Cavernous Type Research Articles

Connecting the dots: Linking superior ophthalmic vein and internal jugular vein diameter to carotid cavernous fistula type and location.

The specific objectives of this study are to identify the carotid cavernous fistula (CCF) type based on computerized tomography angiography (CTA) results, determine the cut-off diameter of the superior ophthalmic vein (SOV) and internal jugular vein (IJV) in CCF patients, and to evaluate the correlation between diameters of the right and left SOV and IJV with CCF type and location. A retrospective analysis of data from 35 CCF patients at our institution was conducted between January 2016 and October 2022. The analysis separated the vascular diameters of the right and left SOV and IJV, which were compared to 35 non-CCF patients. The non-CCF group consisted of individuals who underwent CTA for conditions unrelated to vascular abnormalities. In 35 CCF patients, the dilatation of the left SOV was significantly correlated with direct CCF type with a cutoff of >0.5 cm and significantly associated with indirect CCF type with a cutoff of <0.5 cm (P = 0.017), while the right SOV was not significantly correlated (P = 0.187). There was no significant correlation between the right and left IJV with CCF type or location (right IJV, P = 0.996 and left IJV, P = 0.558). However, the analysis indicated that IJV size differences between CCF and non-CCF patients were significant. Dilation of the left SOV correlates with both direct and indirect CCF types, while the right SOV and IJV (both sides) do not show a significant correlation with CCF type or location. This suggests that left SOV dilation may serve as an early indicator of CCF type, particularly in cases involving the left side.

Is It Time for a Paradigm Shift in the Surgical Management of Trigeminal Schwannomas? Evaluating the Role of the Transorbital Approach: An Anatomo-Clinical Study and Systematic Literature Review

BackgroundEndoscopic transorbital approach emerged in recent years as an effective, minimally invasive route to access Meckel’s cave area. Several case series proved its effectiveness in the surgical treatment of trigeminal schwannomas. Nonetheless, this route provides the advantages of a minimally invasive approach associated with low morbidity rates. In this anatomo-clinical study we illustrate the usefulness of the superior eyelid transorbital approach for the surgical treatment of trigeminal schwannoma guiding the clinical applicability of the anatomical findings into the real surgical practice. MethodsSuperior eyelid transorbital endoscopic approach was performed on eight cadaveric specimens, and the surgical results were confirmed in a retrospective review of all the surgical cases of transorbital surgery performed by the senior authors providing an illustrative case. Finally, we performed a literature review of all the case series of trigeminal schwannomas operated through an endoscopic transorbital approach. ResultsStepwise dissection was divided in 3 phases: skin, endo-orbital and endocranial. The illustrative case provided demonstrate gross total resection of a cavernous sinus type trigeminal schwannomas treated through this route. Literature review revealed 68 cases of trigeminal schwannomas that were successfully treated using the transorbital approach. ConclusionsThe endoscopic transorbital approach may offer a valuable alternative for the surgical treatment of trigeminal schwannomas. This technique provides a minimally invasive, direct and natural “interdural” route to the lateral wall of the cavernous sinus and Meckel's cave.

Evaluating and study of natural gas injecting in Shunbei-1 block fault-controlled fractured-cavity type reservoir

The fault cavern type reservoir in Block 1 of Shunbei area is located in the ultra-deep layer and is classified as a volatile oil reservoir. The reservoir is characterized by very deep burial with an oil/gas ratio between 250 and 500 m3/tone and a saturation pressure range of 28–36 MPa. As of March 2021, the formation pressure has dropped to 30.5 MPa and the pressure retention rate is 35.8%. In order to effectively develop this reservoir, it was decided to use a water injection development method with a planned transition to natural gas injection in March 2022 to further enhance recovery and maintain formation pressure. Through evaluation and research, the pressure distribution, production capacity change and reservoir dynamic response during the water injection development stage were analyzed with respect to the characteristics of fracture-controlled fracture-cave type reservoir in Shunbei-1 block. On this basis, the necessity, feasibility, and expected effects of conversion to natural gas injection are explored, including improvement of displacement efficiency, reduction of fluid output, and enhancement of formation energy replenishment. In addition, this study also carries out in-depth research and prediction on the optimization of natural gas injection parameters, the selection of injection methods and possible problems, aiming to provide scientific basis and technical support for the efficient and sustainable development of this block. In order to smoothly promote the implementation of natural gas injection development, a special reservoir description technique applicable to fault cavern type reservoirs was adopted. Based on this foundation, an in-depth study was conducted on the mechanism of natural gas displacement, so as to optimize the layout of the well network and the setting of injection and extraction parameters. In addition, a set of evaluation system for natural gas injection effect in fault cavern type reservoirs was constructed. By adopting the natural gas injection development method and combining the corresponding supporting technology development and optimization measures, the reservoir development efficiency and oil (gas) production rate have been effectively improved, and the risk of gas flaring has been reduced at the same time. These research results are of great significance for ensuring the comprehensive development and effective utilization of oil and gas resources, and provide strong technical support for future development work.

Rare Adrenal Tumor: Cavernous Hemangioma. A Case Report and Review of the Literature

Introduction: Adrenal hemangioma is a very rare, benign vascular tumor, the cavernous type is the most common. Case report: We present the case of a 66-year-old female patient, diagnosed with an adrenal left mass of 56× 65 ×58 mm. The patient underwent laparoscopic tumoral resection. Histopathological examination revealed adrenal cavernous hemangioma. Discussion  Conclusion: Adrenal cavernous hemangioma is a benign tumor, generally unilateral, often asymptomatic, discovered incidentally or after autopsy. it can be misdiagnosed preoperatively as adenomas or malignant tumors of the adrenal gland. Diagnosis of certainty remains the prerogative of anatomopathological examination. The treatment of choice is surgical excision due the difficulty of excluding malignancy and hemorrhagic risk.

Clinical and morphological characteristics and diagnosis of external haemangiomas in children

Background. The relevance lies in the increasing occurrence of haemangiomas in children under 1 year old when diagnosis confirmation through morphological methods is necessary. The purpose of the research is to characterise the histological initial and final changes of cutaneous haemangiomas and to present the main clinical manifestations of haemangiomas in children. Materials and methods. Several clinical (for detailed diagnosis of the disease), morphological (histological examination of the material) and statistical methods were used in the work. The object of the research was 98 children with haemangiomas of the facial skin aged 6 months to 16 years. Results. The morphological study demonstrated that in 49 cases (50 %), the typical simple capillary structure of haemangioma was identified, in 35 cases (35.7 %) — cavernous type of neoplasm. Only 18.3 % of the children had combined haemangiomas. Capillary-type haemangiomas contain many small capillaries with a narrow lumen, covered by adhering fleshy epithelium. Conclusions. During the phase of the active growth of haemangiomas, there is a predominance of massive endothelial cells, suggesting that the vascular component, particularly proliferating epithelium-lined capillaries, makes up the main and largest part of the hyperplasia.

Effectiveness of sclerotherapy injection in haemangioma of the head and neck region

Link of Video Abstract: https://youtu.be/6NXSL59eReA Background: Hemangiomas are benign tumors that originate from blood vessels. Sclerotherapy effectively treats benign vascular lesions, especially small lesions located at sites with aesthetic impact. Polidocanol is the solution most commonly known to work by causing a local inflammatory reaction, thrombosis obliteration of the hemangiomatous space, and fibrosis of the endothelial space, leading to the lesion's regression. This study evaluated the effectiveness of polidocanol sclerotherapy injection therapy (Aethoxysklerol 3%) in patients with cavernous haemangioma at Dr. Soetomo general hospital. Method: This study is a cross-sectional correlative analysis study, with research samples derived from medical records of patients with cavernous type haemangioma who were indicated to undergo sclerotherapy injection therapy (Aethoxysklerol 3%) at Dr. Soetomo general hospital in the period 2017-2023 who met the inclusion and exclusion criteria. The data obtained will be processed using SPSS software version 25.0 for Windows. Statistical tests were significant if the p-value was &lt;0.05. Results: There were 26 samples in this study, with the gender of patients mostly female (65.4%) and aged &gt;20 years (38.5%). The most common location was buccal region hemangioma (34.2%). The results of the therapeutic response showed that 50% of the majority of patients not well responded, 34,2% showed no response, and only 15.4% responded well with a p-value = 0.000. Conclusion: Injection sclerotherapy using polidocanol (Aethoxysklerol) in 3x administration sessions is a treatment method that has not been effective in treating hemangioma.

Rare Oral Hemangioma in Pregnancy: A Case Series Providing Clinical Insight into Patient Care.

BACKGROUND Hemangiomas are defined as benign soft tissue vascular tumors that are histologically classified as capillary, cavernous, or mixed types. Hemangiomas can also be described based on clinical appearance as superficial, mixed, or deep lesions. Following a thorough search, only 3 case reports of superficial protruding lip mass were found in the literature. Other cases of tongue hemangioma have been reported in infants or young toddlers, and only rarely in adults. CASE REPORT The first case was a 43-year-old pregnant woman, with an unremarkable medical and surgical history, in the second trimester who presented to the Otolaryngology Clinic with a chief concern of a progressively growing lesion, measuring 0.7×0.5 cm, over the lateral right side of the tongue for the last 2 weeks after accidentally biting her tongue during dinner. The second case was a 26-year-old woman with unremarkable medical and surgical history who presented to our Otolaryngology Clinic with a chief concern of a non-painful soft fungating pink-red lip lesion 1.5×1 cm across the right lower lip growing for the last 4 months. This lesion appeared during the third trimester of pregnancy following a lip injury that was described as minor trauma. CONCLUSIONS Although hemangiomas can occur anywhere on the body, they are most commonly found in the head and neck. These lesions are usually recognized quickly by patients and treating physicians and are thus clinically diagnosed. Most vascular benign lesions regress on their own, but if detected early, they are surgically excised for cosmetic and functional reasons.

Intestinal hemangiomas in 8 horses.

This retrospective study describes 8 cases of intestinal hemangioma diagnosed in horses during postmortem examination or surgical biopsy at the University of Tennessee College of Veterinary Medicine. In all cases, the intestine was the sole organ affected, and lesions were focal (3/8) or multifocal (5/8). Nodules were most commonly within the small intestine (7/8), particularly the jejunum (5/7). One case was in the left dorsal colon, which is the first report of hemangioma in the large colon of a horse. Lesions were discrete, raised, smooth, black to red, and ranged from 2 to 15 mm in diameter. Microscopically, all lesions were cavernous type and mural, most frequently within the muscularis (6/8). A majority of cases occurred in middle aged to older horses (average age of 19.3 years), and no breed or sex predilections were identified. The hemangiomas were considered incidental findings.

Clinical and genetic characteristics of 9 rare cases with coexistence of dual genetic diagnoses

Objective: To analyze the clinical and genetic characteristics of pediatric patients with dual genetic diagnoses (DGD). Methods: Clinical and genetic data of pediatric patients with DGD from January 2021 to February 2022 in Peking University First Hospital were collected and analyzed retrospectively. Results: Among the 9 children, 6 were boys and 3 were girls. The age of last visit or follow-up was 5.0 (2.7,6.8) years. The main clinical manifestations included motor retardation, mental retardation, multiple malformations, and skeletal deformity. Cases 1-4 were all all boys, showed myopathic gait, poor running and jumping, and significantly increased level of serum creatine kinase. Disease-causing variations in Duchenne muscular dystrophy (DMD) gene were confirmed by genetic testing. The 4 children were diagnosed with DMD or Becker muscular dystrophy combined with a second genetic disease, including hypertrophic osteoarthropathy, spinal muscular atrophy, fragile X syndrome, and cerebral cavernous malformations type 3, respectively. Cases 5-9 were clinically and genetically diagnosed as COL9A1 gene-related multiple epiphyseal dysplasia type 6 combined with NF1 gene-related neurofibromatosis type 1, COL6A3 gene-related Bethlem myopathy with WNT1 gene-related osteogenesis imperfecta type XV, Turner syndrome (45, X0/46, XX chimera) with TH gene-related Segawa syndrome, Chromosome 22q11.2 microduplication syndrome with DYNC1H1 gene-related autosomal dominant lower extremity-predominant spinal muscular atrophy-1, and ANKRD11 gene-related KBG syndrome combined with IRF2BPL gene-related neurodevelopmental disorder with regression, abnormal movement, language loss and epilepsy. DMD was the most common, and there were 6 autosomal dominant diseases caused by de novo heterozygous pathogenic variations. Conclusions: Pediatric patients with coexistence of double genetic diagnoses show complex phenotypes. When the clinical manifestations and progression are not fully consistent with the diagnosed rare genetic disease, a second rare genetic disease should be considered, and autosomal dominant diseases caused by de novo heterozygous pathogenic variation should be paid attention to. Trio-based whole-exome sequencing combining a variety of molecular genetic tests would be helpful for precise diagnosis.

Гістоморфологічні особливості демодекозу повiк

The purpose of the study was to present characteristic histomorphological patterns that indicate demodicosis as the main cause of heterogeneous macroscopic changes in eyelid tissues that do not have clinical specifics and are not associated by ophthalmologists with this parasitic disease. Materials and methods. Clinical and morphological analysis covers 8 cases of demodicosis identified during the histological examination of biopsy and surgical material for the period from 2019 to 2022, carried out on the basis of the laboratory of pathological anatomy of the State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine”. The surgical biopsy material was processed according to the generally accepted histological technique. In each case, up to 6 serial histological sections stained with hematoxylin-eosin were examined. Results and discussion. Diagnosis of demodicosis in ophthalmology is based on clinical and laboratory research, directed at the manifestation of the parasite itself. The traces of demodectic invasion in the tissues of the appendages of the eye, which may indicate the nature of granulomatous and tumor-like processes, as a rule, become the object of pathomorphological investigation. Histomorphological diagnosis should be based on the identification of a pathognomonic picture: characteristic cysts at the site of the destroyed sebaceous glands. Against the background of these changes, partially preserved sebaceous glands can be detected, which makes it possible to understand the origin of the patterns, which otherwise can be mistaken for dilated vessels of the sinusoidal or cavernous type, as well as cysts of artificial origin. The presence of foci of dystrophic calcification against the background of cystic ducts can also be considered a pathognomonic picture, but it was found rare. The presence of foci of fibrosis, inflammatory infiltration, including granulomatous, is also characteristic of this pathology, but cannot be the basis for making the correct diagnosis. On the contrary, underestimation of these changes can lead to the omission of the main etiological factor. Understanding the real picture of the prevalence of post-demodectic changes in the eyelids will become possible only with a careful approach to the diagnosis of surgical and biopsy material, taking into account the above histomorphological features. Conclusion. The study showed that post-demodectic changes in the appendages of the eye are quite rare and account for no more than 0.1% of the total volume of biopsy and surgical material, which is tested by a diagnostic study for the above time. However, the real prevalence of this pathology is probably higher, because some patients may not seek medical help without experiencing serious damage to the quality of life or resorting to self-treatment

"Capillary Hemangioma on the hard palate- A puzzling expression”

Hemangiomas of the head and neck are benign tumours that have their origin from the blood vessels. Hemangiomas are classified as capillary, cavernous , sclerosing and central type. The nature of this tumour is progressively slow growing, including involvement of greater portions of the superficial and deep blood vessels, functions maybe affected, depending on the location. Hemangiomas are common in the head and neck and have rare occurrence in the oral cavity. Lips, buccal mucosa and tongue are the common sites, hemangiomas occur rarely on the palate. This is a case of unusual location of capillary hemangioma on the palate in a middle aged man diagnosed by histopathology after surgical excision.

Endoscopic Far-Lateral Supracerebellar Infratentorial Approach for Petroclival Region Meningioma: Surgical Technique and Clinical Experience.

The management of petroclival region meningioma remains the ultimate achievement in neurosurgery, because of the formidable technical challenges involved. To describe the technique and feasibility of the purely endoscopic far-lateral supracerebellar infratentorial approach (EF-SCITA) for the treatment of petroclival region meningiomas. We reviewed the clinical data of 10 consecutive cases of petroclival region meningiomas treated with the EF-SCITA from August 2018 to August 2020. The clinical outcomes were analyzed. The patient was placed in the lateral position, and then, a "C" shaped incision and craniotomy with exposed sigmoid and transverse sinuses were performed. With the endoscopic holder, endoscopic procedures were performed using standard 2-hand microsurgical techniques. Whether the tentorium or Meckel cave was handled depended on the tumor extension. The mean diameter was 45 × 25 mm. Dizziness and headache were the main symptoms. All 10 patients achieved gross total or subtotal resection (Petroclival Meningioma Grade I-III) with good neurological outcomes. The EF-SCITA provides satisfactory, direct exposure to the petroclival region. Cranial nerve deficits are the main postoperative complications. Two patients had a trochlear nerve injury, 3 patients had transient facial paralysis, and 2 patients had oculomotor paralysis (1 total and 1 incomplete), but both of them recovered during the follow-up period. One patient experienced an ipsilateral superior cerebellar artery infarction, and another patient had transient hemiparesis. The EF-SCITA is effective for most petroclival region meningiomas, except for the cavernous sinus type. This approach simplifies craniotomy procedures, omits burdensome petrosectomy, and avoids crossing posterior neurovascular structures.

Imaging Findings From Different Pathological Types of Oral and Maxillofacial Intramuscular Hemangiomas for Selecting Optimum Management.

ObjectivesTo assess computed tomography (CT) and magnetic resonance imaging (MRI) findings of intramuscular hemangiomas (IMHs) in oral and maxillofacial region and correlate them with the histopathological classifications for selecting optimum management.MethodsThe clinical data and pretreatment findings of 32 patients with pathologically proven IMHs on CT (n = 10), MRI (n = 27), or both (n = 5) were analyzed retrospectively. Correspondence of clinical and imaging characters with 3 different pathological classifications (cavernous, capillary, and mixed) of IMHs was studied. A number of pitfalls and overlap of imaging features can result in misdiagnosis of different IMHs lesions.ResultsFour patients had multi-muscular lesions, and 28 had single-muscular lesions. The predilection site were the tongue (11 cases, 34.4%) and the masseter muscle (10 cases, 31.2%). Cavernous type (17 cases, 53.1%) was the most common IMHs type. All patients showed slightly hypointense or isointense on T1-weighted imaging, 3 patients showed hyperintense on T2-weighted imaging and the others showed slightly hyperintense. The most common enhancement pattern was progressive (29 cases, 90.6%). The capillary type (9 cases, 28.1%) and mixed type (6 cases, 28.1%) of IMHs on imaging indicated characteristics of lesions with rich blood supply status, the cavernous type (17cases, 53.1%) of IMHs belonged to relatively poor blood supply lesions. A total of 5 patients (15.6%) were initially misdiagnosed, there were recurrences in 4 IMHs patients. Extra functional MRI (fMRI) was performed on these 5 misdiagnosed patients, the average ADC of the 5 patients was 1.50 × 10−3 mm2/s. The presence of vermicular vessels was different among these three types of IMHs.ConclusionsThe reason for the misdiagnosis in localized IMHs may be the obvious border of mass-like lesions and the lack of enlarged vessels. Combined evaluation of presence of vermicular vessels and fMRI might be more accurately for determining the IMHs and create a preoperative plan.

1610 Haemangiomas of the Small Intestine: Poorly Known Cause of Abdominal Pain

Abstract Background Haemangioma of the small intestine is a rare disease in adult patients and is usually located in the jejunum. The usual clinical features include abdominal pain, bleeding, and obstruction. Acute intestinal bleeding leading to anaemia is the most common presentation in most patients. Intussusception and even perforation caused by cavernous haemangioma are extremely rare Case Summary we report a 31-year-old male with a right upper quadrant pain, nausea, elevated CRP. ultrasound abdomen suggestive of hepatic haemgioma whereas the CT abdomen showed left upper quadrant mass. He had laparoscopy converted the laparotomy showed5*5cm small intestine mass. small bowel resection and anastomosis was done. Histology has confirmed haemangioma. Discussion Small bowel haemangioma accounts for 5 to 10 % of all benign neoplasms of the small intestine. It is thought to be one of the congenital benign vascular lesions. Haemangiomas are classified as cavernous, capillary, or mixed type, and the cavernous type is the most common Malignant change is quite unusual. Multiple lesions are often associated with similar neoplasms in other organs, such as the liver and skin. Conclusions Small intestine haemangioma are often very difficult to diagnose. Early diagnosis and appropriate intervention could provide good outcomes. Diagnostic and therapeutic measures should be taken to avoid further complications.

Angioleiomyoma of the extremities: correlation of magnetic resonance imaging with histopathological findings in 25 cases.

To identify the characteristic magnetic resonance imaging (MRI) findings in angioleiomyoma and to clarify its relationship with histopathological findings. We retrospectively analyzed the MRI findings and pathological subtypes in 25 patients with subcutaneous angioleiomyoma of the extremities. Based on the previous reports, MRI findings that could be characteristic of angioleiomyoma were extracted. According to the World Health Organization classification, all cases were classified into three pathological subtypes: solid, venous, and cavernous. The relationship between MRI findings and pathological subtypes was analyzed. The pathological subtypes were solid (n = 10), venous (n = 11), and cavernous (n = 4). The following MRI findings were observed: (a) hypo- or iso-intense linear and/or branching structures on a T2-weighted image (positive total/solid/venous/cavernous: 19/5/10/4, respectively), which we defined as "dark reticular sign"; (b) peripheral hypointense rim on a T2-weighted image (positive total/solid/venous/cavernous: 19/7/8/4, respectively); and (c) presence of any adjacent vascular structures (positive total/solid/venous/cavernous: 6/3/3/0, respectively). Chi-square test showed a significant relationship between dark reticular sign and pathological subtypes (p = 0.0426). The dark reticular sign was found more frequently in the venous and cavernous types than in the solid type. The other MRI findings did not reveal a significant relationship between pathological subtypes. We present the largest case series exploring MRI findings in angioleiomyoma. The dark reticular sign was a characteristic MRI finding of angioleiomyoma and was seen in most of the venous and cavernous types, which may facilitate preoperative diagnosis.

A Case of Glottic Cavernous Hemangioma Mimicking Malignancy in Elderly Patient

The etiology of laryngeal hemangioma is unclear, and it is classified into infant and adult types. The former is capillary hemangioma and relatively common, the latter is cavernous type and very rare. The adult laryngeal hemangioma mainly occurs in supraglottis and glottis. A 75-year-old man came to our clinic with a voice change that started four months ago. The laryngoscopic finding showed that the surface of oval-shaped mass is covered with turbid exudates. We performed the laryngeal microsurgery with CO2 laser. The mass was pathologically proven as cavernous hemangioma. We report a very rare and didactic case with review of relevant literature.

Morphology of the lips, cheeks, and the hard palate of the Egyptian water buffalo (Bubalus bubalis): a focus on histological, histochemical, and ultrastructural aspects.

The available data is scanty about Egyptian water buffalo lips, cheeks, and palate. The current investigation was focused on describing the morphology of the lip, cheek, and palate. Our study included the gross, light, and electron microscopic examinations of ten heads of the Egyptian water buffalos. The nasolabial plate surface carried numerous scales of keratinized epithelium. Internal labial surface and labial mucocutaneous junctions were covered with stratified squamous keratinized epithelium. Two types of hair follicles in the dermis included ordinary and cavernous types characterized by cavernous space. The conical papillae on the internal aspect of the oral commissure were projected from the mucous membrane. Seromucous glands were occasionally observed under the oral mucous membrane of the commissure and gave positive PAS and AB. Conical papillae density on the inner cheek surface had some variations: the rostral part had large papillae, while the dorsal part had numerous papillae than the ventral part, the caudal part had a smaller number of papillae, while the middle part was devoid of papillae. Parotid duct opening in the buccal vestibule was without papillae. Conical papillae had two surfaces; the rostral surface was highly keratinized than the caudal one. The buccal gland was a compound tubuloacinar mixed (mucoserous) gland and mucus acini only reacted to PAS and AB. The oral surface of palatine rugae was covered with highly keratinized epithelium than the aboral surface. Palatine glands showed PAS and AB positive. The result describes the relationship between the available food particles, environmental conditions and the lip, cheek, and palate appearance, and structure.

Lateral nasal wall haemangioma in a young female: a rare case

&lt;p class="abstract"&gt;Hemangiomas are benign tumours originating from vascular structures in the body. Histologically they are divided into capillary, cavernous and mixed types. Although it is very commonly seen in head and neck region, it is very rarely seen in the nasal cavity, nasopharynx and paranasal sinuses and it accounts for only 10% of all head and neck haemangiomas. In this patient the haemangioma was seen arising from the lateral nasal wall, of the right nasal cavity. So far in the literature very few such cases have been reported till date. &lt;/p&gt;

ATRIAL HAEMANGIOMA – A CASE REPORT AND REVIEW OF THE LITERATURE

Primary cardiac tumours are rare entities and haemangiomas represent only 2.8% of these tumours. Haemangiomas are usually revealed by various symptoms depending on their size and location or can be incidentally discovered during routine examination or at autopsy. We report the case of a 70 years old Caucasian male referred for autopsy after being found deceased in his apartment. The main cause of death was considered to be haemorrhagic stroke secondary to rupture of an anterior communicating artery aneurysm with bronchopneumonia as a concurring cause. Heart dissection revealed the presence of a round, reddish, tumour adherent to the posterior wall of the left atrium and unrelated to the cause of death. Microscopic examination established the diagnosis of cavernous haemangioma. An interrogation of PubMed database for the time interval between 2008 and 2018 revealed only 11 cases of cardiac haemangiomas, 6 of them of cavernous type. In conclusion, cardiac haemangiomas are exceptional discoveries but cardiologists and cardiac surgeons should be aware of their existence as the symptoms and medical imaging aspects are non-specific and potentially mislead the diagnosis.

Imaging of intramuscular haemangiomas of the extremities.

Intramuscular haemangiomas are benign soft tissue tumours that are more frequently seen in children and young adults. As they may be difficult to diagnose clinically, imaging has an important role in the detection, diagnosis and preoperative planning of these lesions. Haemangiomas of the extremities may be classified into capillary, cavernous, venous and mixed types, with or without an arteriovenous shunt, depending on the predominant vascular channels. Nonvascular components such as fat, smooth muscle, fibrous tissue and thrombus may also be present. This pictorial essay highlights the imaging features of intramuscular haemangiomas, with an emphasis on magnetic resonance imaging.