Hemangioma of the lunate (Klippel-Trénaunay syndrome). Case report

Angiography, Thermography and Other Circulation Tests in Vascular Tumours of the Hand

Studies were undertaken to compare and evaluate angiographic findings, thermography, systolic digital pressure and blood flow measurements in the assessment of patients with vascular tumours in the upper extremity. Fourteen patients, eight with hemodynamically active and six with hemodynamically slow tumours were investigated. Angiography was necessary to establish the preoperative diagnosis and estimate the spread of these vascular tumours. Small arterio-venous shunts with diffuse spread in the extremity caused a moderate temperature increase over the whole area, whereas large or medium-sized shunts and conglomerates of small shunts were visible as "hot spots" on the thermograms obtained by high resolution, infrared thermo graphic technique. In such cases thermography, a non-invasive and inexpen sive procedure, can replace angiography in the post-operative follow-up examinations, or can be used to follow the course of disease in non-operated patients. In two cases thermograms indicated presence of arterio-venous shunts, while no such communications could be seen on the preoperative angiograms. It is therefore assumed that thermography is a more sensitive method for the detection of very small shunts.

Risk of tumorigenesis in overgrowth syndromes: a comprehensive review

Overgrowth syndromes (OGS) comprise a heterogeneous group of disorders in which the main characteristic is that either weight, height, or head circumference is 2-3 standard deviations (SD) above the mean for sex and age. A striking feature of OGS is the risk of neoplasms. Here, the relative frequency of specific tumors in each OGS, topographic location, and age of appearance is determined by reviewing published cases. In some OGS (Perlman, Beckwith-Wiedemann, and Simpson-Golabi-Behmel syndromes and hemihyperplasia) more than 94% of tumors appeared in the abdomen usually before 10 years of age, mainly embryonal in type. In Perlman syndrome, only Wilms tumor has been recorded, whereas in Sotos syndrome, lympho-hematologic tumors are most frequent. Based on literature review, a specific schedule protocol for tumor screening is suggested for each OGS. A schedule with different intervals and specific tests is proposed for a more rational cost/benefit program for these disorders.

Vascular tumours of the hand

The series comprises 74 patients with benign and 2 with malignant vascular tumours located in the upper extremity and treated at our hospital during the period 1962-80. In 9 instances the tumour was associated with skeletal hypertrophy of the involved extremity (Klippel-Trénaunay syndrome), whereas in another 7 patients a hypotrophy of the skeleton of the affected extremity was seen. Preoperative angiography was performed on 39 patients and characteristic features for the various types of tumours are discussed. Fifty-nine patients underwent surgical treatment. The observation period ranged from 1 to 18 years (mean 7 years). Twenty-six patients were cured, 19 improved, and 14 had recurrence. The cure rate was found to depend on the presence of arteriovenous shunts, the size of the tumour and its localization. Tumours with diameters of less than or equal to 2 cm located on the fingers or on the dorsum of the hand had the best prognosis.