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MacLellan AD, Easton AS, Alubankudi R, Pickett GE. Documented growth of an intracranial capillary hemangioma: A case report. Neuropathology 2024; 44:76-82. [PMID: 37403213 DOI: 10.1111/neup.12933] [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: 01/02/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 07/06/2023]
Abstract
Intracranial capillary hemangiomas in adults are rare, and diagnosis can be challenging. Hemangiomas, in general (and particularly in the skin), are more often noted in the pediatric population. Due to the lack of imaging undertaken in the presymptomatic phase, the literature provides few clues on the rate of growth of these unusual tumors. Therefore, we report a case of a 64-year-old man with a medical history of Lyme disease who presented with exhaustion and confusion. Imaging demonstrated an intra-axial lesion with vascularity in the posterior right temporal lobe, raising the possibility of a glioma. Imaging two years prior revealed a very small lesion in the same location. The patient underwent a craniectomy, total resection of the lesion was completed, and his symptoms of confusion resolved. Biopsy revealed a capillary hemangioma composed of small vascular channels lined by endothelial cells and pericytes without smooth muscle. Features of glioma, vascular neoplasms or neuroborreliosis (cerebral Lyme disease) were not identified. Our case documents the growth over two years of a rare intracranial capillary hemangioma in an older adult male.
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Affiliation(s)
| | - Alexander S Easton
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rufus Alubankudi
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gwynedd E Pickett
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Sasaki K, Kuge A, Shimokawa Y, Yamaki T, Kondo R, Sonoda Y. Intracranial parenchymal capillary hemangioma: A case report. Surg Neurol Int 2023; 14:401. [PMID: 38053706 PMCID: PMC10695465 DOI: 10.25259/sni_695_2023] [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: 08/18/2023] [Accepted: 10/19/2023] [Indexed: 12/07/2023] Open
Abstract
Background Capillary hemangioma is a rare benign hemangioma that occurs in the soft tissues of the skin, orbit, head, and neck. Intracranial cases, especially intraparenchymal cases, are extremely rare. In this study, we report the course of an intracranial parenchymal capillary hemangioma with left mild motor paresis and involuntary movements of the left upper extremity and was successfully treated by surgical resection, including radiological and pathological examinations. Case Description This is a case of a 60-year-old woman who presented with motor weakness and involuntary movement of the left upper extremity. Computed tomography and magnetic resonance imaging revealed the right frontal hemorrhagic mass lesion without enhancement of contrast medium. Cerebral digital subtraction angiography showed no vascular stain and abnormal arteriovenous shunt. Preoperatively, we diagnosed cavernous hemangioma with a hemorrhagic component located in the right motor cortex. Because this case was symptomatic, we performed a craniotomy and gross total resection of the right frontal lesion. The diagnosis of capillary hemangioma was made by histological examination, including immunohistological study. Conclusion Because intraparenchymal capillary hemangiomas are difficult to diagnose with preoperative imaging, surgical treatment, and histopathological examination are important.
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Affiliation(s)
- Kosuke Sasaki
- Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Atsushi Kuge
- Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, Japan
- Department of Emergency Medicine, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Yu Shimokawa
- Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Tetsu Yamaki
- Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Rei Kondo
- Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Yamagata University, Yamagata, Japan
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Wardhana DPW, Awyono S, Lauren C, Muhammad Rosyidi R, Saputra H. Intraparenchymal cerebellar capillary hemangioma in a 32-year-old man: a case report. Front Surg 2023; 10:1141522. [PMID: 37228758 PMCID: PMC10203496 DOI: 10.3389/fsurg.2023.1141522] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.
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Affiliation(s)
- Dewa Putu Wisnu Wardhana
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Academic Hospital of Universitas Udayana, Universitas Udayana,Badung, Indonesia
| | - Steven Awyono
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
| | - Christopher Lauren
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
| | - Rohadi Muhammad Rosyidi
- Department of Neurosurgery, West Nusa Tenggara General Hospital, Medical Faculty of Mataram University,Mataram, Indonesia
| | - Herman Saputra
- Department of Anatomical Pathology, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
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Yoda RA, Cimino PJ. Neuropathologic features of central nervous system hemangioblastoma. J Pathol Transl Med 2022; 56:115-125. [PMID: 35501672 PMCID: PMC9119802 DOI: 10.4132/jptm.2022.04.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Hemangioblastoma is a benign, highly vascularized neoplasm of the central nervous system (CNS). This tumor is associated with loss of function of the VHL gene and demonstrates frequent occurrence in von Hippel-Lindau (VHL) disease. While this entity is designated CNS World Health Organization grade 1, due to its predilection for the cerebellum, brainstem, and spinal cord, it is still an important cause of morbidity and mortality in affected patients. Recognition and accurate diagnosis of hemangioblastoma is essential for the practice of surgical neuropathology. Other CNS neoplasms, including several tumors associated with VHL disease, may present as histologic mimics, making diagnosis challenging. We outline key clinical and radiologic features, pathophysiology, treatment modalities, and prognostic information for hemangioblastoma, and provide a thorough review of the gross, microscopic, immunophenotypic, and molecular features used to guide diagnosis.
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Affiliation(s)
- Rebecca A. Yoda
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, Division of Cytopathology, University of Washington, Seattle, WA, USA
- Corresponding Author: Rebecca A. Yoda, MD, Department of Laboratory Medicine and Pathology, University of Washington, 325 9th Avenue, Box 359791, Seattle, WA 98104-2499, USA Tel: +1-206-744-3145, Fax: +1-206-744-8240, E-mail:
| | - Patrick J. Cimino
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA
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Capillary hemangioma of the sphenoid sinus with intrasellar and parasellar extensions. Radiol Case Rep 2021; 17:156-160. [PMID: 34820041 PMCID: PMC8599932 DOI: 10.1016/j.radcr.2021.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
Capillary hemangiomas are benign vascular tumors usually diagnosed in infancy and involving skin and soft tissues. We report a rare case of an adult capillary hemangioma of the left sphenoid sinus extending into the intrasellar and parasellar regions. A 71-year-old woman presented with complaints of headaches and diplopia. Magnetic resonance imaging revealed a T2-hyperintense mass-like lesion involving the left posterior ethmoid and sphenoid sinuses and left cavernous sinus, that had extended into the intrasellar and parasellar regions. Dynamic contrast-enhanced computed tomography revealed enhancing vessel-like structures within the lesion during the arterial phase, which were observed to expand further in the late phase of the examination. This characteristic feature indicated increased vascularity, suggesting the presence of a capillary hemangioma. The patient underwent endoscopic resection via the endonasal transpterygoid approach, and the lesion was diagnosed histopathologically as a capillary hemangioma. To aid diagnosis and clinical management, radiologists should be aware of the imaging findings related to capillary hemangiomas.
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Massman LJ, Conteh F, Cochran EJ, Zwagerman NT. Intracranial Capillary Hemangiomas: A Peripartum Presentation and Review of the Literature. World Neurosurg 2020; 145:220-228. [PMID: 32920159 DOI: 10.1016/j.wneu.2020.09.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intracranial capillary hemangiomas (ICHs) are rare vascular tumors composed of a bed of many narrow thin-walled vessels. Within the confines of the skull, these tumors can lead to serious neurologic deficits including cranial nerve dysfunction, mood/personality disturbances, and signs of intracranial mass effect. METHODS We report the case of a 23-year-old, 5-week postpartum woman with a history of progressive painful ophthalmalgia of the right eye presenting with rapid onset of ptosis, diplopia, and right-sided facial pain and hypesthesia. Imaging demonstrated a small extraaxial mass within the right cavernous sinus. She underwent 2 operations via an endoscopic endonasal approach for biopsy followed by complete resection. Histology showed a highly mitotic capillary hemangioma, which was negative for both estrogen and progesterone receptors. RESULTS We review cases of ICH reported in the literature and provide an updated summary of the presentation, diagnosis, and treatment of ICH. We then present a brief analysis of the reported cases with respect to age and sex. CONCLUSIONS We conclude that, in experienced hands, the endoscopic endonasal approach can be used to access the cavernous sinus for complete resection of ICHs of the cavernous sinus. We also suggest that further attention be paid to such cases in pregnant and peripartum women as these tumors may progress more quickly in this subpopulation.
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Affiliation(s)
| | - Fatu Conteh
- Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Elizabeth J Cochran
- Department of Pathology, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nathan T Zwagerman
- Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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