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Sakai H, Hasegawa I, Tsuzaki J, Okamoto S, Kurata T. Venous Malformation in the Anterior Mediastinum. Cureus 2024; 16:e58581. [PMID: 38644948 PMCID: PMC11031365 DOI: 10.7759/cureus.58581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 04/23/2024] Open
Abstract
Venous malformations (VMs) located in the anterior mediastinum are rare. Thus, diagnosis using imaging is often challenging, and they are typically diagnosed only after total tumor resection. Herein, we report a case of VM located in the anterior mediastinum diagnosed using computed tomography (CT) and magnetic resonance imaging (MRI). A 56-year-old woman presented for further evaluation of an anterior mediastinal mass observed during a chest CT. On CT, the mass was observed to have scattered calcifications and early and persistent enhancement with contrast material pooling dorsally in the delayed phase. On MRI, the mass was isointense on T1-weighted imaging and hyperintense on T2-weighted imaging without flow voids. From these images, we suspected the mass to be a VM, but the possibility of an arterial malformation/fistula could not be ruled out. Initially, a contrast material was injected via the arm, but to improve differentiation, it was also injected via the leg. The 4D-CT of the leg indicated no early enhancement of the mass; however, gradual enhancement was observed. This led to a definite diagnosis of VM. As she had no symptoms, we opted for a CT follow-up, and the mass remained stable for one year post-diagnosis. This case report underscores the usefulness of injecting contrast material through the leg in distinguishing VM from AVM/Fs in the anterior mediastinum.
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Affiliation(s)
- Hiroto Sakai
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Ichiro Hasegawa
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Junya Tsuzaki
- School of Medicine, Divison of Radiology, Keio University, Tokyo, JPN
| | - Saori Okamoto
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Tadayoshi Kurata
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
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2
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Guntupalli G, Ramadugu R, Suvvari TK, Ravipati S, Thomas V. Familial multiple lipomatosis associated with multiple cherry hemangiomas and moles: a rare case report. J Surg Case Rep 2024; 2024:rjae037. [PMID: 38328454 PMCID: PMC10847404 DOI: 10.1093/jscr/rjae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/14/2024] [Indexed: 02/09/2024] Open
Abstract
Lipomas are common benign mesenchymal tumours, whereas lipomatoses are uncommon. Familial multiple lipomatosis (FML) is a rare syndrome characterized by multiple usually painless lipomas which may be associated with other conditions. FML is considered to be genetic, with various patterns of inheritance suggested. In this case report, we described a case of multiple familial lipomatosis that was misdiagnosed as dercum's disease.
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Affiliation(s)
- Gopalaswamy Guntupalli
- Department of Surgery, Kamineni Academy of Medical Sciences and Research Centre, LB Nagar, Hyderabad, Telangana 508254, India
| | - Rithika Ramadugu
- Department of Surgery, Kamineni Academy of Medical Sciences and Research Centre, LB Nagar, Hyderabad, Telangana 508254, India
| | - Tarun K Suvvari
- Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India
| | - Shivani Ravipati
- Department of Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Gannavaram, Andhra Pradesh 521286, India
| | - Vimal Thomas
- Tbilisi State Medical University, Tbilisi 0186, Georgia
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3
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Alanazi FM, Alqahtani S, Alruwaili SH, Alzamil AA, AlGhamdi FR. Cavernous Hemangioma in the Parotid Gland of an Adult: A Case Report and Review of Literature. Cureus 2024; 16:e52285. [PMID: 38357088 PMCID: PMC10865161 DOI: 10.7759/cureus.52285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Hemangiomas are benign vascular tumors and are classified into cavernous, capillary, and mixed, with the head and neck area as the most common site. Hemangiomas are common in pediatrics and rare in adults. Diagnosing cavernous hemangioma is challenging and requires a complete history, proper physical examination, and several radiological modalities to improve diagnostic accuracy because it is uncommon in adults. Herein, we present a case of a 66-year-old female Saudi patient with cavernous hemangioma from the diagnosis until the surgical treatment. No previous studies are reported in Saudi Arabia and this is a rare presentation of cavernous hemangioma at this age. Cavernous hemangioma in the parotid gland in adults is uncommon and is difficult to diagnose. Therefore, a thorough physical examination and several radiological modalities are required to improve diagnostic accuracy. The most effective treatment of cavernous hemangioma in adults is surgical resection.
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Affiliation(s)
- Farhan M Alanazi
- Otolaryngology-Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, SAU
- Otolaryngology-Head and Neck Surgery, Prince Mohammed Medical City, Jouf, SAU
| | - Saeed Alqahtani
- Otolaryngology-Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, SAU
| | | | | | - Fareed R AlGhamdi
- Otolaryngology-Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, SAU
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4
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Hartel A, Frommherz L, Giehl K, Häberle B. [Vascular malformation and tumors]. MMW Fortschr Med 2023; 165:53-55. [PMID: 37973754 DOI: 10.1007/s15006-023-3097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Alexandra Hartel
- Interdisziplinäres Zentrum für Gefäßanomalien (IZG) - Campus Innenstadt/Kinderchirurgische Klinik und Poliklinik im Dr. von Haunerschen Kinderspital, LMU Klinikum, Lindwurmstr. 4, 80377, München, Deutschland.
| | - Leonie Frommherz
- Zentrum für seltene und genetische Hautkrankheiten, LMU Klinikum, Klinik für Dermatologie und Allergologie, Frauenlobstraße 7-9, 80337, München, Deutschland
| | - Kathrin Giehl
- Zentrum für seltene und genetische Hautkrankheiten, LMU Klinikum, Klinik für Dermatologie und Allergologie, Frauenlobstraße 7-9, 80337, München, Deutschland
| | - Beate Häberle
- Interdisziplinäres Zentrum für Gefäßanomalien (IZG) - Campus Innenstadt/Kinderchirurgische Klinik und Poliklinik im Dr. von Haunerschen Kinderspital, LMU Klinikum, Lindwurmstr. 4, 80377, München, Deutschland
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5
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Cao DY, Zhou J, Dernell C, Chaney K, Wanat KA. Red papules associated with progressive functional decline. JAAD Case Rep 2023; 40:23-26. [PMID: 37675064 PMCID: PMC10477733 DOI: 10.1016/j.jdcr.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Affiliation(s)
- David Y. Cao
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jessica Zhou
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Carl Dernell
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Keri Chaney
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karolyn A. Wanat
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
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6
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Liu S, Jiao Y. Skin Changes of POEMS. J Gen Intern Med 2023; 38:3065-3066. [PMID: 36944904 PMCID: PMC10593714 DOI: 10.1007/s11606-023-08171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Simeng Liu
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Yang Jiao
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
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7
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Song W, Liu S, Yu Y, Xu Q, Liu S, Chen J. Lung metastasis from thyroid cancer: A case report of unusual imaging presentation of lung metastases. Medicine (Baltimore) 2023; 102:e34733. [PMID: 37565894 PMCID: PMC10419426 DOI: 10.1097/md.0000000000034733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
RATIONALE Thyroid cancer (TC) is the most common malignancy of the head and neck and endocrine system. Distant metastases from TC are rare and are diagnosed in only 1% to 4% of patients, and these patients have a poor prognosis, which is the leading cause of TC-related deaths. There are few reports on metastatic TC in China and abroad, and even fewer reports on lung metastases from TC. We report a special patient with lung metastases of TC. PATIENT CONCERNS The patient is a 31-year-old female who was found to have both lung nodules during physical examination. Chest computed tomography (CT) showed that the density of both lung nodules was the same as the vascular density, considering that the possibility of vascular origin was not excluded. DIAGNOSIS After consultation with the whole hospital, it was considered that vascular malformations, hemangiomas, and malignant metastases were not excluded, the patient percutaneous lung biopsy had a high risk of bleeding, and thoracoscopic lobectomy could be performed in thoracic surgery to further clarify the pathology and diagnosis. OUTCOMES The patient underwent thoracoscopic left lower lobe wedge resection on February 24, 2021. Postoperative pathology: (left lower lung mass) metastatic carcinoma, combined with morphology and immunohistochemistry, leaning toward thyroid follicular carcinoma lung metastasis. On May 27, 2021, the patient underwent "total thyroidectomy + lymph node dissection in the right cervical VI region." Pathological examination: (right lobe and isthmus of the thyroid gland) papillary TC, follicular subtype, and classic type, with interstitial fibrosis. The patient was diagnosed with lung metastasis of TC. LESSONS This patient had the same CT value of lung metastases as the vascular CT value, which is relatively rare in our clinical practice and worthy of our study. The special CT imaging presentation of this TC patient with lung metastases further broadened our horizon. In clinical practice, when we encounter similar cases, we should combine more with other tests and examinations of patients to avoid misdiagnosis and missed diagnosis.
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Affiliation(s)
- Wenjing Song
- Medical Oncology, Dalian Medical University, Dalian, Liaoning, China
- Oncology Department, the First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Shiwei Liu
- Joint surgery Department, the First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Yuan Yu
- Oncology Department, the First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Qian Xu
- Oncology Department, the First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Shuzhen Liu
- Oncology Department, the First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Jun Chen
- Medical Oncology, the Second Hospital of Dalian Medical University, Dalian, Liaoning, China
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8
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Modiri O, Malick MSS, Scollan ME, Duron V, Morel K, Middlesworth W, Garzon MC. Hybrid lung lesions in children with segmental infantile hemangiomas, a new association? Pediatr Dermatol 2023; 40:144-147. [PMID: 36059216 DOI: 10.1111/pde.15123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/07/2022] [Indexed: 01/25/2023]
Abstract
Infantile hemangiomas (IHs) are the most common tumors of infancy and, in rare instances, can present in the setting of congenital structural anomalies or as part of syndromic disorders. In this study, we present three cases of children with segmental IHs born with concurrent pulmonary anomalies: congenital pulmonary airway malformations and bronchopulmonary sequestration. To date, no known association between these entities and hemangiomas has been described.
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Affiliation(s)
- Omeed Modiri
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | | | - Margaret E Scollan
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Vincent Duron
- Department of Surgery, Columbia University Medical Center, New York, New York, USA
| | - Kimberly Morel
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA.,Department of Pediatrics, Columbia University Medical Center, New York, New York, USA
| | - William Middlesworth
- Department of Surgery, Columbia University Medical Center, New York, New York, USA
| | - Maria C Garzon
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA.,Department of Pediatrics, Columbia University Medical Center, New York, New York, USA
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9
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Debaibi M, Sghair A, Sahnoun M, Zouari R, Essid R, Kchaou M, Dhaoui A, Chouchen A. Primary retroperitoneal cavernous hemangioma: An exceptional disease in adulthood. Clin Case Rep 2022; 10:e05850. [PMID: 35592049 PMCID: PMC9097370 DOI: 10.1002/ccr3.5850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
Primary retroperitoneal cavernous hemangioma is an extremely rare disease in clinical practice. It is classified as a vascular tumor. Only three cases have been reported in the literature. The diagnosis is uncommon due to the lack of specific radiological features. It becomes symptomatic as a consequence of its enormous size or complications like rupture or compression. We herein report a unique case of primary retroperitoneal cavernous hemangioma treated with conventional surgery in a 35-year-old male patient admitted to our department for chronic abdominal pain. Retroperitoneal cavernous hemangioma is an extremely rare vascular tumor in adulthood. Confirmation is made by histopathological examination after total surgical resection.
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Affiliation(s)
- Mehdi Debaibi
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Asma Sghair
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Moez Sahnoun
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Rami Zouari
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Rime Essid
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Majdi Kchaou
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Amen Dhaoui
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
- Departement of Anatomical PathologyInternal Security Forces HospitalMarsaTunisia
| | - Adnen Chouchen
- Departement of General SurgeryInternal Security Forces HospitalMarsaTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
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10
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Marcoux S, Théorêt Y, Dubois J, Essouri S, Pincivy A, Coulombe J, McCuaig C, Powell J, Soulez G, Kleiber N. Systemic, local, and sclerotherapy drugs: What do we know about drug prescribing in vascular anomalies? Pediatr Blood Cancer 2021; 68:e29364. [PMID: 34596969 DOI: 10.1002/pbc.29364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/08/2021] [Accepted: 08/31/2021] [Indexed: 01/20/2023]
Abstract
Off-label drug prescribing, frequent in the treatment of vascular anomalies (VA), relies on the quality of the literature reporting drug efficacy and safety. Our objective is to review the level of evidence (LOE) surrounding drug use in VA, which is more prevalent in pediatric care. A list of drugs used in VA was created with a literature review in July 2020. For each drug listed, the article displaying the highest LOE was determined and then compared between efficacy/safety data, routes of administration, pharmacological categories and a subset of VA. The influence of research quality on study results was also explored. The median LOE for the 74 drugs identified poor methodological quality, with a predominance of retrospective studies or case reports. Drug safety is currently inadequately reported. This is alarming as many treatments display significant safety concerns. Also, current literature displays major publication bias that probably leads to overestimation of drug efficacy in VA.
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Affiliation(s)
- Simon Marcoux
- Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Clinical Pharmacology Unit, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Yves Théorêt
- Department of Pharmacology and Physiology, Université de Montréal, Montréal, Quebec, Canada.,Clinical Pharmacology Unit, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Josée Dubois
- Department of Radiology, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Sandrine Essouri
- Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Research Center, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Alix Pincivy
- Library, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Jérôme Coulombe
- Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Catherine McCuaig
- Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Julie Powell
- Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Gilles Soulez
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | - Niina Kleiber
- Department of Pharmacology and Physiology, Université de Montréal, Montréal, Quebec, Canada.,Clinical Pharmacology Unit, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Vascular Anomaly Team, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.,Research Center, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
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11
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Schmid F, Hoeger PH. Propranolol response in patients with segmental versus focal facial hemangiomas: A retrospective case-control study. J Am Acad Dermatol 2021; 87:490-491. [PMID: 34752824 DOI: 10.1016/j.jaad.2021.10.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Florian Schmid
- Department of Pediatrics, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Peter H Hoeger
- Department of Pediatrics, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany; Department of Pediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany.
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12
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Cheng P, Chen K, Zhang S, Mu KT, Liang S, Zhang Y. IDH1 R132C and ERC2 L309I Mutations Contribute to the Development of Maffucci's Syndrome. Front Endocrinol (Lausanne) 2021; 12:763349. [PMID: 34790172 PMCID: PMC8591216 DOI: 10.3389/fendo.2021.763349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background Maffucci's syndrome is characterized by the coexistence of multiple enchondromas and soft-tissue hemangiomas. It has been clear that somatic mosaic isocitrate dehydrogenase type 1 (IDH1) or isocitrate dehydrogenase type 2 (IDH2) mutations are associated with Maffucci's syndrome and Ollier disease, but the mechanisms underlying hemangiomas of the Maffucci's syndrome is still obscure. This study aimed to determine the mechanism of hemangiomas in Maffucci's syndrome. Methods We received a 26-year-old female patient with typical Maffucci's syndrome, and exome sequencing was conducted using DNA from her peripheral blood and enchondroma tissues. Somatic mutations were characterized by a comparative analysis of exome sequences and further confirmed by the sequencing of PCR products derived from original blood and tissue samples. The mutations of an additional 69 patients with Ollier disease were further tested. The functional impacts of these somatic mutations on Maffucci's syndrome, especially the development of hemangiomas, were evaluated. Results We reported a typical case of Maffucci's syndrome, which was confirmed by both imaging findings and pathology. Through exome sequencing of this patient's DNA samples, we identified an R132C mutation in the isocitrate dehydrogenase type 1 (IDH1) gene and an L309I mutation in the ELKS/RAB6-interacting/CAST family member 2 (ERC2) gene in this patient. Approximately 33.3% of the clones were positive for the IDH1 R132C mutation, and 19.0% of the clones were positive for the ECR2 L309I mutation. The IDH1 R132C mutation was detected in most of the patients with Ollier disease (51/69 patients), and the mean frequency of this mutation was 63.3% in total sequence readouts, but the ECR2 L309I mutation was absent in all of the patients with Ollier disease. In vitro experiments confirmed that the IDH1 R132C mutation promotes chondrocyte proliferation, and the ERC2 L309I mutation enhances angiogenesis. Conclusions Our results suggest that while IDH1 is a known pathogenic gene in enchondromatosis, ERC2 is a novel gene identified in Maffucci's syndrome. The somatic L309I mutation of ERC2 contributes to the pathogenesis of hypervascularization to facilitate the development of hemangiomas in Maffucci's syndrome. The combination of the IDH1 R132C and ERC2 L309I mutations contributes to the development of Maffucci's syndrome, and these results may enable further research on the pathogenesis of Maffucci's syndrome.
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Affiliation(s)
- Peng Cheng
- Department of Orthopedics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Chen
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Shu Zhang
- The Center for Biomedical Research, Key Laboratory of Organ Transplantation, Ministry of Education and Chinese Academy of Medical Sciences, NHC Key Laboratory of Organ Transplantation, Huazhong University of Science and Technology, Wuhan, China
| | - Ke-tao Mu
- Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Liang
- Department of Orthopedics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Zhang
- Department of Nephrology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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13
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Reyes-Hadsall SC, Fayiga FF, Duarte AM. Verrucous venous malformation with thrombocytopenia in a neonate. Pediatr Dermatol 2021; 38:1553-1557. [PMID: 34749432 DOI: 10.1111/pde.14857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Verrucous venous malformations (VVM) are rare, congenital, slow-flow vascular anomalies that have been historically difficult to characterize due to clinical mimics and unclear histological evaluation. A life-threatening complication of VVMs is localized intravascular coagulation. Herein, we describe a male neonate who presented with a congenital VVM on the left lower extremity with associated severe thrombocytopenia. We discuss the multifaceted diagnostic approach used to identify this VVM, while highlighting the use of WT-1 as a negative predictive marker; we additionally outline novel treatment options and management beyond cutaneous involvement.
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Affiliation(s)
- Sophia C Reyes-Hadsall
- University of Miami Miller School of Medicine, Miami, FL, USA.,Children's Skin Center, Miami, FL, USA
| | - Folasade F Fayiga
- Children's Skin Center, Miami, FL, USA.,Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL, USA.,The Dr. Philip Frost Department of Dermatology and Cutaneous Surgery at The University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ana M Duarte
- Children's Skin Center, Miami, FL, USA.,Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL, USA.,The Dr. Philip Frost Department of Dermatology and Cutaneous Surgery at The University of Miami Miller School of Medicine, Miami, FL, USA
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14
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Abstract
Vascular malformations, affecting ≈1% to 1.5% of the population, comprise a spectrum of developmental patterning defects of capillaries, arteries, veins, and/or lymphatics. The majority of vascular malformations occur sporadically; however, inherited malformations exist as a part of complex congenital diseases. The malformations, ranging from birthmarks to life-threatening conditions, are present at birth, but may reveal signs and symptoms-including pain, bleeding, disfigurement, and functional defects of vital organs-in infancy, childhood, or adulthood. Vascular malformations often exhibit recurrent patterns at affected sites due to the lack of curative treatments. This review series provides a state-of-the-art assessment of vascular malformation research at basic, clinical, genetic, and translational levels.
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Affiliation(s)
- Harish P Janardhan
- Division of Cardiovascular Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Sherin Saheera
- Division of Cardiovascular Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Roy Jung
- Division of Cardiovascular Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Chinmay M Trivedi
- Division of Cardiovascular Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (H.P.J., S.S., R.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Molecular, Cell, and Cancer Biology (C.M.T.), University of Massachusetts Medical School, Worcester.,Li-Weibo Institute for Rare Diseases Research (C.M.T.), University of Massachusetts Medical School, Worcester
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15
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Maruyama S, Koda M, Matono T, Isomoto H. Association of tumor size and internal echo pattern with coagulopathy associated with hepatic hemangioma. Mol Clin Oncol 2021; 14:83. [PMID: 33758664 PMCID: PMC7947948 DOI: 10.3892/mco.2021.2245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/05/2021] [Indexed: 01/18/2023] Open
Abstract
Little is known concerning causal factors associated with the size and echogenicity of hepatic hemangiomas. The aim of the present study was to investigate the associations between tumor size and echo pattern and coagulation factors, and to elucidate the growth pattern of hemangiomas. In 214 consecutive patients with hepatic hemangiomas, ultrasonography was performed to determine total tumor number, size, echogenicity and location, and serum laboratory tests for liver function and coagulation factors were carried out. The ultrasonographic appearance of hemangiomas was homogeneous in 75.7% of cases and mixed in 24.3% of cases. A mixed echo pattern was seen in 1 out of 145 masses (0.7%) with a diameter <20 mm, in 30 out of 48 (62.5%) with a diameter of 20-40 mm, and in all of the 21 (100%) with a diameter >40 mm. Platelet counts (P<0.0001) and fibrinogen levels (P<0.01) were lower in patients with larger and mixed tumors. Levels of thrombin-antithrombin III complex (TAT), D-dimer, and fibrin and fibrinogen degradation products (FDP) were significantly elevated along with an increase in tumor size (all P<0.0001), and the number of patients with the abnormal values of TAT, D-dimer, and FDP was significantly higher in the mixed group than in the homogeneous group (all P<0.0001). Fibrinogen (P<0.01), platelet count (P<0.001), portal vein diameter (P<0.0001), splenic index (P<0.01), and levels of TAT, D-dimer and FDP (all P<0.0001) were significantly associated with tumor size. Multivariate analysis revealed TAT, D-dimer and FDP as independent predictors of tumor size. The internal echo pattern became mixed as size increased. The size and echogenicity of hemangiomas were closely associated with coagulation factors. Therefore, it was speculated that differences in size and echogenicity were caused by intratumoral thrombosis and subsequent hemorrhage.
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Affiliation(s)
- Shigeo Maruyama
- Department of Internal Medicine, Maruyama Medical Clinic, Hamada, Shimane 697-0034, Japan
| | - Masahiko Koda
- Department of Internal Medicine, Hino Hospital, Hino, Tottori 689-4504, Japan
| | - Tomomitsu Matono
- Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8504, Japan
| | - Hajime Isomoto
- Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8504, Japan
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16
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Abstract
We report the very rare case of recurrent unilateral pleural effusion in a 53-year-old male. Computed tomography (CT) scan and magnetic resonance imaging revealed a left-sided paravertebral mass at D3 level. Multiple biopsy and CT scan lead us to the diagnosis of "Angiomatous Malformation." The lesion was excised surgically which on final histopathological report termed hemangioma.
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Affiliation(s)
- Gaurav Patel
- Department of Surgical Oncology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Suyash Agrawal
- Department of Surgical Oncology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Prakash Patil
- Department of Surgical Oncology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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17
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Natsis NE, Gordon SC, Kaushik A, Seiverling EV. A practical review of dermoscopy for pediatric dermatology part II: Vascular tumors, infections, and inflammatory dermatoses. Pediatr Dermatol 2020; 37:798-803. [PMID: 32749020 DOI: 10.1111/pde.14284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In addition to the evaluation of melanocytic growths (Part I), dermoscopy is helpful in the identification and management of vascular tumors, skin infections, and inflammatory conditions. In this practical review, we present the classic dermoscopic findings of the following: vascular tumors, infectious conditions (molluscum contagiosum, scabies, verruca vulgaris), inflammatory conditions (psoriasis, atopic dermatitis), juvenile xanthogranuloma, and nevus sebaceus.
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Affiliation(s)
- Nicola E Natsis
- UCSD School of Medicine, San Diego, California, USA.,Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California, USA
| | - Samantha C Gordon
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Anshika Kaushik
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California, USA.,Department of Dermatology, UCSD, San Diego, California, USA
| | - Elizabeth V Seiverling
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA.,Division of Dermatology, Maine Medical Center and Maine Medical Partners, South Portland, Maine, USA
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18
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Abstract
PHACE syndrome classically presents with a large, segmental facial infantile hemangioma (IH) associated with structural and vascular abnormalities involving the head and neck, heart, and eyes. We evaluated an infant who presented with ptosis caused by a clinically subtle, deep right-sided periorbital IH identified on MRI that also incidentally revealed hypoplasia of the right common carotid and right internal carotid arteries, supporting a diagnosis of PHACE syndrome. She subsequently developed acute-onset, transient right-sided facial erythema without anisocoria, triggered by feeding and emotional stress. We believe this represents a Frey syndrome-like developmental dysautonomia, previously unreported in association with PHACE syndrome, suggesting an associated defect in neurovascular embryogenesis.
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Affiliation(s)
| | - Elaine C Siegfried
- Division of Dermatology, Department of Pediatrics, Saint Louis University and Cardinal Glennon Children's Hospital, St. Louis, MO, USA
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19
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Abstract
Tufted angioma (TA) is a rare vascular tumor characterized by histologic tufts of proliferating capillaries that occurs in infancy or early childhood, with a poorly understood pathogenesis. Though benign, TA can be associated with the Kasabach-Merritt phenomenon (KMP), a life-threatening consumptive coagulopathy and thrombocytopenia. Here, we explored the genetic mechanism underlying a case of TA associated with KMP via targeted sequencing of laser capture micro-dissected lesion and blood DNA, and identified a somatic, activating GNA14 mutation specific to the tumor. Our findings support aberrant GNA14 activation underlies the pathogenesis of TA associated with KMP.
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Affiliation(s)
- Young H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.,Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Carmen Fraile
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.,Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Richard J Antaya
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.,Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.,Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
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20
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West ES, Totoraitis K, Yadav B, Kirkorian AY, Drolet BA, Teng JM, Smidt AC, Sugarman JL, Frieden IJ. Atypical presentations of congenital hemangiomas: Extending the clinical phenotype. Pediatr Dermatol 2019; 36:835-842. [PMID: 31576603 DOI: 10.1111/pde.13930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Congenital hemangiomas (CH) are a group of benign vascular tumors that are present at birth and exhibit variable involution during infancy. Congenital hemangiomas that do not involute are typically solitary patch or plaque-type tumors that grow proportionally with somatic growth. We report a case series of 9 patients with persistent CH, which exhibited uncommon features including segmental involvement, recurrent or severe pain, or growth via volumetric increase in size or apparent increased extent of anatomic involvement over time. METHODS Via retrospective chart review, we included patients with persistent CH and atypical presentations. Available data regarding clinical characteristics, natural history, histopathology, imaging, and genetic tests were collected. RESULTS Data on 9 patients were collected, including 7 noninvoluting CH and 2 partially involuting CH. Three of the 9 cases had segmental distribution, 6 had apparent growth or clinical evolution, and 4 were symptomatic with pain. One also had marked localized intravascular coagulopathy. CONCLUSIONS Ongoing or recurrent pain and large extent of anatomic involvement can be features of CH, albeit uncommon ones, and can pose both diagnostic and management challenges. Tissue genomic studies can offer a novel tool for CH diagnosis.
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Affiliation(s)
- Emily S West
- Department of Dermatology, University of California at San Francisco, San Francisco, California
| | - Kristin Totoraitis
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Bhupender Yadav
- Department of Radiology, Children's National Health Network, Washington, District of Columbia
| | - Anna Yasmine Kirkorian
- Division of Dermatology, Children's National Health Network, Washington, District of Columbia.,Department of Dermatology, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia
| | - Beth A Drolet
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joyce M Teng
- Department of Dermatology, Stanford University, Palo Alto, California
| | - Aimee C Smidt
- Department of Dermatology, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Jeffrey L Sugarman
- Department of Dermatology, University of California at San Francisco, San Francisco, California
| | - Ilona J Frieden
- Department of Dermatology, University of California at San Francisco, San Francisco, California
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21
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Ouedraogo MS, Korsaga/Some N, Ouedraogo NA, Tapsoba GP, Traoré F, Konkissere GO, Barro/Traoré F, Niamba P, Traoré A. Angiomas at the university hospital of Yalgado Ouedraogo in Ouagadougou, Burkina Faso: Epidemiological and clinical profile. Med Sante Trop 2019; 29:419-23. [PMID: 31884998 DOI: 10.1684/mst.2019.0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.
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22
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Zeng Z, Liu S, Cai J, Li Z, Wu H, Chen H, Huang Y. miR-501 promotes hemangioma progression by targeting HOXD10. Am J Transl Res 2019; 11:2439-2446. [PMID: 31105850 PMCID: PMC6511771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/13/2019] [Indexed: 06/09/2023]
Abstract
MicroRNAs (miRNAs) are often abnormally expressed in human cancers to act as either oncogenes or tumor suppressor genes. MiRNA-501 (miR-501) has been found to be abnormally expressed in certain types of cancer, but its expression and biological role in hemangioma remain to be fully elucidated. In this study, the expression of miR-501 in hemangioma cell lines was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). The TargetScan algorithm, luciferase activity reporter assay, and Western blot analysis were conducted to validate homeobox D10 (HOXD10) as a direct target of miR-501. The results revealed that miR-501 expression was upregulated in hemangioma cell lines. Downregulation of miR-501 inhibited hemangioma cell proliferation, cell cycle progression, colony formation, migration, and invasion in vitro. Bioinformatics analysis indicated that HOXD10 was a putative target of miR-501. In addition, in a luciferase reporter system, it was confirmed that HOXD10 is a direct target of miR-501. It was also demonstrated HOXD10 downregulation reversed the effects of the miR-501 inhibitor on hemangioma cell activities. These findings indicated that miR-501 targeted HOXD10 to promote hemangioma cell processes, suggesting that miR-501 has an oncogenic role in the pathogenesis of hemangioma.
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Affiliation(s)
- Zhaofan Zeng
- Department of Vascular Surgery, Hainan General HospitalHaikou 570311, P. R. China
| | - Sahua Liu
- Department of Vascular Surgery, Hainan General HospitalHaikou 570311, P. R. China
| | - Junhong Cai
- Molecular Laboratory Center, Hainan General HospitalHaikou 570311, P. R. China
| | - Zhenzhen Li
- Department of Vascular Surgery, Hainan General HospitalHaikou 570311, P. R. China
| | - Hongfei Wu
- Department of Vascular Surgery, Hainan General HospitalHaikou 570311, P. R. China
| | - Hao Chen
- Department of Vascular Surgery, Hainan General HospitalHaikou 570311, P. R. China
| | - Yanjing Huang
- Department of Medical Oncology, Hainan General HospitalHaikou 570311, P. R. China
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23
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Haggstrom AN, Baselga E, Chamlin SL, Drolet BA, Garzon MC, Holland KE, Horii KA, Lauren C, Lucky A, Mancini AJ, Mathes E, McCuaig CC, Morel K, Newell B, Pope E, Powell J, Puttgen K, Rahnama-Moghadam S, Song W, Frieden IJ. Localized infantile hemangiomas of the face and scalp: Predilection for the midline and periorbital and perioral skin. Pediatr Dermatol 2018; 35:774-779. [PMID: 30168172 DOI: 10.1111/pde.13626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Infantile hemangiomas are common vascular tumors. Identifying sites of predilection may provide insight into pathogenesis. Previous studies have suggested a predilection for the boundary of facial metameres. The objective was to observe patterns of localized hemangiomas on the face and scalp, determine sites of predilection, and place these patterns in a developmental context. METHODS A retrospective review of photographic archives at 10 Hemangioma Investigator Group pediatric dermatology centers identified localized infantile hemangiomas of the face and scalp. Heat map software was used to identify areas of predilection. Dot maps were used to assess frequency, and densities of infantile hemangiomas were compared between facial units using t-testing. The scalp was divided into quintiles to assess relative frequencies. RESULTS Four thousand one hundred fifty-three focal face and scalp infantile hemangiomas were mapped, of which 2962 (71%) were mapped to a frontal facial template. On the face, 73.8% (2186/2962) of hemangiomas occurred along the midline axis or perpendicularly across the ocular axis in a cross-shaped area of predilection intersecting at the glabella. Scalp hemangiomas show a predilection for the midline, with 149/295 (50.5%) noted on the top of the scalp at the midline (P < 0.001). Localized hemangiomas do not demonstrate a preferential laterality. CONCLUSION The distribution of localized infantile hemangiomas of the face and scalp is not random. There is preferential involvement of the midline face and scalp and the ocular axis. The regions corresponding to the boundaries between the embryonic facial segments, including the maxillary and mandibular metameres, are not accentuated in the distribution of infantile hemangiomas.
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Affiliation(s)
- Anita N Haggstrom
- Department of Dermatology and Pediatrics, Indiana University, Indianapolis, Indiana
| | - Eulalia Baselga
- Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Sarah L Chamlin
- Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Beth A Drolet
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Maria C Garzon
- Department of Dermatology, Columbia University, New York, New York.,Department of Pediatrics, Columbia University, New York, New York
| | - Kristen E Holland
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Christine Lauren
- Department of Dermatology, Columbia University, New York, New York.,Department of Pediatrics, Columbia University, New York, New York
| | - Anne Lucky
- Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Anthony J Mancini
- Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erin Mathes
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Catherine C McCuaig
- Dermatology Service, Department of Pediatrics, University Hospital Center Sainte-Justine, Montreal, Canada
| | - Kimberly Morel
- Department of Dermatology, Columbia University, New York, New York.,Department of Pediatrics, Columbia University, New York, New York
| | | | - Elena Pope
- Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Julie Powell
- Dermatology Service, Department of Pediatrics, University Hospital Center Sainte-Justine, Montreal, Canada
| | - Kate Puttgen
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Wei Song
- Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Ilona J Frieden
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Department of Pediatrics, University of California, San Francisco, San Francisco, California
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24
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Abstract
Screening electrocardiography (ECG) before initiation of propranolol for treatment of infantile hemangiomas (IH) is controversial. A retrospective chart review was conducted to assess the utility of pretreatment ECG in infants with IH starting propranolol. Although nearly half of the ECGs were abnormal, no contraindications to treatment were identified from screening ECG, and no association was found between any of the reported side effects and abnormal ECG. These results support previously published data, and in a larger cohort, providing further confirmation that pretreatment ECG is not necessary in most infants with IH.
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Affiliation(s)
- Emily B Lund
- Section of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Sarah L Chamlin
- Departments of Pediatrics and Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Anthony J Mancini
- Departments of Pediatrics and Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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25
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Chen L, Wan BL, Zang YZ, Li J, Huang YM. [Clinical analysis of nasal granulomatous capillary hemangioma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:875-877. [PMID: 29921063 DOI: 10.13201/j.issn.1001-1781.2018.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Indexed: 11/12/2022]
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26
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Al Malki A, Al Bluwi S, Malloizel-Delaunay J, Mazereeuw-Hautier J. Massive hemorrhage: A rare complication of rapidly involuting congenital hemangioma. Pediatr Dermatol 2018; 35:e159-e160. [PMID: 29572940 DOI: 10.1111/pde.13474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Rapidly involuting congenital hemangioma is a subtype of congenital hemangioma. Ulceration and bleeding are rarely reported in rapidly involuting congenital hemangioma, with only four cases reported in the literature to our knowledge. We describe a case of a newborn girl who presented with rapidly involuting congenital hemangioma complicated by ulceration and severe bleeding and discuss treatment.
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Affiliation(s)
- Aysha Al Malki
- Department of Dermatology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France
| | - Shatha Al Bluwi
- Department of Dermatology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France
| | - Julie Malloizel-Delaunay
- Department of Vascular Medicine, Paul Sabatier University and Toulouse University Hospital, Toulouse, France
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27
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Gao Z, Zhang Y, Li W, Shi C. Effectiveness and safety of polidocanol for the treatment of hemangiomas and vascular malformations: A meta-analysis. Dermatol Ther 2017; 31. [PMID: 29082587 DOI: 10.1111/dth.12568] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
A meta-analysis was conducted to investigate the efficacy and safety of polidocanol versus other conventional therapies in treating hemangiomas (HMs) and vascular malformations (VMs). Literature search was conducted in the Cochrane, Embase, PubMed, Web of Science, CNKI, CBM, VIP, and WanFang databases until March 5, 2017. A meta-analysis was conducted using Revman 5.3 software. A total of 19 randomized controlled trials (RCTs) involving 1,514 participants met the inclusion criteria. Regarding the effectiveness, statistically significant differences were observed between polidocanol and all the independent treatments (p = .006), but not between polidocanol and pingyangmycin (p = .16). Combination therapy of polidocanol with any other conventional treatments (p = .0001), pingyangmycin (p = .005) or hemoclip (p = .008) elicited a better response compared to treatment with these treatments independently. A meta-analysis on the risk of adverse events (AEs) showed a lower risk for polidocanol versus other treatments, for example, all the conventional treatments used independently (p < .00001) and pingyangmycin (p < .00001). Combination therapy of polidocanol with pingyangmycin also yielded a significantly lower risk of AEs (p < .00001). Polidocanol is at least as effective as other conventional therapies on HMs and VMs (especially venous malformations). The former is much safer. Combining its use with other treatments may produce excellent results. Our study provides strong evidence supporting the use of polidocanol for HMs and VMs.
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Affiliation(s)
- Zhi Gao
- Pharmacy Department, Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China
| | - Yi Zhang
- Pharmacy Department, Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China
| | - Wei Li
- Pharmacy Department, Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China
| | - Chen Shi
- Pharmacy Department, Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China
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28
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Srinivas D, Sarma P, Shukla D, Bhat D, Pandey P, Somanna S, Chandramouli A. Multimodality Management of Cavernous Sinus Hemangiomas-An Institutional Experience. J Neurol Surg B Skull Base 2017; 78:399-407. [PMID: 28875118 DOI: 10.1055/s-0037-1602790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 03/24/2017] [Indexed: 10/19/2022] Open
Abstract
Objective Cavernous sinus hemangiomas (CSHs) are benign lesions accounting for less than 2% of the cavernous sinus tumors. They provide a formidable surgical challenge because of their vascularity and their being surrounded by critical neurovascular structures. In this study, one of the largest in available literature, we analyze our experience in the management of these unusual tumors and review the available literature. Materials This is a retrospective analysis of patients who were managed surgically (both microsurgical and Gamma knife radiosurgery [GKRS]) for CSH at our Institution from 2007 to 2015. Complete demographic, clinical-radiologic surgical records were analyzed. Follow-up data were collected from the hospital records. Results Total 23 patients were managed. Among these, 15 patients underwent microsurgery (group 1) whereas 8 underwent GKRS (group 2). Predominant clinical presentation in both the groups included headache and involvement of multiple cranial nerves. Five patients in group 1 had deteriorating vision. The volume of tumors ranged from 29 to 115 cm 3 (mean = 64.57 cm 3 ) in group 1 and from 2.1 to 11.6 cm 3 in group 2. GKRS was performed with a mean dose of 13 Gy, an average isodose line of 50% with an average coverage of 96%. In group 1, the follow-up period ranged from 6 to 62 months (mean = 29.4 months). The extraocular movement (EOM) preservation rate in our series was not favorable, as most patients presented late with large tumors and established deficits. Recurrence/residual tumor was seen in two cases. In group 2, the follow-up was 5 to 48 months. All of them showed significant reduction in size. Conclusion Both surgery and radiosurgery are highly effective in the management of CSHs. They are complementary to each other, with individual characteristics-the size and volume of the lesion-being the main factors in deciding the choice of treatment.
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Affiliation(s)
- Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pragyan Sarma
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Dhananjay Bhat
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Paritosh Pandey
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sampath Somanna
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Ananthakrishna Chandramouli
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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Agarwal S, Sharma A, Maria A. Diffuse neonatal hemangiomatosis presenting as congestive heart failure. Dermatol Pract Concept 2017; 7:66-69. [PMID: 29085724 PMCID: PMC5661156 DOI: 10.5826/dpc.0703a15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 04/11/2017] [Indexed: 12/15/2022] Open
Abstract
Diffuse neonatal hemangiomatosis is a rare condition with a very high mortality rate if left untreated. We report a neonate having around 490 cutaneous and multiple diffuse liver hemangiomas presenting as congestive heart failure. Prompt treatment was instituted with decongestive drugs and prednisolone for anticipated life threatening complications due to hepatic hemangiomas. Propranolol was added later as it is known to precipitate congestive failure and also to avoid long-term complications of steroids. The child responded well. However, there is no consensus regarding the initial line of management, which needs to be individualized keeping in mind the efficacy, long-term side effects of the drug and the clinical presentation.
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Affiliation(s)
- Sheetal Agarwal
- Department of Pediatrics, PGIMER and Dr RML Hospital, Delhi, India
| | - Anu Sharma
- Department of Pediatrics, PGIMER and Dr RML Hospital, Delhi, India
| | - Arti Maria
- Department of Neonatology, PGIMER and Dr RML Hospital, Delhi India
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30
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Fong CJ, Garzon MC, Hoi JW, Kim HK, Lauren CT, Morel K, Geller L, Antonov N, Weitz N, Wu J, Hielscher AH. Assessment of Infantile Hemangiomas Using a Handheld Wireless Diffuse Optical Spectroscopic Device. Pediatr Dermatol 2017; 34:386-391. [PMID: 28548465 PMCID: PMC5501760 DOI: 10.1111/pde.13150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Infantile hemangiomas (IHs) are vascular tumors with the potential for significant morbidity. There is a lack of validated objective tools to assess IH severity and response to treatment. Diffuse optical spectroscopy (DOS), a noninvasive, nonionizing imaging modality, can measure total hemoglobin concentration and hemoglobin oxygen saturation in tissue to assess IH vascularity and response to treatment. Our objective was to evaluate the utility of a wireless, handheld DOS system to assess IH characteristics at selected points during their clinical course. METHODS Thirteen subjects (initial age 5.8 ± 2.0 mos) with 15 IHs were enrolled. IHs were classified as proliferative, plateau phase, or involuting. Nine patients with 11 IHs were untreated; four patients with 4 IHs were treated with timolol or propranolol. Each IH was evaluated by placing the DOS system directly on the lesion as well a normal contralateral skin site. IH vascularity and oxygenation were scored using a newly defined normalized hypoxia fraction (NHF) coefficient. Measurements were recorded at various intervals from the initial visit to 1 to 2 years of age. RESULTS For the nine untreated IHs, the NHF was highest at 6 months of age, during proliferation. Differences in NHFs between the proliferation and the plateau (p = 0.02) and involuting (p < 0.001) stages were statistically significant. In treated patients, the NHF normalized to 60% after 2 months. One treated IH came within 5% of the NHF for normal skin after 12 months. CONCLUSIONS DOS can be used to assess the vascularity and tissue oxygenation of IHs and monitor their progression and response to treatment.
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Affiliation(s)
- Christopher J Fong
- Department of Biomedical Engineering, Columbia University, New York City, New York
| | - Maria C Garzon
- Department of Dermatology, Columbia University Medical Center, New York City, New York.,Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Jennifer W Hoi
- Department of Biomedical Engineering, Columbia University, New York City, New York
| | - Hyun K Kim
- Department of Radiology, Columbia University Medical Center, New York City, New York
| | - Christine T Lauren
- Department of Dermatology, Columbia University Medical Center, New York City, New York.,Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Kimberly Morel
- Department of Dermatology, Columbia University Medical Center, New York City, New York.,Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Lauren Geller
- Department of Pediatrics, Mount Sinai Hospital, New York City, New York.,Department of Dermatology, Mount Sinai Hospital, New York City, New York
| | - Nina Antonov
- Department of Dermatology, Columbia University Medical Center, New York City, New York
| | - Nicole Weitz
- Department of Dermatology, Columbia University Medical Center, New York City, New York
| | - June Wu
- Department of Surgery, Columbia University, New York City, New York
| | - Andreas H Hielscher
- Department of Biomedical Engineering, Columbia University, New York City, New York.,Department of Radiology, Columbia University Medical Center, New York City, New York.,Department of Electrical Engineering, Columbia University, New York City, New York
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31
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Dicko A, Safi T, Tounkara TM, Fofana Y, Tall K, Touré S, Karabinta Y, Traore B, Traoré A, Lamissa C, Guindo B, Martin L, Faye O. [Prevalence of infantile haemangiomas on black skin]. Mali Med 2017; 32:18-20. [PMID: 30079645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Hemangiomas are regenerative benign vascular tumors of the child, which may be of interest to all organs, most often located on the skin. The aim of our study is to determine the prevalence of haemangiomas on black skin. It is a descriptive cross-sectional study that took place from November 2015 to August 2016 at CNAM, in the department of dermatology-leprology- Venereology of Mali. RESULTS Of 14,810 patients seen in consultation, we received 17 cases of hemangioma, ie 0,11%. The average age was 5 months with extremes of 1 month and 60 months. Tuberous angiomas represent 82,35% of clinical forms, subcutaneous angiomas 11,76% and mixed angiomas 5,89%. In 4/17 of our patients there was an infectious complication, following an ulceration on the first day of the consultation. The average lesion size was 3,25cm with extreme 0.5cm and 8cm. The number of lesions per patient was 1 in 16 patients and 2 in 1 patient. In 10/17 patients the lesions were localized at the cephalic level, 3/17 at the trunk level, and 4/17 at the perineum. CONCLUSION Infantile hemangioma is a poorly reported condition on black skin. The demands for care are motivated either by the character showing lesions or by ulcerative complications. Sensitization of populations and ongoing training of health workers are needed to detect hemangiomas.
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Affiliation(s)
- A Dicko
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - T Safi
- Faculté de médecine et d'odontostomatologie
| | | | - Y Fofana
- Faculté de médecine et d'odontostomatologie
| | - K Tall
- Faculté de médecine et d'odontostomatologie
| | | | - Y Karabinta
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - B Traore
- Faculté de médecine et d'odontostomatologie
| | - A Traoré
- Faculté de médecine et d'odontostomatologie
| | - C Lamissa
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - B Guindo
- Faculté de médecine et d'odontostomatologie
| | - L Martin
- Faculté de médecine d'Angers (France)
| | - O Faye
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
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Kothari P, Gupta A, Patil PS, Kekre G, Kamble R, Dikshit KV. Complete sternal cleft - A rare congenital malformation and its repair in a 3-month-old boy: A case report. J Indian Assoc Pediatr Surg 2016; 21:78-80. [PMID: 27046980 PMCID: PMC4790134 DOI: 10.4103/0971-9261.176961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Complete midline sternal cleft is a rare congenital anomaly resulting from failed midline ventral fusion of the sternal bars. Very few cases of complete sternal cleft have been described in literature. We present a case of complete sternal cleft in a 3-month-old child. The patient underwent primary closure of the defect using stainless steel wires.
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Affiliation(s)
- Paras Kothari
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Abhaya Gupta
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Prashant S Patil
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Geeta Kekre
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Ravi Kamble
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Kiran Vishesh Dikshit
- Department of Paediatric Surgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
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Cortese A, Pantaleo G, D'Alessio G, Garzi A, Amato M. Hemangiomas of the maxillofacial area: Case Report, Classification and Treatment Planning. Open Med (Wars) 2015; 10:529-534. [PMID: 28352749 PMCID: PMC5368859 DOI: 10.1515/med-2015-0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 11/04/2015] [Indexed: 12/20/2022] Open
Abstract
Vascular lesions of the maxillofacial area are even more challenging than in other different body district, because of the high aesthetic and functional relevance of this area for the sense organs presence like eye, brain, tongue, ear and nose. For these reasons, we propose an accurate classification based on hemodynamic and histologic aspects usefulthat is for diagnostic and therapeutic planning. A female, 60 years old patient came to our observation showing a vascular lesion of the lower left lip, and complaining for aesthetical and functional impairment. To confirm the diagnosis of vascular malformation and to detect lesion flow rate or other possible localization, a Tc red blood cell scintigraphy was carried out. Result was a venous low flow lesion; hence, sclerotherapy by a 3% Polidocanol solution (Atossisclerol) followed by surgery was planned. The aim of this work was to propose a diagnostic and therapeutic scheme with an integration of ISSVA and a flow rate classifications for a three-step planning based on 1) the biological findings in an early age at the lesion discover with a pharmacological treatment; 2) Hemodynamic study of the lesions at growing age followed by sclerotherapy or embolization; 3) Imaging study of these lesions for patients candidate to surgery when after step 1 and step 2 diagnostic and therapeutic planning results were incompletely successful.
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Affiliation(s)
- Antonio Cortese
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy
| | - Giuseppe Pantaleo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Corso Umberto I, 40, 80138 Napoli, Italy
| | - Giuseppe D'Alessio
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Alfredo Garzi
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Massimo Amato
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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Li SB, Xu GQ, Gao F, Huo R. Treatment with propranolol for infantile hemangiomas: A case series of 106 infants. Exp Ther Med 2015; 10:51-4. [PMID: 26170911 DOI: 10.3892/etm.2015.2485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 04/28/2015] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the clinical benefit and side effects of propranolol treatment in 106 children with infantile hemangiomas (IHs). A retrospective chart review was conducted on all children who attended the clinic between September 16, 2009 and November 11, 2013. Propranolol was administered in a progressive schedule reaching 1.0-1.5 mg/kg/day, divided into three doses. Demographic data, clinical features, imaging, treatment regimens and outcomes were investigated. Any adverse effects following medication were evaluated and managed accordingly. Preliminary analysis of the data showed the inclusion of 106 children (71 female and 35 male) with a mean age and weight at onset of treatment of 5.1 months and 7.3 kg, respectively. All 106 patients responded positively to treatment. Side effects that required intervention and/or close monitoring included diarrhea (n=10), hypotension (n=7), nightmares (n=2), agitation (n=1) and cold extremities (n=1). No long-term adverse effects were observed in any of the patients. In conclusion, propranolol administered orally at 1.0-1.5 mg/kg/day had a rapid therapeutic effect for resolving IHs with few complications.
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35
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Porcel Chacón R, del Boz González J, Navarro Morón J. Delayed-onset of multiple cutaneous infantile hemangiomas due to propranolol: a case report. Pediatrics 2015; 135:e1064-6. [PMID: 25780066 DOI: 10.1542/peds.2014-3053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2015] [Indexed: 11/24/2022] Open
Abstract
Infantile hemangiomas are the most common vascular tumors in childhood. In view of its proven effectiveness in such cases, propranolol is the drug of choice. We present the case of a male infant who started treatment with propranolol shortly after birth due to heart disease. After 7 months, when the patient had suffered various respiratory exacerbations, this treatment was suspended. One week later, multiple skin lesions (ie, multifocal infantile hemangiomas) began to appear, with no extracutaneous involvement. It was decided to resume treatment with propranolol, although at lower doses than before, and the skin lesions improved rapidly, with some disappearing completely. Treatment was definitively withdrawn at age 16 months, with only slight recurrence of the lesions. The case described is of multifocal infantile hemangiomas without extracutaneous involvement appearing beyond the neonatal period after treatment with propranolol beginning in the first days of life. The details of the case support the hypothesis that this drug is not only therapeutic but also plays a prophylactic role against infantile hemangiomas. In turn, this supports the recent proposal that this drug may be useful in preventing the growth and spread of tumors with high angiogenic potential. It is postulated that the inhibition of β-adrenergic receptors is associated with multiple intracellular processes related to the progression and metastasis of different tumors.
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36
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Abarzúa-araya Á, Navarrete-dechent CP, Heusser F, Retamal J, Zegpi-trueba MS. Atenolol versus propranolol for the treatment of infantile hemangiomas: A randomized controlled study. J Am Acad Dermatol 2014; 70:1045-9. [DOI: 10.1016/j.jaad.2014.01.905] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 01/15/2014] [Accepted: 01/20/2014] [Indexed: 02/07/2023]
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Abstract
In last few years, thanks to laser technology with minimally invasive approach, there was a growing need for treatment of oral vascular malformations inside the dental offices. Generally, the diagnosis of oral vascular malformations is based on clinical history, clinical examination and imaging exams. In the present paper, we review, researching by PubMed, the technical aspects, clinical indications, potentialities and limitations of color-Doppler ultrasound in the work-up of oral vascular malformations. Different imaging modalities are encountered for the diagnosis and follow-up of these lesions such as computed tomography, magnetic resonance imaging, color-Doppler ultrasound and angiography. To date, color-Doppler ultrasound is considered the first-line imaging approach since it provides a non-invasive, cost effective, real time evaluation of oral vascular anomalies. It provides both morphological and vascular information, which are useful to determine the best therapeutic options. Ultrasonography, for these reasons, could be considered as a valuable diagnostic tool in the preliminary assessment of oral vascular anomalies.
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Affiliation(s)
- Gaimari Gianfranco
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Fioravanti Eloisa
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Cantisani Vito
- Department of Radiology, University “La Sapienza”, Rome, Italy
| | | | - Tenore Gianluca
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Romeo Umberto
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
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38
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Sobhana CR, Beena VT, Soni A, Choudhary K, Sapru D. Hemangiolymphangioama of buccal mucosa: Report of a rare case and review of literature on treatment aspect. Natl J Maxillofac Surg 2013; 3:190-4. [PMID: 23833496 PMCID: PMC3700155 DOI: 10.4103/0975-5950.111379] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hemangiomas are lesions that are not present at birth. They manifest within first month of life, exhibit a rapid proliferative phase, and slowly involute to non-existent. Hemangiomas of the oral cavity are not common pathological entities, but the head and neck are common sites. Furthermore some time histologically lymphatic channels may be evident in hemangiomas, and then it will be categorized according predominant component, e.g.; hemangiolymphangiomas or lymphangiohemangiomas, vice versa is true for lymphangiomas. Most true hemangiomas involute with time, but 10-20% of true hemnagioma in completely involute and required post- adolescent ablative treatment. In the present article we are reporting a case of hemangiolypmangiomas of left buccal mucosa in an 18-year-old male patient. We have also reviewed various treatment modalities and their clinical implication.
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Affiliation(s)
- C R Sobhana
- Department of Oral and Maxillofacial Surgery, Government Dental College, Trivandrum, India
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39
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Gao H, Wang B, Zhang X, Liu F, Lu Y. Maffucci syndrome with unilateral limb: a case report and review of the literature. Chin J Cancer Res 2013; 25:254-8. [PMID: 23592908 DOI: 10.3978/j.issn.1000-9604.2013.03.05] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/21/2013] [Indexed: 11/14/2022] Open
Abstract
Maffucci syndrome is a congenital, non-hereditary mesodermal dysplasia manifested by multiple enchondromas and hemangiomas. It is associated with diverse secondary musculoskeletal deformities, which is exceedingly rare. We report a case of hemangiomas and enchondromas localized in the unilateral limb in a patient with Maffucci syndrome. Treatment consists of orthopedic and surgical intervention to minimize deformities and for cosmetic purpose. Careful surveillance for malignant degeneration of both skeletal and non-skeletal tumors, especially in the brain and abdomen, is essential.
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Affiliation(s)
- Hua Gao
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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40
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Kakiuchi-Kiyota S, Crabbs TA, Arnold LL, Pennington KL, Cook JC, Malarkey DE, Cohen SM. Evaluation of expression profiles of hematopoietic stem cell, endothelial cell, and myeloid cell antigens in spontaneous and chemically induced hemangiosarcomas and hemangiomas in mice. Toxicol Pathol 2012; 41:709-21. [PMID: 23125116 DOI: 10.1177/0192623312464309] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
It is unclear whether the process of spontaneous and chemically induced hemangiosarcoma and hemangioma formation in mice involves the transformation of differentiated endothelial cells (ECs) or recruitment of multipotential bone marrow-derived hematopoietic stem cells or endothelial progenitor cells (EPCs), which show some degree of endothelial differentiation. In the present study, immunohistochemical staining for hematopoietic stem cell markers (CD45 and CD34), EC markers (vascular endothelial growth factor receptor 2 [VEGFR2], CD31, and factor VIII-related antigen), and a myeloid lineage marker (CD14) was employed to better define the origin of hemangiosarcomas and hemangiomas in mice. Staining was negative for CD45, factor VIII-related antigen, and CD14 and positive for CD34, VEGFR2, and CD31, indicating that mouse hemangiosarcomas and hemangiomas are composed of cells derived from EPCs expressing CD34, VEGFR2, and CD31 but not factor VIII-related antigen. The lack of CD45 expression suggests that mouse vascular tumors may arise from EPCs that are at a stage later than hematopoietic stem cells. Since factor VIII-related antigen expression is known to occur later than CD31 expression in EPCs, our observations may indicate that these tumor cells are arrested at a stage prior to complete differentiation. In addition, myeloid lineage cells do not appear to contribute to hemangiosarcoma and hemangioma formation in mice.
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Affiliation(s)
- Satoko Kakiuchi-Kiyota
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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41
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Sharma VK, Verma SK, Goyal L, Chaudhary PK. Hemangiomatous ameloblastoma in maxilla: A report of a very rare case. Dent Res J (Isfahan) 2012; 9:345-9. [PMID: 23087743 PMCID: PMC3469904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hemangiomatous ameloblastoma (HA), which is a rare ameloblastic variant, is presented in a 15-year-old boy in the maxillary right molar region associated with unerupted canine and premolars. Radiologic and computed tomographic analysis was suggestive of cystic lesion. An histology picture confirmed the diagnosis of HA. There are less than eight cases documented in the literature and mostly are in the middle age with mandibular location. This is first ever reported case of HA in a 15-year-old boy with maxillary location. Due to less number of documented cases and no long-term follow-ups, clinical behavior and prognosis of this lesion are uncertain. In this case report, the clinical, histological, and radiographic features of HA are presented.
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Affiliation(s)
- Vivek K. Sharma
- Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sanjeev K. Verma
- Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Lata Goyal
- Department of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India,Address for correspondence: Dr. Lata Goyal, Department of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. E-mail:
| | - Prabhat Kumar Chaudhary
- Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Abstract
Vascular anomalies are an extensive group of malformations of the arterial, venous, and lymphatic systems, either in isolation or, more often, in combination. Although mostly congenital, they can occasionally be acquired as well. They present a challenge both for workup and therapy. This article attempts to describe some of their main anomalies, their workup, and their therapies, with the goal of increasing the comfort level of endovascular therapists.
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Affiliation(s)
- Sandeep Vaidya
- Department of Radiology, University of Washington, Seattle, Washington
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Mogler C, Beck C, Kulozik A, Penzel R, Schirmacher P, Breuhahn K. Elevated expression of c-kit in small venous malformations of blue rubber bleb nevus syndrome. Rare Tumors 2010; 2:e36. [PMID: 21139838 PMCID: PMC2994504 DOI: 10.4081/rt.2010.e36] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 05/10/2010] [Accepted: 05/11/2010] [Indexed: 12/13/2022] Open
Abstract
The blue rubber bleb nevus syndrome (BRBNS, syn. bean syndrome) is a rare disease
characterized by multiple cutaneous and gastrointestinal venous malformations
associated with severe bleeding. However, the underlying molecular mechanisms
are unknown and no targeted therapeutic approach exists to date. Here we report
the case of a 19-year-old male patient with severe BRBNS in whom we analyzed the
expression of tyrosine kinases frequently involved in tumor development by
immunohistochemistry (vascular endothelial growth factor receptor-2, stem cell
growth factor receptor (c-kit), platelet-derived growth factor
receptor-β, and stem cell tyrosine kinase-1). A prominent expression of
c-kit was detectable in smaller blood vessels, which also showed a moderate
expression of the proliferation marker MIB1. Surprisingly, other growth factor
receptors stained negatively. We therefore conclude that pharmacological
inhibition of the c-kit signaling pathway in cavernous hemangiomas by selective
kinase inhibitors may offer options in the treatment of BRBNS patients.
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