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Liu J, Liu C, Long K, Liu H. A jugular venous compression adjunct for surgical excision of distensible orbital venous malformations. Orbit 2024:1-10. [PMID: 39158479 DOI: 10.1080/01676830.2024.2389304] [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: 04/10/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
PURPOSE Orbital venous malformations (VM) pose challenges in complete resection due to indistinct borders and bleeding proclivity. Current methods for aiding surgical excision of distensible orbital venous malformations are inadequate. We investigated whether external neck compression could facilitate intraoperative distension of venous orbital lesions during surgical excision in patients diagnosed with VM. METHODS Eighteen patients (8 males and 10 females) diagnosed with distensible venous anomalies were enrolled. Neck compression technology, was employed to distend the lesions before puncture embolization using n-butyl-2-cyanoacrylate glue under general anesthesia. The surgical process, along with preoperative to postoperative changes in ocular symptoms, were recorded. RESULTS The average surgical duration was 95 min. A mean of 3.41 ml surgical glue was used for embolization. The compression belt maintained pressure at 35-40 mmHg. Total lesion resection was achieved in 12 patients, with 6 patients undergoing subtotal removal not requiring supplementary surgery. Symptoms were entirely alleviated in 17 patients, and signs of distensible lesions during the Valsalva maneuver were absent. One patient underwent secondary surgery for residual eyelid lesions. Minor complications included mild ocular movement restriction, residual subcutaneous induration, transiently increased orbital pressure, and lower lid ectropion in four, three, four, and one patient, respectively. Three patients experienced a mild post-operative visual acuity decrease, although none experienced vision loss. CONCLUSIONS Direct orbital embolization aided by a jugular vein compression device is safe and demonstrates satisfactory outcomes in orbital varicose vein treatment.
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Affiliation(s)
- Jinhua Liu
- Department of Ophthalmology, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China
| | - Cuihong Liu
- Department of Ophthalmology, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China
| | - Keqin Long
- Department of Nursing, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China
| | - Honglei Liu
- Department of Ophthalmology, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China
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2
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[Acute unilateral proptosis]. DIE OPHTHALMOLOGIE 2022; 119:752-756. [PMID: 34842973 DOI: 10.1007/s00347-021-01534-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 01/26/2023]
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3
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Cohen LM, Goldberg RA, Rootman DB. Recurrence of Distensible Orbital Venous-dominant Venolymphatic Malformations After Sclerotherapy Versus Embolization With Excision. Ophthalmic Plast Reconstr Surg 2021; 38:283-288. [PMID: 34798656 DOI: 10.1097/iop.0000000000002085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Treatment for orbital venolymphatic malformations (VLMs) commonly includes 3 major options: sclerotherapy, surgery, and embolization followed by surgical excision. Each has certain advantages, although it is not clear whether all are effective. The authors characterize the clinical course for a series of patients with distensible orbital venous-dominant VLM treated with sclerotherapy and/or embolization with excision. METHODS In this cross-sectional cohort study, patients affected by distensible orbital venous-dominant VLM presenting to the orbital and ophthalmic plastic surgery service from 2014 to 2020 were identified. Patients were included if they presented with a moderate-flow, distensible venous-dominant malformation associated with Valsalva-related symptoms (e.g., pain, proptosis, and diplopia). RESULTS Six cases were treated with sclerotherapy. Four underwent multiple treatments, with a mean ± SD of 3.5 ± 2.3 (range 1-7). All patients in this group failed to improve or experienced recurrence of symptoms after sclerotherapy. Twelve cases were treated with embolization and excision. Resolution of symptoms in all 12 cases was noted and maintained for a mean of 3.4 ± 2.1 years. There have been no cases of recurrence. Patients treated with sclerotherapy were more likely to experience recurrence of symptoms compared to those treated with embolization and excision (p < 0.001). CONCLUSIONS Treatment of distensible venous-dominant moderate-flow orbital VLM with sclerotherapy may provide temporary improvement in some cases. However, in the medium to long term, recurrence was universal in this series. Embolization with excision appears to provide more definitive management, avoiding recurrence in all cases for a mean follow-up of 3 years.
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Affiliation(s)
- Liza M Cohen
- Division of Orbital and Ophthalmic Plastic Surgery, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, U.S.A
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Risks and Benefits of Surgical Excision of Orbital Cavernous Venous Malformations (So-Called Cavernous Hemangioma): Factors Influencing the Outcome. Ophthalmic Plast Reconstr Surg 2021; 37:248-254. [PMID: 32826827 DOI: 10.1097/iop.0000000000001767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess risks and benefits associated with surgical excision of orbital cavernous venous malformation and analyze factors influencing the outcome. METHODS Design: cohort study. Participants: 164 consecutive patients undergoing surgical removal of orbital cavernous venous malformation. Intervention: lateral or anterior orbitotomy. Outcome measures: visual acuity, visual field, pupillary function, ocular motility, and fundus examination. Influence of the mass volume and tumor location on the outcome was evaluated. The threshold value and risk group for the volume were evaluated using the receiver operating characteristic analysis; 8 orbital different quadrants, extraconal/intraconal position, and orbital apex extension were considered as variables to evaluate the location. RESULTS Postoperatively overall visual acuity (p = 0.0084), visual field (p < 0.0001), diplopia (p < 0.0001), proptosis (p < 0.0001), ocular motility (p = 0.02), ptosis (p = 0.033), choroidal fold (p < 0.0001), disk edema (p = 0.0004) were significantly improved. The commonest location was the lateral quadrant (28%). Choroidal folds were associated with tumor greater than 1100 mm3 (p = 0.001). Visual loss occurred in 2 patients (1.2%) and tonic pupil in 5 (3%,) Visual deterioration was associated with the apical extension (p = 0.001). Pupil efferent defect was associated with lateral quadrant location (p = 0.011) and apical extension (p = 0.05). CONCLUSIONS Surgical removal of orbital cavernous venous malformation is a useful treatment modality, particularly for large size tumors. Removal of cavernous venous malformations located at the lateral aspect of the orbit carries an increased risk of permanent tonic pupil. Postoperative blindness is rarely seen and is often associated with the apical extension. Tailoring the surgical approach, depending on the relative position to the optic nerve, may have an important bearing on outcome.
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Al-Obaidani AA, Raniga S, Al Hadidi A, Sabt B, Al-Mujaini A. Orbital Vascular Malformation. Sultan Qaboos Univ Med J 2021; 21:e139-e140. [PMID: 33777438 PMCID: PMC7968897 DOI: 10.18295/squmj.2021.21.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/26/2020] [Accepted: 09/16/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Sameer Raniga
- Department of Radiology, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Buthaina Sabt
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdullah Al-Mujaini
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman.,Department of Ophthalmology, Sultan Qaboos University, Muscat, Oman
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Huang XM, Yang WC, Liu Y, Tang DR, Wu T, Sun FY. Mutations in MC4R facilitate the angiogenic activity in patients with orbital venous malformation. Exp Biol Med (Maywood) 2020; 245:956-963. [PMID: 32363922 DOI: 10.1177/1535370220919056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPACT STATEMENT The detailed molecular mechanism of orbital venous malformation (OVM) is still not clear. Using whole exome sequencing, 4 types of melanocortin 4 receptor (MC4R) mutation were detected in 7 of 27 patients with OVM, and all types of MC4R mutations resulted in the upregulation of MC4R expression. In vitro study indicated that MC4R has impacts on the proliferation, cell cycle, migration, and tube formation of the endothelial cells. Moreover, MC4R mutations altered the downstream signaling, including cAMP concentration and the expression levels of several PI3K/AKT/mTOR downstream genes, including p21, cyclin B1, ITGA10, and ITGA11. MC4R mutations may lead to the pathogenesis of OVM through modulating the downstream signaling to alter the angiogenic activity of endothelial cells.
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Affiliation(s)
- Xiao-Ming Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.,Orbital Disease Institute, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Wan-Chen Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Yang Liu
- Orbital Disease Institute, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Dong-Run Tang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Tong Wu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Feng-Yuan Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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Chai P, Yu J, Li Y, Shi Y, Fan X, Jia R. High-throughput transcriptional profiling combined with angiogenesis antibody array analysis in an orbital venous malformation cohort. Exp Eye Res 2020; 191:107916. [PMID: 31926133 DOI: 10.1016/j.exer.2020.107916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 12/15/2022]
Abstract
Orbital venous malformations (OVMs) are the most common benign orbital vascular disorders in adults and are characterized as enlarging encapsulated vascular neoplasms. These painless lesions grow slowly and become symptomatic with proptosis or visual disturbance. However, the pathogenic mechanism and diagnostic markers of OVMs remain poorly understood. To identify potential pathways involved in OVM formation, a cDNA microarray analysis was conducted with OVM samples and normal vascular tissues. These data were deposited in the National Omics Data Encyclopedia (NODE) database (accession number: OER033009). These pathway expression data were further confirmed by reverse transcription qPCR (RT-qPCR) in an OVM cohort. To explore the diagnostic markers in OVM, an angiogenesis antibody array was analyzed. The altered factors were further validated by enzyme-linked immunosorbent assay (ELISA) in the OVM cohort. Transcriptome screening revealed upregulated autophagy and VEGF pathways and downregulated Hippo, Wnt, hedgehog and vascular smooth muscle contraction signaling pathways in OVM samples. Furthermore, plasma EGF (p < 0.001) and Leptin (p < 0.01) levels were significantly elevated in OVM patients. Here, for the first time, we revealed the transcriptional background and plasma diagnostic markers in OVM, providing a novel understanding of OVM pathogenesis and facilitating the early diagnosis of OVM.
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Affiliation(s)
- Peiwei Chai
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Jie Yu
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Yongyun Li
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Yingyun Shi
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
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8
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De Maria L, De Sanctis P, Tollefson M, Mardini S, Garrity JA, Morris PP, Bendel E, Brinjikji W. Sclerotherapy for low-flow vascular malformations of the orbital and periocular regions: Systematic review and meta-analysis. Surv Ophthalmol 2019; 65:41-47. [PMID: 31425703 DOI: 10.1016/j.survophthal.2019.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 07/25/2019] [Accepted: 08/05/2019] [Indexed: 01/27/2023]
Abstract
Percutaneous sclerotherapy is an alternative strategy for the treatment of vascular malformations of the orbital and periorbital regions. The safety and efficacy of sclerotherapy in this setting have not been fully established. We present the results of a systematic review and meta-analysis examining the safety and efficacy of percutaneous sclerotherapy for the treatment of vascular malformations of the orbit. We searched PubMed, MEDLINE, and EMBASE from 2000 to 2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy for orbital and periorbital vascular malformations. Two independent reviewers selected studies and abstracted data. The primary outcome of this study is the efficacy of sclerotherapy which includes complete response, partial response, or no response to sclerotherapy. Data were analyzed using random-effects meta-analysis. Thirteen studies reporting on 154 patients were included. The rate of complete cure after percutaneous sclerotherapy was 54.9% (95% confidence interval [CI] = 34.2%-75.7%). The rate of emergent decompressive surgery was 3.4% (95% CI = 0.5%-6.2%), and the rate of vision loss was 2.7% (95% CI = 0.1%-5.3%). I2 values were above 50% for most outcomes indicating substantial heterogeneity. Our systematic review and meta-analysis of 13 studies and over 150 patients found that percutaneous sclerotherapy is a safe and effective treatment modality for the treatment of low-flow vascular malformations of the orbit.
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Affiliation(s)
- Lucio De Maria
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
| | | | - Megha Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA; Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - Samir Mardini
- Department of Plastic Surgery, Mayo Clinic, Rochester, MN, USA
| | - James A Garrity
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
| | | | - Emily Bendel
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Waleed Brinjikji
- Department of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA
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Ahmad S, Akhtar FK. Percutaneous sclerotherapy of para-orbital and orbital venous malformation: A single center, case series. Phlebology 2018; 34:355-361. [DOI: 10.1177/0268355518805364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To present a case series of percutaneous sclerotherapy of para-orbital and orbital venous malformations. Method Seven patients with venous malformations in the orbital and para-orbital region were reviewed. Puncture venogram was performed on all patients and image guided bleomycin injections using biplane digital subtraction in angiography suite. Results Average age of patients at the time of the procedure was 22 years old with the youngest being five years of age and the oldest being 50 years. Follow-ups ranged from 3 months to 18 months and the average follow-up duration was 13 months. The patients had no intraprocedural complications and reported symptomatic relief of pain as per the last follow-up. Patients have shown no symptoms or signs of recurrence of lesions with uneventful recovery so far. Conclusions Percutaneous sclerotherapy of orbital Venous Malformations with bleomycin is a safe and well-controlled procedure done in real time; it has no major systemic adverse side effects and higher efficacy than other sclerosing agents.
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Affiliation(s)
- Saima Ahmad
- Lahore General Hospital Lahore General Hospital, Lahore, Pakistan
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10
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Colletti G, Biglioli F, Poli T, Dessy M, Cucurullo M, Petrillo M, Tombris S, Waner M, Sesenna E. Vascular malformations of the orbit (lymphatic, venous, arteriovenous): Diagnosis, management and results. J Craniomaxillofac Surg 2018; 47:726-740. [PMID: 30770258 DOI: 10.1016/j.jcms.2018.09.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 08/02/2018] [Accepted: 09/10/2018] [Indexed: 11/27/2022] Open
Abstract
Vascular malformations are often found inside the orbit. Isolated venous malformations (frequently misnamed as cavernous hemangiomas) are the most frequent among these. However, also lymphatic and arteriovenous malformations can affect the orbit. The complex anatomy of the orbit and the fact that its content easily suffers from compartmental syndrome explain why treating orbital vascular malformations can be challenging and technically demanding. In this study, two institutions have retrospectively collected their cases, consisting in a total of 69 vascular malformations of the orbit. Each type of malformation has been evaluated separately in terms of diagnosis, indications for treatment, techniques and outcomes. Moreover, the authors have analyzed in detail venous malformations, identifying three different types, named orbital venous malformation (OVM) 1, 2 and 3. These behave differently from each other, and a prompt differential diagnosis is mandatory to pose correct indications, minimize risks and improve results. Overall, surgery was the technique of choice for OVM1, microcystic lymphatic malformations (LM) and arteriovenous malformations (AVM). A pure transnasal approach with mass removal and reconstruction of the medial wall with polyethylene sheets was chosen for OVM1 (intra- or extraconal) located in the medial or superomedial compartment. Sclerotherapy had a role in treating macrocystic LM and OVM3.
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Affiliation(s)
- Giacomo Colletti
- University of Milan, San Paolo Hospital, Department of Maxillo Facial Surgery (Head: Prof. Federico Biglioli), Italy.
| | - Federico Biglioli
- University of Milan, San Paolo Hospital, Department of Maxillo Facial Surgery (Head: Prof. Federico Biglioli), Italy
| | - Tito Poli
- University of Parma, Department of Maxillo Facial Surgery (Head: Prof. Enrico Sesenna), Italy
| | - Margherita Dessy
- University of Milan, San Paolo Hospital, Department of Maxillo Facial Surgery (Head: Prof. Federico Biglioli), Italy
| | - Marco Cucurullo
- University of Milan, San Paolo Hospital, Department of Maxillo Facial Surgery (Head: Prof. Federico Biglioli), Italy
| | - Mario Petrillo
- University of Milan, San Paolo Hospital, Department of Radiology (Head: Prof G.P. Carrafiello), Italy
| | | | - Milton Waner
- New York Vascular Birthmark Institute, United States
| | - Enrico Sesenna
- University of Parma, Department of Maxillo Facial Surgery (Head: Prof. Enrico Sesenna), Italy
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Padia R, Bly R, Bull C, Geddis AE, Perkins J. Medical Management of Vascular Anomalies. CURRENT TREATMENT OPTIONS IN PEDIATRICS 2018; 4:221-236. [PMID: 30505648 PMCID: PMC6261360 DOI: 10.1007/s40746-018-0130-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW This chapter will summarize the most recent literature regarding the current state of medical treatment for vascular anomalies. RECENT FINDINGS Research into the biology of these anomalies has strengthened our understanding of each anomaly and has helped to pave the way for more tailored treatment options involving molecular and/or genetic targets. SUMMARY While there is still a role for surgical intervention, medical therapies that target the etiology of vascular anomalies may represent an alternative or adjunctive approach in the management of these lesions.
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Affiliation(s)
- Reema Padia
- Division of Pediatric Otolaryngology, Department of Surgery, Seattle Children's Hospital and Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, United States
| | - Randall Bly
- Division of Pediatric Otolaryngology, Department of Surgery, Seattle Children's Hospital and Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, United States
| | - Catherine Bull
- Division of Pediatric Otolaryngology, Department of Surgery, Seattle Children's Hospital and Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, United States
| | - Amy E. Geddis
- Cancer and Blood Disorders Clinic, Seattle Children's Hospital, Seattle, Washington, United States
| | - Jonathan Perkins
- Division of Pediatric Otolaryngology, Department of Surgery, Seattle Children's Hospital and Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, United States
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12
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Tan EMS, Siljee SD, Brasch HD, Enriquez S, Tan ST, Itinteang T. Embryonic Stem Cell-Like Subpopulations in Venous Malformation. Front Med (Lausanne) 2017; 4:162. [PMID: 29046873 PMCID: PMC5632722 DOI: 10.3389/fmed.2017.00162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 09/15/2017] [Indexed: 01/16/2023] Open
Abstract
Background Venous malformation (VM) consists of a network of ectatic anomalous thin-walled venous channels. A role for an activating TIE2 mutation in the development of the dilated luminal vessels in VM, and its proposed involvement of embryonic stem cells (ESCs), led us to investigate the expression of ESC markers in subcutaneous VM (SCVM) and intramuscular VM (IMVM). Methods Formalin-fixed paraffin-embedded sections of SCVM from seven patients and IMVM samples from seven patients were analyzed for the expression of Nanog, pSTAT3, OCT4, SOX2, SALL4, and CD44, using 3,3′-diaminobenzidine (DAB) immunohistochemical (IHC) staining. All these samples did not express lymphatic marker D2-40. NanoString mRNA analysis and RT-PCR were performed on snap-frozen samples of SCVM (n = 3) and IMVM (n = 3) from the respective original cohorts of patients included in DAB IHC staining. To confirm co-expression of two proteins, immunofluorescent (IF) IHC staining on two representative samples of IMVM and SCVM samples from the original cohorts of patients included for DAB IHC staining was performed. Results DAB IHC staining demonstrated expression of all of the above ESC markers in both SCVM and IMVM samples. IF IHC staining showed that these markers were localized to the endothelium within these lesions and that Nanog, pSTAT3, SOX2, and CD44 were also expressed by cells outside of the endothelium. NanoString mRNA analysis confirmed transcription activation of pSTAT3, OCT4, and CD44. RT-qPCR confirmed transcription activation of Nanog, SOX2, and SALL4. Conclusion Our findings support the presence of two ESC-like subpopulations, one within and one outside of the endothelium, of both SCVM and IMVM. Given that the endothelial ESC-like subpopulation expresses the more primitive marker, OCT4, it is exciting to speculate that they give rise to the non-endothelial subpopulation.
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Affiliation(s)
- Elysia M S Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | | | - Helen D Brasch
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | | | - Swee T Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand.,Centre for the Study and Treatment of Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital, Wellington, New Zealand
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Steiner F, Taghavi K, FitzJohn T, Tan ST. Stratification and characteristics of common venous malformation by anatomical location. JPRAS Open 2017. [DOI: 10.1016/j.jpra.2017.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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