventually painful skin formation. Treatment includes conservative therapy, sclerotherapy and surgical excision. Aim of the paper is to evaluate the therapeutic effect of scleraotherapy in pediatric patients with venous malformations. Material and methods: In a three-year period, from 2019 to 2021, venous malformation was found in 33 patients aged 4 to 14 years (average age: 8 years). Pain as a symptom occurred in 8 patients. Two patients had lesions measuring up to 5 cm and 5 cm respectively, while in the remaining subjects the lesion was over 5 cm. Ultrasound was performed routinely in all subjects, and MRI in two patients. Conservative treatment was instituted in 13 patients with venous malformations of the extremities, surgical excision with local reconstruction was performed in 11 patients, and sclerotherapy with bleomycin under general anesthesia was performed in 8 patients. Combined treatment was used in one patient that presented with venous malformation of the upper arm that underwent partial sclerotherapy with subsequent operative excision due to a phlebolith. Follow-up examinations revealed regression of the change not only from functional but from aesthetic aspect as well. Conclusion: Sclerotherapy is the established golden standard, first-line treatment for venous malformations. Excellent results were achieved as the reduction of the lesions was below 50% of the initial size. However, the modality of treatment should be individualized to each patient as it can sometimes require a combination of more than one treatment option. Venous malformations are best treated early, but they usually recur over time. Treatment helps relieve symptoms and control the growth of vascular malformations.
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Kim H, Labropoulos N. Ultrasound Examination of Venous Malformation. Phlebology 2022. [DOI: 10.37923/phle.2022.20.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hyangkyoung Kim
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Nicos Labropoulos
- Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA
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39
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Giese RA, Valero C, Shah JP. Surgical management of vascular tumors and malformations of the head and neck in adults. J Oral Pathol Med 2022; 51:854-859. [PMID: 35467767 DOI: 10.1111/jop.13302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022]
Abstract
Vascular tumors and malformations present a diagnostic and therapeutic challenge to many physicians. Because these lesions are rare, few surgeons have enough experience with them other than those practicing in tertiary vascular anomaly treatment centers. Some patients may have been misdiagnosed or mistreated during childhood and present in adult age with either recurrence or with an untreated lesion. Ideally, a multidisciplinary treatment team should be involved to discuss management with the patient including specialists in surgery, interventional radiology, pathology, hematology, genetics, and dermatology. As our understanding of the pathogenesis of these lesions grows, novel therapies are being employed which may decrease the need for surgery. Nevertheless, some lesions need definitive treatment with surgery. Improving understanding of the surgical management of vascular anomalies will improve cosmetic and functional outcomes for patients.
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Affiliation(s)
- Rachel A Giese
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas, USA
| | - Cristina Valero
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russia
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40
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Gocal W, Hilal E, Tragon T. Nd:YAG Laser Treatment of Massive Tongue Venous Malformation: A Case Report. EAR, NOSE & THROAT JOURNAL 2022:1455613221086030. [PMID: 35323070 DOI: 10.1177/01455613221086030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Venous malformations (VM) are slow-flow vascular lesions that result from morphogenesis errors. Composed of dysfunctional veins lacking smooth muscle cells, VMs grow slowly and may initially be managed by observation. Treatment is indicated for lesions that cause functional impairment. One treatment option is laser therapy, which is very effective due to its tissue penetration and relative selectivity. The Nd:YAG laser has been shown to treat small and moderately sized mucosal vascular lesions; in this case, it was applied in a staged approach for treatment of a massive venous malformation of the tongue. A 66-year-old male presented with a venous malformation involving the tongue and lower lip, the lesion estimated to be 10 x 14 x 15 cm in size. The Nd:YAG laser was used in three separate stages to photocoagulate the venous lesion. Follow-up for recurrence is ongoing, but currently shows complete malformation ablation with a 36.2% volume reduction after treatment. The Nd:YAG laser is an effective tool in the treatment of large vascular lesions. Successful laser application in a staged approach for the treatment of a venous malformation of this size and complexity further supports its clinical value. Monitoring for possible recurrence of the venous malformation should be ongoing.
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Affiliation(s)
- Wiktoria Gocal
- Allegheny General Hospital, PA, USA
- 6618Drexel University College of Medicine, PA, USA
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41
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O'Donovan K, McCarron EP, Mulholland K, Wieboldt J, McManus TE. Disseminated adult haemangiomatosis without cutaneous involvement. QJM 2022; 114:875-876. [PMID: 34043801 DOI: 10.1093/qjmed/hcab154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/16/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- K O'Donovan
- Department of Rheumatology, Musgrave Park Hospital, Belfast Health and Social Care Trust (BHSCT), Belfast BT9 7JB, UK
| | - E P McCarron
- Department of Clinical Biochemistry and Metabolic Medicine, Royal Victoria Hospital, BHSCT, Belfast BT12 6BA, UK
- Department of Medicine, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University, Belfast BT7 1NN, UK
| | - K Mulholland
- Department of Histopathology, Altnagelvin Area Hospital, Western Health and Social Care Trust (WHSCT), Derry BT47 6SB, UK
| | - J Wieboldt
- Department of Respiratory Medicine, South West Acute Hospital, WHSCT, Enniskillen BT74 6DN, UK
| | - T E McManus
- Department of Medicine, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University, Belfast BT7 1NN, UK
- Department of Respiratory Medicine, South West Acute Hospital, WHSCT, Enniskillen BT74 6DN, UK
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42
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Anikin IA, Khamgushkeeva NN, Knyazev AD, Mamedova AD. [Jugulotympane paraganglioma associated with polysegmentary congenital hemangioma]. Vestn Otorinolaringol 2022; 87:84-88. [PMID: 36107186 DOI: 10.17116/otorino20228704184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The describes a clinical observation of a combination of jugulotympanic paraganglioma of the left temporal bone with multifocal congenital hemangioma. The interest of the case is that such a combination of pathologies is extremely rare. A comprehensive study and surgical treatment of a patient with this clinical diagnosis was carried out. In the diagnosis, objective otorhinolaryngological studies, otomicroscopy and MSCT of the temporal bones and MRI of the middle ear with contrast were used. Surgical intervention was performed under multicomponent anesthesia with tracheal intubation, transmastoid access. The postoperative management of the patient after surgical treatment is described.
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Affiliation(s)
- I A Anikin
- St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia
| | - N N Khamgushkeeva
- St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia
| | - A D Knyazev
- St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia
| | - A D Mamedova
- St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia
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Bonilla-Velez J, Whitlock KB, Ganti S, Zenner K, Cheng CV, Jensen DM, Pham MHM, Mitchell RM, Dobyns W, Bly RA, Bennett JT, Dahl JP, Perkins JA. Acetylsalicylic acid suppression of the PI3K pathway as a novel medical therapy for head and neck lymphatic malformations. Int J Pediatr Otorhinolaryngol 2021; 151:110869. [PMID: 34537546 PMCID: PMC9632366 DOI: 10.1016/j.ijporl.2021.110869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Head and neck lymphatic malformations (HNLM) are caused by gain-of-function somatic mutations in PIK3CA. Acetylsalicylic acid (ASA/aspirin) is thought to limit growth in PIK3CA-mutated neoplasms through PI3K pathway suppression. We sought to determine if ASA could be beneficial for HNLM. METHODS Retrospective case series of patients (0-18 years) offered ASA (3-5 mg/kg/day) for HNLM treatment (2010-2018). Clinical and treatment characteristics, patient-reported symptom improvement, medication tolerance, compliance, and complications were recorded. Treatment response was determined by change in patient/caregiver-reported symptoms, or HNLM size [complete (resolved), partial (decreased), or stable]. RESULTS Fifty-three patients were offered ASA, 23 (43%) accepted (median age 10 years, IQR 6-14). Compared to patients who declined, patients receiving ASA were more likely to have extensive malformations: ex-utero intrapartum treatment procedure, bilateral malformations, oral cavity location, ≥2 invasive treatments, or tracheotomy (p < 0.05). All patients with tissue available had PIK3CA mutations (13/23). Treatment indications included oral pain/blebs (12, 52%), recurrent pain/swelling (6, 26%), or sudden/persistent swelling (5, 22%). Treatment plan was commonly one 81 mg tablet daily (19, 83%) for 3-12 months (8, 42%). Therapeutic adherence was reported by 18 patients (78%). Symptoms improved in 18 patients [78%; decreased pain (9, 39%) and swelling (8, 35%)]. Treatment resulted in partial (14, 61%) or complete response (4, 17%). Three patients developed oral bleb bleeding, which resolved with medication discontinuation. CONCLUSION ASA seems to be a well-tolerated, low-risk medication for HNLM treatment. This pilot study suggests that it often improves symptoms and reduces HNLM size. Further prospective, randomized studies are warranted to comprehensively assess indications, safety, and efficacy. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Juliana Bonilla-Velez
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA; Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA.
| | - Kathryn B. Whitlock
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Sheila Ganti
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Kaitlyn Zenner
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Chi Vicky Cheng
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Dana M. Jensen
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Minh-Hang M. Pham
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Ryan M. Mitchell
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Department of Otolaryngology–Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - William Dobyns
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Randall A. Bly
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - James T. Bennett
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA, USA,Division of Genetic Medicine, Department of Pediatrics, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA
| | - John P. Dahl
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Jonathan A. Perkins
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA,Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, USA
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Kerr AM, Sisk BA. Unanswered questions and unmet needs: A call for communication research in vascular anomalies. PATIENT EDUCATION AND COUNSELING 2021; 104:2839-2842. [PMID: 33858723 DOI: 10.1016/j.pec.2021.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/03/2021] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Anna M Kerr
- Department of Primary Care, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA.
| | - Bryan A Sisk
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
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Mungia AM, Owibingire SS, Moshy JR, Sohal KS, Sianga W. Pattern and management outcomes of head and neck hemangiomas: a prospective study from Tanzania. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Hemangiomas arise from the proliferation of endothelial cells surrounding blood-filled cavities. They have a slightly higher female predilection and about 60–70% of them occur in the head and neck region. Various medical and surgical options are available for the treatment of hemangiomas. Aim: To determine the pattern and management outcomes of head and neck hemangiomas in Tanzania. Material and methods: This was a one-year prospective, cross-sectional study that involved all consecutive patients with head and neck hemangiomas treated in Muhimbili National Hospital. A structured questionnaire was used to collect information including age and sex of the patient, chief complaint and, duration, size and site of the lesion. The treatment modalities were surgery and/or intralesional bleomycin injection (IL-Bleo). A standard dose of bleomycin was 0.3 to 0.6 mg/kg per injection not exceeding 15 units per cycle with a maximum of 6 cycles. Frequency distribution and cross-tabulation were performed and association between variables was assessed by the Chi-square test, whereby the p-value was set at p < 0.05. Results: A total of 58 patients were included in the study. The male to female ratio was 1:1.4 and the median age was 6.15 years. Majority (74%) of the patients had infantile hemangioma. The most common presenting complaint of patients/guardians of the patients were facial disfigurement (94.8%), pain (32.8%) and ulceration (22.4%). The most frequently involved sites were the lips (55.2%) followed by the cheeks (37.9%). In patient who were managed surgically, there was a 100% reduction in size of the lesion. Of those who were treated with bleomycin, the percentage reduction in the area of the lesion ranged from 8.33% to 100% with mean of 72.6%. Only 6% of the patient had post IL-Bleo complications. Conclusion: Head and Neck hemangiomas are more common in females and majority are infantile hemangioma. Facial disfigurement is the commonest presenting complication of these lesions, and the lips and the cheeks are mostly affected areas. Intralesional bleomycin is an effective treatment modality which has low complication rates.
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Lai KKH, Li CK, Tsang A, Wong SYS, Ko CKL. Ocular adnexal intramuscular hemangioma arising from the eyelid: case report and literature review. Orbit 2021; 42:290-294. [PMID: 34686104 DOI: 10.1080/01676830.2021.1990352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intramuscular hemangioma (IMH) is rare in the ocular adnexa and is uncommonly found in infants. We describe a 1-month-old female infant with an unremarkable birth history presented with subacute onset of right upper eyelid swelling. Clinical examination revealed a purplish subcutaneous mass over the right upper eyelid causing mechanical ptosis. MRI revealed a well-defined subcutaneous mass, which was hyperintense on the T1 weighted images and showed intense enhancement after administration of intravenous gadolinium. Our working diagnosis was infantile capillary hemangioma, and the patient received two intralesional steroid injections without diminishing the lesion size. The lesion had become static in size and the subsequent MRI 14 years later revealed the same lesion had become hyperintense on the T1 weighted image. An excisional biopsy revealed mixed type IMH. IMH should be considered among young patients with upper eyelid swelling, particularly in those who show a poor response to steroid treatment.
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Affiliation(s)
- Kenneth K H Lai
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Chun Kit Li
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Alan Tsang
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Sivia Y S Wong
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Callie K L Ko
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
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Abstract
INTRODUCTION Appropriate treatment of scalp arteriovenous malformations (SAVMs) remains largely unclear given the rarity of reported cases. This single-institution case series presents consecutive patients with extracranial SAVMs and long-term follow up.The primary aim of this study was to review treatment decisions, evaluate clinical outcomes, and compare our experience to available literature in order to better understand SAVMs and improve future outcomes. MATERIALS AND METHODS A retrospective review of consecutive patients with extracranial SAVMs between January 2015 and December 2019 was performed. Treatment factors of interest included embolization method, embolic agents, and decision to proceed with surgical resection. Relevant clinical outcomes included recurrence rates, cure rates, and complications. RESULTS Seven patients were included in the present series. Satisfactory outcomes were ultimately achieved for all 7 patients using embolization with or without combined surgical resection. Embolizations performed in combination with resection were curative in 4 of 4 cases (100%). Embolizations performed without resection were curative in 0 of 4 cases (0%), satisfactory in 2 of 4 cases (50%), and unsatisfactory in 2 of 4 cases (50%). DISCUSSION All SAVM patients in this series were treated satisfactorily using embolization with or without operative resection. This study strongly suggests that embolization combined with surgical resection during the same admission yields the best treatment outcomes for SAVMs, specifically demonstrating lower rates of recurrence and embolization-related complications. Decisions on whether or not to proceed with resection should be made by the interventional radiologist, the plastic surgeon, and the patient together.
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Essa RA, Ahmed SK, Bapir DH, Rasul SA, Abubakr CP, Khdir AA. Surgical management of oropharynx hemangioma: A comprehensive review literature. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Becerra-Heredia JL, Fiori-Chíncaro GA, Agudelo-Botero AM. [Flebolites in the maxillofacial region: a challenge for imaging diagnosis. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e086. [PMID: 38463723 PMCID: PMC10919838 DOI: 10.21142/2523-2754-0904-2021-086] [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: 10/17/2021] [Accepted: 11/24/2021] [Indexed: 03/12/2024] Open
Abstract
Vascular alterations or disorders of the blood and / or lymphatic vessels have their own characteristics, the identification of calcifications being a correct parameter to be able to make a proper diagnosis. The objective of the study was to describe the radiographic characteristics of the phleboliths, and whether they represent a challenge for diagnosis. according to the literature reviewed in the Medline (PubMed) database, Scielo, Google Scholar and some specialized journals. Phleboliths were found to have very particular radiographic characteristics, with concentric radiolucent and radiopaque images that resemble rings. However, not all the presentations are similar, this makes the diagnosis misleading with other calcifications in this region, such as sialoliths where their appearance is usually similar. Furthermore, there is the relationship with vascular anomalies and hemangiomas. finally, the evidence points to very specific characteristics of this lesion, and it is necessary to individualize each case, due to the differences that exist from one patient to another.
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Affiliation(s)
- Jorge Luis Becerra-Heredia
- Facultad de Estomatología, Universidad Inca Garcilaso de la Vega. Lima, Perú. Universidad Inca Garcilaso de la Vega Facultad de Estomatología Universidad Inca Garcilaso de la Vega Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Instituto Latinoamericano de Altos Estudios en Estomatología (ILAE). Lima, Perú. Instituto Latinoamericano de Altos Estudios en Estomatología (ILAE) Lima Perú
| | - Ana María Agudelo-Botero
- Fundación Centro de Investigaciones y Estudios Odontológicos CIEO. Bogotá, Colombia. Fundación Centro de Investigaciones y Estudios Odontológicos CIEO Bogotá Colombia
- Facultad de Estomatología, Universidad Militar Nueva Granada. Bogotá, Colombia Universidad Militar Nueva Granada Facultad de Estomatología Universidad Militar Nueva Granada Bogotá Colombia
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Sahoo NK, Bhat S, Kumar S. Neonatal vascular malformation of parietal bone. Natl J Maxillofac Surg 2021; 12:431-434. [PMID: 35153445 PMCID: PMC8820297 DOI: 10.4103/njms.njms_253_20] [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: 11/24/2020] [Revised: 02/02/2021] [Accepted: 07/31/2021] [Indexed: 11/28/2022] Open
Abstract
Vascular malformations (VaMs) are congenital lesions and are present at birth. They grow commensurately with age. These lesions often affect the soft tissues with intraosseous involvement of the scalp being rare. Here, we discuss a case of intraosseous VaM in a 2-month-old infant which was involving the parietal bone.
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Affiliation(s)
- N K Sahoo
- Department of Oral and Maxillofacial Surgery, Army Dental Centre (R and R), New Delhi, India
| | | | - Sanjay Kumar
- Department of Neurosurgery, Armed Forces Medical College, Pune, Maharashtra, India
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