Giant Cavernous Hemangioma Research Articles

S4454 Postoperative Sequelae in Giant Cavernous Hemangioma: Recurrent Cholangitis and Enlargement of Residual Hemangioma Following Hepatic Lobectomy

S4454 Postoperative Sequelae in Giant Cavernous Hemangioma: Recurrent Cholangitis and Enlargement of Residual Hemangioma Following Hepatic Lobectomy

Multimodality imaging for the diagnosis of giant cavernous hemangioma of the right ventricle

Multimodality imaging for the diagnosis of giant cavernous hemangioma of the right ventricle

The role of liver transplantation in the treatment of giant cavernous hemangioma with hemangiomatosis : A report of two cases

The role of liver transplantation in the treatment of giant cavernous hemangioma with hemangiomatosis : A report of two cases

A Rare Giant Cavernous Hemangioma: A Case Report with the Review of the Literature

Objective: Vascular tumors of the breast are extremely rare; among these tumors, hemangiomas are tumors without pathognomonic features. Hemangiomas of the breast are incidentally seen in mastectomy cases. Diagnosis of these tumors using conventional imaging methods is rare. Core needle biopsy and aspiration biopsy cannot help the diagnosis. Case: A 69-year-old woman presented to the outpatient clinic with a sudden hematoma on a slow-growing mass in the right breast with a 1-year history. After breast ultrasonography and dynamic contrast-enhanced magnetic resonance imaging supported a 5 × 4 × 2 cm hemangioma, fine needle aspiration biopsy was performed and sent to pathology after excisional biopsy because of the hematinic material. The pathological findings of the mass were positive for breast hemangioma, and no disease recurrence has been observed in the last six months. Conclusions: Preoperative diagnosis of breast hemangiomas is difficult. Surgical excision is recommended if the vascular lesion is larger than 2 cm, shows atypical features on core needle biopsy, or has discordant radiologic and pathologic findings.

Giant cardiac cavernous haemangioma of the right atrium in a newborn successfully managed using combined therapy.

Cardiac tumours are extremely rare. Most of the cases are diagnosed post-mortem.In this case, a tumour was found in a neonate during routine ultrasound screening in the first trimester of pregnancy. After birth, resection of the formation was performed and histologically confirmed as a cavernous haemangioma. Additionally, propranolol was prescribed in order to prevent relapse.

Hypo-fractionated Gamma Knife Radiosurgery for Intra-cranial Pathologies: A Single-Center Prospective Analysis of Feasibility, Safety, Efficacy, and Complication Profile.

Single-session stereotactic radiosurgery (SRS) is a proven and effective treatment modality for various benign, malignant, and functional intra-cranial pathologies. In certain situations, single-fraction SRS is limited because of lesion size and location. Hypo-fractionated gamma knife radiosurgery (hfGKRS) is an alternative approach for such unconventional indications. To evaluate the feasibility, efficacy, safety, and complication profile of hfGKRS with evaluation of different fractionation schemes and dosing patterns. The authors prospectively evaluated 202 patients treated with frame-based hfGKRS over a 9-year period. GKRS was administered fractionated because of either a large volume (>14 cc) or an inability to spare neighboring organs at risk from permissible radiation in single-session GKRS. The inter-fraction interval was kept at 24 hours, and the dose calculation was performed with linear quadratic equations. Patients with more than 3 years of clinical and radiological follow-up were included in prospective analysis. At pre-decided follow-up criteria, treatment effects and side effects were documented on objective scales. A total of 169/202 patients met inclusion criteria. 41% patients received treatment in three fractions, whereas 59% received two-fraction GKRS. Two patients of giant cavernous sinus hemangiomas were treated with 5 Gy in the five-fraction regimen. In patients with more than 3 years of follow-up, the obliteration rate was 88% for complex arteriovenous malformations (AVMs) treated with hfGKRS because of eloquent locations, whereas it was 62% for Spetzler-Martin grade 4-5 AVMs. For non-AVM pathologies (meningiomas, schwannomas, pituitary adenomas, paragangliomas, hypothalamic hamartomas, etc.), the 5-year progression free survival was 95%. Tumor failure was noted in 0.05% patient population. Radiation necrosis developed in 8.1% patients, and radiation-induced brain edema developed in 12% patients. It was resistant to treatment in 4% patients. No patient developed radiation-induced malignancy. Hypo-fractionation did not provide any hearing improvement in giant vestibular schwannomas. hfGKRS is a valuable standalone treatment option for candidates unsuitable for single-session GKRS. The dosing parameters need to be tailored as per the pathology and neighboring structures. It provides comparable results to single-session GKRS with an acceptable safety and complication profile.

Giant cavernous hemangioma of the left atrial appendage: a case description and literature review

Giant cavernous hemangioma of the left atrial appendage: a case description and literature review

A rare case of giant cavernous splenic haemangioma

Introduction: Tumors of spleen are generally rare disorders. The most common primary splenic neoplasm is haemangioma, although very rare. Giant, cavernous splenic haemangioma is extremely rare, less than 100 cases have been reported in the literature. Case report: We present a case of giant haemangioma in a 65 years-old patient. Radiological diagnostic methods were not conclusive. Magnetic resonance imaging showed en expansive, heterogenous lesion with signs of necrosis and haemorrhage in the central part. Those characteristics raised suspicion in malignant neoplasm, especially haemangiosarcoma and metastatic neoplasm. The surgical team performed total splenectomy, with special attention to possible bleeding as a severe complication. Pathohistological finding was undoubted. There were certain signs of benign, cavernous splenic haemangioma with areas of coagulative necrosis. Conclusion: We need to be aware of such rare entity. MRI is the most reliable diagnostic method, but the pathohistological analysis is definitive. Surgery is a treatment of choice.

Symptomatic giant cavernous hemangioma as an indication for liver transplantation

Symptomatic giant cavernous hemangioma as an indication for liver transplantation

Gd-EOB-DTPA Enhanced MRI Features of Liver Hemangiomatosis Coexistent with GCH.

This study aimed to clarify features of giant cavernous hemangioma (GCH) and liver hemangiomatosis, existing simultaneously on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). A total of 17 patients with reported hepatic hemangiomatosis between 2015 and 2017 were identified retrospectively. All our patients underwent pre-contrast MRI, triphasic (atrial, portal, venous) Gd-EOB-DTPA dynamic enhancement and hepatobiliary phase (20 minutes delayed). The location, size, morphology and signal characteristics on T1-weighted (T1WI) and T2-weighted images (T2WI), and Gd-EOB-DTPA-enhanced MRI of liver hemangiomatosis were evaluated. Hemangiomatosis involved the liver adjacent to the edge of the GCH with no normal liver tissue found in 13 cases; in the other 4 patients, a small area of normal liver tissue separated GCH from hemangiomatosis was seen. On non-contrast MRI images, hemangionmatosis presented as numerous microcystic lesions, with low signal intensity on T1WI and high signal intensity on T2WI, compared with unaffected liver. After administration of Gd-EOB-DTPA, heterogeneous enhancement was presented in the arterial phase, during portal and venous phase imaging, becoming more homogeneous. 11 cases showed hypointensity in the hepatobiliary phase (6 cases with intratumor necrosis), and 6 cases showed hyper-intensity in the hepatobiliary phase with a remaining unfilled portion. Hemangiomatosis is extremely rare in the liver adjacent to a GCH. MRI is of great diagnostic and clinical value for this kind of tumor according to the configuration, size, signal, and style of enhancement, but the final diagnosis depends on pathology. Gd-EOB-DTPA-enhanced MRI may help in diagnosing hemangiomatosis coexistent with GCH.

Infrequent Giant Cutaneous Cavernous Hemangioma of the Eyelid

A 55-year-old man presented with a painless, well-circumscribed, and slowly growing mass on the right upper eyelid, present for 55 years. The mass was pedicled to the skin of the right upper eyelid. The mass was dark violet, resulting in complete mechanical ptosis and visual field occlusion (Fig A). Resection was performed via a cutaneous incision approach with an adjacent pedicled flap graft. The pathological diagnosis was cavernous hemangioma (Fig B). Most periocular cavernous hemangiomas are subcutaneous or orbital lesions, making our case an unusual presentation for this condition (Magnified version of Fig A-B is available online at www.aaojournal.org).

A Patient With Large Cavernous Hemangioma in the Cavernous Sinus Straddling the Saddle With Bilateral Optic Nerve Compression.

This report describes the removal of a giant cavernous hemangioma while protecting the blood vessels and nerves to the greatest degree of safety, relieving the intracranial space, and relieving the symptoms of the patient. Large cavernous hemangioma crossing into the cavernous sinus in a saddle surgery procedure was retrospectively analyzed, summarizing many cross-regional giant cavernous hemangioma treatments. The patient underwent non-en bloc resection of the tumor with rapid removal. The internal carotid artery and adjacent nerves were safely preserved. Large cavernous hemangiomas spanning from the cavernous sinus to the area of the butterfly saddle require complete evaluation, and appropriate surgical entry should be selected. With the surgeon having rich surgical experience, the operation can protect the patient's neurological function.

A rare case report: Giant hepatic cavernous hemangioma

Hepatic cavernous hemangioma is the most common benign tumour of liver. Most of them are small in size and asymptomatic. Giant hepatic hemangiomas are uncommon with rare complications of rupture and haemorrhage. We report here a 41 year old female with asymptomatic giant cavernous hemangioma. Pre-operative findings was suspected on CT scan. Pathological findings of the resected mass were consistent with giant cavernous hemangioma. The patient was discharged post operatively without further complications and the patient condition was found to be improved during follow up.

Giant Cardiac Cavernous Hemangioma Diagnosed with Contrast-Enhanced Ultrasound: A Case Report

Presently, there are few reports in the database about a contrast-enhanced ultrasound-assisted diagnosis of cardiac cavernous hemangioma. We report a case of giant cavernous hemangioma of the heart, which was diagnosed using contrast-enhanced ultrasound. Finally, it was confirmed by surgical pathology. This case demonstrates that contrast-enhanced ultrasound can play an important role in the diagnosis of cardiac cavernous hemangioma.

Long-term outcomes of staged Gamma Knife radiosurgery for giant cavernous sinus hemangiomas: a single-center retrospective study.

Cavernous sinus hemangiomas (CSHs) are rare benign tumors originating from the cavernous sinus. Gamma Knife radiosurgery (GKRS) has been recommended as a primary treatment for small- to medium-sized CSHs. The optimal treatment for giant CSHs is still controversial. In this study, the authors retrospectively reviewed the effectiveness and safety of staged GKRS treatment for giant CSHs. Twenty-two patients with giant CSH who received staged GKRS treatment in the Gamma Knife Treatment Center of Henan Province during the period from January 1, 2011, to December 31, 2018, were enrolled in this study. Six patients had received microsurgery before GKRS, the other 16 patients were diagnosed according to clinical symptoms and MR images. All of the enrolled patients received 2-stage GKRS, and the mean interval between the two GKRS treatments was 6.5 months (range 6-12 months). For the first GKRS, the median isodose line was 48% (range 45%-50%), the median marginal dose was 13 Gy (range 11.5-14 Gy), and the median coverage of CSHs was 80% (range 70%-88%). For the second GKRS treatment, the median isodose line was 50% (range 45%-55%), the median marginal dose to the CSHs was 10.5 Gy (range 9-12.5 Gy), and the median coverage of the CSHs was 88% (range 80%-94%). All of the patients received an outpatient review of an enhanced MR image of the head and a clinical physical check every 6 months after the first GKRS treatment. The mean follow-up duration was 52 months (range 24-84 months). The tumor control rate was 100% 24 months after staged GKRS, and at the last follow-up the mean tumor shrinkage rate was 96.7% (range 90.6%-100%) and the mean residual CSH volume was 2.1 ml (range 0-8.5 ml). Twenty patients suffered central nervous system (CNS) injury symptoms to varying degrees before staged GKRS treatment. Complete symptom recovery was found in 11 (55%) patients, improved symptoms in 5 (25%) patients, and no change in 4 (20%) patients after treatment. Only 1 patient suffered temporary preexisting headache aggravation and 1 patient suffered temporary preexisting diplopia aggravation 1 week after receiving the first GKRS treatment. Subacute or chronic complications were not detected after staged GKRS. Staged GKRS is an effective treatment for giant CSHs. Because of the impressively low incidence of adverse effects, staged GKRS may be considered as a primary treatment for giant CSHs.

Combined surgical treatment of giant cavernous hepatic hemangioma: A case report.

Introduction and importanceHepatic hemangiomas are the most common benign liver tumors, which in most cases are small in size and do not require specific treatment. Giant hepatic hemangiomas are a rare pathology. The purpose of this report is to demonstrate the case of combined treatment of giant hepatic hemangioma.Case presentationA man of the Caucasian race, 37 years old, appealed to the clinic with a complaint about the presence of palpable abdominal mass. During the examination a giant cavernous hemangioma of the left lobe of the liver with a vertical size of up to 210 mm was discovered. Endovascular transarterial embolization (ETE) of tumor-feeding hepatic artery followed by radical surgery on mass removal is performed.Clinical discussionGiant hemangiomas often cause compression of nearby structures and cause symptoms such as pain, abdominal discomfort, nausea, early food saturation, etc. Cases of spontaneous rupture of cavernous hemangioma, including fatal outcome, are also described. We suggest that some patients should go through surgical treatment even if they do not have any complaint.ConclusionsOur experience shows that endovascular embolization of the hepatic arteries can be effectively applied as a pre-surgical preparation method in order to reduce hemangioma size and blood loss volume during surgical intervention.

Adult diffuse hepatic hemangiomatosis

Diffuse hepatic hemangiomatosis (DHH) is an uncommon vascular lesion, though hemangiomas are the commonest benign tumors of the liver. The etiology is largely unknown to date; however, its association with giant cavernous hemangiomas (GCH) has been reported in the literature. We present herein, the case of a 37-year-old hypothyroid woman with abdominal fullness for 2 months. The contrast-enhanced computed tomography revealed multiple well-encapsulated lesions involving the liver lobes and was diagnosed as giant cavernous hemangiomas. Most of them, except the deep-seated ones, were enucleated. Histopathological examination highlighted the presence of GCH with irregular margin, replacement of hepatic parenchyma, and presence of multiple micro-hemangiomas suggesting the possibility of DHH further substantiated by retrospective radiological assessment. No extrahepatic vascular lesion was noted, and the post-operative recovery and follow-up were uneventful. Adult DHH is an uncommon entity. The diagnosis of DHH and its distinction from GCH are important from the management and prognostic point of view as recurrence, extrahepatic manifestations, features of consumption coagulopathy, and death from the complications are not uncommon.

466 Resection or Enucleation for Extremely Giant Hepatic Haemangiomata? A Case Report and Review of The Literature

Abstract Background Cavernous hepatic haemangiomas are benign liver tumours and although common when small, giant haemangiomas (usually accepted as being greater than 10cm) are infrequent. Treatment is indicated in patients who are symptomatic or if diagnosis is unclear, although with giant haemangiomas, many support expectant management of asymptomatic lesions due to the risk of major complications. Traditionally hepatic resection has been the primary treatment option for these lesions, but a variety of other techniques, including enucleation, have been described as safe and effective alternatives. There remains equipoise in respect of the best management of giant haemangiomas above 10cm. Cases of such size are rare and so there is a paucity of data available. Case presentation We present a case of a 65-year-old male who underwent successful anatomical liver resection for a 5kg giant cavernous haemangioma of 26cm diameter following its incidental identification during an ultrasound scan. We also discuss and compare the role of resection and enucleation for the treatment of haemangiomata greater than 20cm in diameter. Conclusions This case demonstrates successful resection of an unusually giant haemangioma which, in contrast to the majority of literature, provides a valuable addition to the limited evidence base for management of this condition by anatomical resection.

Spontaneous intracapsular hemorrhage of a giant hepatic cavernous hemangioma: a rare case report and literature review

BackgroundHepatic cavernous hemangioma is the most common type of benign liver tumor. Although ruptures and hemorrhages of hepatic hemangioma are rare complications, they are associated with high mortality. Most practitioners only pay more attention to abdominal hemorrhages caused by the rupture of hepatic hemangiomas. However, spontaneous intracapsular hemorrhages can often be neglected and poorly understood.Case presentationA 65-year-old man was referred to our institution with right upper quadrant pain, which had occurred suddenly and without a history of recent trauma. The blood test results were normal. Magnetic resonance imaging (MRI) of the abdomen showed a cystic mass in the right liver lobe. Considering the possibility of hepatic cystadenoma with hemorrhage, the patient underwent a right hepatic lobectomy. The pathological findings unexpectedly revealed intratumoral hemorrhage of hepatic hemangioma. The patient recovered well and was discharged eight days after surgery.ConclusionsIntracapsular hemorrhage of hepatic cavernous hemangioma is challenging to diagnose and has a high potential risk of rupture. MRI is beneficial for diagnosing subacute internal hemorrhage cases, and it is recommended to undergo surgery for patients with a definitive diagnosis.

Anesthetic management of a giant cavernous hemangioma of liver posted for right hepatectomy

Anesthetic management of a giant cavernous hemangioma of liver posted for right hepatectomy