Benign Vascular Tumors Research Articles

Identification of Potential Therapeutics for Infantile Hemangioma via in silico Investigation and in vitro Validation.

Infantile Hemangioma (IH) is a prevalent benign vascular tumor affecting approximately 5-10% of infants. Its underlying pathogenesis remains enigmatic, and current therapeutic approaches show limited effectiveness. Our study aimed to discover potential IH-associated therapeutics through a transcriptomic, computational drug repurposing methodology. Utilizing the IH-specific dataset GSE127487 from the Gene Expression Omnibus, we identified differentially expressed genes (DEGs) and conducted weighted gene coexpression network analysis (WGCNA). Subsequently, a protein-protein interaction (PPI) network was constructed to obtain the top 100 hub genes. Drug candidates were sourced from the Connectivity Map (CMap) and Comparative Toxicogenomics Database (CTD). Our analysis revealed 1203 DEGs and a significant module of 1780 mRNAs strongly correlated with IH. These genes were primarily enriched in the PI3K/AKT/MTOR, RAS/MAPK, and CGMP/PKG signaling pathway. After creating a PPI network of overlapping genes, we filtered out the top 100 hub genes. Ultimately, 44 non-toxic drugs were identified through the CMap and CTD databases. Twelve molecular-targeting agents (belinostat, chir 99021, dasatinib, entinostat, panobinostat, sirolimus, sorafenib, sunitinib, thalidomide, U 0126, vorinostat, and wortmannin) may be potential candidates for IH therapy. Moreover, in vitro experiments demonstrated that entinostat, sorafenib, dasatinib, and sirolimus restricted the proliferation and migration and initiated apoptosis in HemEC cells, thereby underscoring their potential therapeutic value. Our investigation revealed that the pathogenic mechanism underlying IH might be closely associated with the PI3K/AKT/MTOR, RAS/MAPK, and CGMP/PKG signaling pathways. Furthermore, we identified twelve molecular-targeting agents among the predicted drugs that show promise as therapeutic candidates for IH.

Topical Therapies of Pyogenic Granuloma in Children: A Systematic Review of Case Reports, Case Series, and Cohort Studies

Abstract Pyogenic granuloma (PG) is a benign vascular tumor removed surgically or by physical modalities, such as electrocautery and cryotherapy. Other treatment options may be warranted, especially in children, using nonsurgical approach. The study aims to determine the effectiveness and safety of topical treatments on PG in children in the clearance of lesions. Systematic literature search were done in February 2023 in the following database: PubMed, HERDIN, Cochrane Library, Hindawi, Directory of Open Access Journals, ScienceDirect, and Google Scholar. The search included studies involving PG treated with topical medications in the pediatric age group. Twenty-five studies (9 cohort studies, 6 case series, and 10 case reports) were included and utilized the following medications: timolol, propranolol, corticosteroids, common table salt, imiquimod, and ingenol mebutate. Among the medications, timolol was the most reported drug to provide partial to complete resolution in 62 out of 149 patients. All the reviewed topical medications provided partial to complete resolution with minimal adverse effects. Among them, topical timolol, propranolol, and table salt have demonstrated high response rates. Topical therapy in children with PG may be considered as a nonsurgical option. However, further clinical trials are warranted to determine its effectiveness.

Adrenal Cavernous Hemangioma: A Rare Incidental Finding from A Routine Ultrasound Assessment

Cavernous hemangioma of the adrenal gland is a very rare benign vascular tumour. Its rarity and non-specific presentation pose a challenge to the radiologists and surgeons in making the correct diagnosis. We report a case of adrenal cavernous hemangioma in a 76 years old gentleman, in which a large heterogeneous mass was incidentally found at his left hypochondriac region during a routine KUB and prostate ultrasound assessment for benign prostatic hyperplasia. A multiphasic CT study performed and revealed a large mass with a maximum diameter of 18 cm occupying the left suprarenal area. Considering the large size of the left suprarenal mass with mass effect to the surrounding structures, the patient undergone left adrenalectomy. His final histopathological diagnosis revealed a cavernous hemangioma. This case highlighted literature review and role of imaging in this extremely rare benign tumour as one of the differential diagnosis of an adrenal incidentaloma.

Medullary and Foraminal Stenosis by Lumbar Vertebral Hemangioma: Case Report

Vertebral hemangiomas can be defined as benign vascular bone tumors, accounting for only about 3% of spinal tumors. In general, they may demonstrate an asymptomatic clinical presentation, being found accidentally on imaging tests. They have an incidence of about 2.0-27% in the general population and do not require intervention in incidental cases.

Reoccurrence of Pyogenic granuloma in a pregnant patient - A case report

Pyogenic granuloma (PG) is a common benign vascular neoplasm that grows rapidly on the skin and mucosal tissues, often leading to surface ulceration and tissue damage. Pregnant women are more prone to developing PG, with up to 5% of pregnant women experiencing the condition. To the best of our knowledge, no case study has been published to date illustrating the management of PG in pregnant patients vulnerable to hemorrhage. A 27-year-old pregnant woman receiving anticoagulant therapy presented with painful lumps on the tongue. She had previously undergone surgical removal of a lump, which reappeared after a month. An external oral examination revealed swelling and a raised, reddish, oval-shaped lesion behind the lower anterior teeth. The lesion was pedunculated with a smooth surface and bleeding. Owing to recurrence and pain, the lumps were excised again using a scalpel. The excised tissue specimens were sent for histopathological assessment to confirm the diagnosis of PG. The tumor was removed with minimal trauma and pressure was applied sublingually to minimize bleeding. Tissue glue was applied for hemostasis, and the patient was instructed to prevent bleeding by applying pressure to the excised area. At the one-week follow-up, no complications were observed. This case report highlights the therapeutic significance of complete tumor excision and pressure therapy in mitigating excessive bleeding, particularly in patients receiving anticoagulant therapy.

Capillary Hemangioma Oral Cavity: Report of Two Cases

Capillary Haemangioma is a benign vascular tumor that is characterized by blood vessel growth and is usually known to be a developing hamartomatous disease of infancy and childhood. The current case report describes an exceptionally unusual atypical appearance of capillary haemangioma. These lesions confront the doctor with a diagnostic quandary and, if not appropriately controlled, can lead to significant problems.

Oral isotretinoin induced giant lobular capillary haemangioma over scalp: a rare case report

With the advent of isotretinoin in the last 2 decades, dermatotheraputics has reached a major milestone especially in treating moderate to severe acne. Oral isotretinoin is an isomer of all-trans retinoic acid and a metabolite of retinol (vitamin A). In addition to its excellent response in moderate to severe acne, there are a number of well-documented side effects related to the use of isotretinoin. Lobular capillary haemangioma is a very rare side effect. It is sometimes known as granuloma pyogenicum and it is an acquired, benign vascular tumor that arises in tissues such as the skin and mucous membranes. Herein, we report a case of isotretinoin-induced lobular capillary hemangioma over the scalp (an atypical site).

Atenolol oral comparado con propranolol oral para hemangioma infantil

Introduction Infantile hemangioma is the most frequent benign vascular tumor in childhood, with an incidence of 3 to 10%. When patients require treatment, oral propranolol, a non-selective lipophilic beta-blocker, is usually considered the therapy of choice. However, its use has been associated with several adverse events related to its β-2 action and its ability to cross the blood-brain barrier. Because of this, oral atenolol, a hydrophilic β-1 receptor-selective beta-blocker, may represent a valid treatment alternative. Nonetheless, there is still controversy regarding the efficacy and safety of atenolol when compared with propranolol as monotherapy for this condition. Methods We searched Epistemonikos, the largest database of systematic reviews in health science, which is maintained by screening multiple sources of information, including MEDLINE/PubMed, EMBASE, and Cochrane, among others. Data were extracted from the identified reviews, data from the primary studies were analyzed, a meta-analysis was performed, and a summary table of the results was prepared using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. Results Nine systematic reviews were identified, including 10 primary studies and three randomized trials. The three randomized trials were included in the analysis of this investigation. Conclusion The use of oral atenolol compared with oral propranolol as monotherapies may result in little or no difference in terms of likelihood of complete remission, decrease in Hemangioma Activity Score, likelihood of post-treatment relapse, and risk of adverse events and severe adverse events, in infantile hemangioma (low certainty of evidence).

Mandibular Gingival Pyogenic Granuloma Spreading to Chin Region: a Case Report

Vascular lesions tumors at the maxillo-facial area could be divided into malformations and tumors. Furthermore, vascular tumors are separated into malignant and benign tumors. Benign vascular tumor such as pyogenic granuloma usually only manifests at the gingiva or oral mucosa region. Few studies have reported extensive-sized facial pyogenic granuloma. This case reports a substantial pyogenic granuloma from the mandibular gingiva down to the chin region. In this case report, we presented a 25-year-old female patient with mastication and esthetic disturbance due to a vascular tumor in her mandibular region. Through thorough examination, a benign vascular lesion was diagnosed pre-operatively. The patient was treated with excisional biopsy and primary closure under general anaesthesia followed by anatomical pathology examination with the result of pyogenic granuloma, resulting in satisfying functional and esthetical outcomes. Patients with vascular lesions need well-executed diagnoses and treatment to achieve favourable anatomic and functional outcomes and preserve their quality of life.

Cavernous haemangioma and mid trimester pregnancy loss leading to severe haemorrhage and hysterectomy: a case report and review of literature.

Cavernous haemangiomas are benign vascular tumours that are known to occasionally involve the female genital tract, including the uterus. They are often underdiagnosed during pregnancy, although they can also lead to severe postpartum or antepartum haemorrhage. Describe our case of an uncommon second-trimester pregnancy loss in a woman with a diffuse cavernous haemangioma of the uterus and cervix and review the wider literature. The review was conducted using MEDLINE, Scopus and PubMed electronic databases from beginning of the database to May 2023, using the following keywords: arteriovenous malformation; cavernous haemangioma/hemangioma; uterine neoplasms; pregnancy complications; abnormal vaginal bleeding. Description of the characteristics of cavernous haemangioma during pregnancy as well as diagnostic criteria and treatment options. Twenty publications were included in the review, which included English-language case reports over a period from 1959 to 2022. No pathognomonic symptoms for cavernous haemangioma of the uterus in a pregnant woman were noted. Complications including massive secondary postpartum haemorrhage, haemoperitoneum, and severe thrombocytopenia with anaemia after delivery were reported. Diagnosis and management during pregnancy can be challenging and requires considerable attention, with a multidisciplinary approach including gynaecologists, radiologists, and pathologists to avoid major complications. An additional case of diffuse cavernous haemangioma of the uterus and cervix is described, that adds to the little existing literature.

Bilateral choroidal haemangioma in an otherwise normal middle aged female

Circumscribed choroidal hemangioma is a rare benign vascular tumor. It is of two types, circumsribed and diffuse. Circumscribed choroidal hemangioma is a well demarcated solitary lesion, usually situated posterior to equator, while diffuse have ill defined thickening of choroid involving more than one zone or quadrant. Patient may present with progressive diminution of vision, metamorphopsia, floaters and visual field defect. The visual symptoms are because of associated subretinal fluid, cystoid macular edema, and in long standing cases, retinal pigment epithelium changes, subretinal fibrosis and retinoschisis. It must be distinguished from amelanotic melanoma and choroidal metastasis. Investigation such as ultrasound, optic coherence tomography, fundus fluorescein angiography, indocyanin green angiography can be used to confirm the diagnosis. Multiple treatment options like transpupillary thermotherapy, photodynamic therapy, plaque brachytherapy and external beam radiotherapy.

Infantile Scalp Hemangiomas: Surgical Management and Lessons Learned

Infantile hemangiomas (IH) are common benign vascular tumors in pediatric patients, often found on the scalp. While most IH naturally regress without intervention, surgical excision becomes necessary when severe anatomic or physiological complications arise. This review examines previously published case studies on pediatric scalp IH excisions, focusing on surgical outcomes and complications. A comprehensive search of the US National Library of Medicine National Institutes of Health (PubMed) database identified 19 relevant case studies. Most patients were female, with a wide age range at the time of excision. Various anatomic locations and sizes of the hemangiomas were observed. The reviewed literature demonstrates that surgical excision of scalp IH can be performed with minimal complications, even for sizable tumors. Successful outcomes and low complication rates highlight the effectiveness of surgical intervention in cases of life-threatening IH sequelae. Further research is warranted to explore optimal timing, techniques, and adjunct therapies for surgical management of scalp IH.

Rare adrenal cavernous hemangioma: a case report highlighting diagnostic challenges.

Adrenal cavernous hemangiomas are rare benign vascular tumors that pose significant diagnostic challenges. Despite their benign nature, features overlapping with malignancies often complicate management decisions. A 64-year-old male presented with a 4.4 cm necrotic left adrenal mass discovered incidentally on imaging. His medical history included papillary thyroid carcinoma, with subsequent thyroidectomy and radioactive iodine ablation. Evaluations for hiccups revealed multiple lung nodules, hypertrophic cardiomyopathy, and anemia. Given the patient's previous cancer history, elevated aldosterone/renin ratio, and mass size, our multidisciplinary tumor board decided to proceed with a left adrenalectomy. Post-surgical pathology confirmed a diagnosis of adrenal cavernous hemangioma. The occurrence of ambiguous adrenal mass with other pathologies, such as our patient's papillary thyroid carcinoma, complicates the diagnostic and therapeutic landscape. As demonstrated in our case, opting for surgery remains a viable solution for adrenal cavernous hemangiomas, especially for masses greater than 4 cm. Interdisciplinary collaboration, exemplified by our tumor board's decision-making process, is crucial for optimal management. This case underscores the need for a multifaceted approach when confronting adrenal masses with such diagnostic ambiguity.

Adult Glottic Hemangioma: A Case Report

Glottic hemangioma is a benign vascular tumor that is rarely seen in the adult population. We report a rare Filipino case of glottic hemangioma in a 65-year-old female presenting with 2 weeks history of hoarseness and a smooth, pedunculated, bluish mass at the anterior one-third of the right vocal cord in flexible laryngoscopy. Direct suspension laryngoscopy showed a pedunculated mass that was paler-looking, similar to the color of the surrounding mucosa, exhibiting the Phonation sign of Menzel. The patient underwent microlaryngeal excision and histopathology showed findings consistent with cavernous hemangioma. Keywords: vocal cord; hemangioma; adult; cavernous

Oncogenic Gαq activates RhoJ through PDZ-RhoGEF

Oncogenic Gαq causes uveal melanoma via non-canonical signaling pathways. This constitutively active mutant GTPase is also found in cutaneous melanoma, lung adenocarcinoma, and seminoma, as well as in benign vascular tumors, such as congenital hemangiomas. We recently described that PDZ-RhoGEF (also known as ARHGEF11), a canonical Gα12/13 effector, is enabled by Gαs Q227L to activate CdcIn addition, and we demonstrated that constitutively active Gαq interacts with the PDZ-RhoGEF DH-PH catalytic module, but does not affect its binding to RhoA or Cdc. This suggests that it guides this RhoGEF to gain affinity for other GTPases. Since RhoJ, a small GTPase of the Cdc42 subfamily, has been involved in tumor-induced angiogenesis and the metastatic dissemination of cancer cells, we hypothesized that it might be a target of oncogenic Gαq signaling via PDZ-RhoGEF. Consistent with this possibility, we found that Gαq Q209L drives full-length PDZ-RhoGEF and a DH-PH construct to interact with nucleotide-free RhoJ-G33A, a mutant with affinity for active RhoJ-GEFs. Gαq Q209L binding to PDZ-RhoGEF was mapped to the PH domain, which, as an isolated construct, attenuated the interaction of this mutant GTPase with PDZ-RhoGEF’s catalytic module (DH-PH domains). Expression of these catalytic domains caused contraction of endothelial cells and generated fine cell sprouts that were inhibited by co-expression of dominant negative RhoJ. Using relational data mining of uveal melanoma patient TCGA datasets, we got an insight into the signaling landscape that accompanies the Gαq/PDZ-RhoGEF/RhoJ axis. We identified three transcriptional signatures statistically linked with shorter patient survival, including GPCRs and signaling effectors that are recognized as vulnerabilities in cancer cell synthetic lethality datasets. In conclusion, we demonstrated that an oncogenic Gαq mutant enables the PDZ-RhoGEF DH-PH module to recognize RhoJ, suggesting an allosteric mechanism by which this constitutively active GTPase stimulates RhoJ via PDZ-RhoGEF. These findings highlight PDZ-RhoGEF and RhoJ as potential targets in tumors driven by mutant Gαq.

Cavernous hemangioma of breast: A case report

Cavernous hemangioma of the breast is a rare benign vascular tumor, whose clinical diagnosis is challenging. We describe a case of cavernous hemangioma in an 81-year-old female, who presented with a history of a slow-growing lump in the left breast from the past few months. Mammography revealed a circumscribed high-density mass with microlobulated margins in the lower outer quadrant with no associated findings. Targeted sonography revealed an isoechoic heterogeneous solid mass in the subcutaneous plane with no associated vascularity on color doppler. It was assigned as BI-RADS IV B and an image-guided core biopsy was done. The histopathology report was of cavernous hemangioma. A close follow-up was advised.

Vascular Tumors and Malformations of the Choroid

Choroidal vascular tumors; it may present as circumscribed and diffuse choroidal hemangiomas and rarely choroidal hemangiopericytoma and phacomatosis pigmentovascularis. Choroidal hemangiomas are benign vascular hamartomatous tumors that occur in two forms: circumscribed and diffuse. The circumscribed form is typically an isolated finding without systemic associations, while the diffuse form generally occurs in association with Sturge–Weber syndrome. Circumscribed choroidal hemangiomas are generally seen as well-circumscribed, round or oval, elevating dome-shaped orange or red masses located posterior to the equator in the fundus, whereas diffuse choroidal hemangiomas have a diffuse red-orange color appearance (tomatoketchup). Although the diagnosis of choroidal hemangioma is better investigated by means of multimodal imaging, indocyanine green angiography and ultrasonography are the most important tests in the differential diagnosis. For circumscribed choroidal hemangiomas with exudative retinal detachment or cystoid macular edema, a variety of treatment modalities are available. Symptomatic patients can be treated with oral propranolol, photodynamic therapy, transpupillary thermotherapy, plaque radiotherapy, external radiotherapy or intravitreal anti-vascular endothelial growth factors.In this review, the pathogenesis, clinical features and treatment methods in choroidal vascular tumors will be discussed.

Murine Models of Infantile Hemangioma: A Comprehensive Review

Infantile hemangioma is the most common benign vascular tumor of infancy and is characterized by a unique life cycle. Animal models that reflect the histological and biological characteristics of infantile hemangioma are critical tools for preclinical studies. Various infantile hemangioma animal models have been developed and improved during the past few decades. However, very few reports have provided practical suggestions for selecting a suitable animal model based on the study purpose. This comprehensive review summarizes the construction methods and application scenarios of different models. The advantages and disadvantages of each model are fully discussed, providing a reference for choosing the most applicable animal model for infantile hemangioma-associated research.

The Efficacy and Safety of Propranolol in Treating Infantile Hemangioma: A Prospective Study

: Hemangiomas are benign vascular tumors that often develop in infants. The most common treatment option for complicated hemangiomas is propranolol. We discuss the use of oral propranolol in treating infantile hemangioma (IH) in an Iranian population at our hospital. We conducted a cross-sectional prospective descriptive study on 62 infants aged 1 to 16 months from 2017 to 2021. Propranolol was gradually administered orally at a dose of 3 mg/kg/day. The hemangioma score was examined at 6 intervals (first visit, 1, 3, 6, 9, and 12 months later). Propranolol therapies were stopped when there was no further decrease in scores for 2 successive visits. The study was completed by 62 patients. In terms of hemangiomas, 46 (74.2%) patients had 1 lesion, 12 (19.4%) had 2 lesions, and 4 (6.5%) had 3 lesions. Over time, the average size of hemangiomas steadily decreased, such that 5 patients (9.1%) were completely treated; 1 patient improved after 3 months, 3 after 6 months, 1 after 9 months, and 57 (91.9%) were partially treated. Aside from being safe and effective, propanol can also obtain a higher response rate when treatment is started early in infants aged less than 3 months.

Pre-Induction Scalp Block in a Patient of von HippelLindau Disease: Promising Use in High-Risk Neurosurgical Procedures

Multiple modalities have been tried for post-craniotomy pain relief, but controversy exists as to the optimal approach. Pre-induction scalp block is a promising technique in high-risk neurosurgical procedures, which reduces the haemodynamic response to skull pin insertion and craniotomy incision, and affords post-operative analgesia. von hippel-lindau (VHL) disease is a rare autosomal dominant disorder with multi-system involvement and various visceral manifestations, the most common of these-being cerebellar hemangioblastoma. Other anomalies include pancreatic-renal cysts, erythrocytosis, hypernephroma, pheochromocytoma and retinal capillary hemangioblastoma. Central nervous system (CNS) hemangioblastomas are often an early manifestation of the disease, and are typically seen in the second decade of life. The majority of hemangioblastomas occur in the cerebellum followed by the spinal cord and brain stem. They are benign vascular tumours but can cause neurological symptoms secondary to pressure or haemorrhage. We hereby present a case of previously diagnosed VHL with recurrent cerebellar hemangioblastoma scheduled for neurosurgical tumour excision and the beneficial use of a pre-induction scalp block to compliment anaesthesia for the patient.