Hemangioma Presenting Research Articles

Long-Term Outcome of Surgical Management in Symptomatic Pediatric Vertebral Hemangiomas Presenting With Myelopathy.

Vertebral hemangiomas are benign, highly vascular lesions of the vertebra, rarely seen in the pediatric age group. To analyze the long-term (>3 yr) outcome of patients of pediatric vertebral hemangioma presenting with myelopathy and to describe our surgical strategy to treat such cases. All patients up to 18 yr of age with a symptomatic vertebral hemangioma treated at our hospital from May 2003 to August 2016, with at least 3-yr follow-up were included. Functional clinical outcomes were measured using American Spinal Injury Association (ASIA) score. There were 7 male and 7 female patients. All hemangiomas were located in the thoracic spine with single-level involvement. Upper thoracic spine involvement was more common (12 cases: 85.71%) than lower thoracic spine involvement (2 cases: 14.29%). All patients had features of myelopathy. The mean age was 14.57 yr, ranging from 10 to 18 yr. The mean follow-up was 62.21 mo, ranging from 36 to 90 mo. All patients had improvement in motor strength of both lower limbs postoperatively. Local pain, which was present in 1 patient, resolved, and the bladder symptoms present in 5 patients also resolved. Our experience in treating symptomatic pediatric vertebral hemangiomas, along with the long-term follow-up data, suggests that good postoperative results can be achieved with minimal complications in carefully selected patients.

S3319 Metastatic Biliary Cholangiocarcinoma With Hepatic Cavernous Hemangioma Presenting as Acute Cholangitis: A Case Report

S3319 Metastatic Biliary Cholangiocarcinoma With Hepatic Cavernous Hemangioma Presenting as Acute Cholangitis: A Case Report

Ruptured Splenic Hemangioma Presenting As Small Bowel Obstruction: A Case Report

Introduction: Splenic hemangioma is a rare vascular tumor of the spleen. Typically asymptomatic, these lesions can present with rupture and hemoperitoneum. Clinical Findings: We report the case of a patient with no previous abdominal surgery that presented with symptoms and imaging consistent with small bowel obstruction (SBO), and an incidental finding of a splenic lesion. Main diagnoses, therapeutic interventions, and outcomes: At diagnostic laparoscopy, a ruptured splenic hemangioma was identified, with obstructive ileus due to hemoperitoneum. The patient subsequently underwent splenectomy to prevent recurrent bleeding. Conclusions: Splenic hemangiomas are rare vascular neoplasms of the spleen, which can be complicated by rupture. While obstructive ileus is a common post-operative phenomenon, it is rarely seen in association with vascular anomalies. This case represents a rare presentation of small bowel obstruction, highlighting the utility of diagnostic laparoscopy in patients with no previous abdominal surgery.

Hepatic hemangioma presenting as a large cystic tumor.

Hepatic hemangioma presenting as a large cystic tumor.

Dilemmatic presentation of hemangioma of the lip: A short case report

Dilemmatic presentation of hemangioma of the lip: A short case report

Benign testicular cavernous hemangioma presenting with acute onset: A case report.

Cavernous hemangioma is a congenital, benign vascular tumor that occurs in the deep dermis and subcutaneous tissue. Testicular cavernous hemangioma is extremely rare, mostly occurring during childhood or adolescence. Testicular cavernous hemangioma is a benign tumor that appears as a slowly growing painless mass. In rare cases, it may be associated with acute testicular infarction or torsion with acute onset. We herein report the case of a patient with an atypical presentation of testicular cavernous hemangioma, characterized by acute painful testicular enlargement triggered by minor injury. The patient underwent right radical orchiectomy, and histopathological examination confirmed the diagnosis of testicular cavernous hemangioma. Although this is a rare tumor, it should be considered in the differential diagnosis of testicular tumors.

Colloid cyst: unusual location of petrous temporal bone

Colloid cysts are benign, thin walled spherical neoplasms, composed of a collagenous capsule, underlying epithelium that arises from brain’s epidermal embryonic remnants and a viscous centre. They are shown to approximate 0.5% of all intracranial tumours with no recorded evidence of the petrous temporal bone involvement. Colloid cyst of the petrous temporal bone often presents with clinical symptoms of headache, hearing loss, facial palsy and imbalance/vertigo. Which is diagnosed on radiological and histological findings. Histologically, they are lined by ciliated cuboidal to pseudo stratified columnar epithelium resting on an eosinophilic basement membrane. Imaging Techniques are helpful in early diagnosis and preventing further complications. Here we will be discussing about a 24-year-old female, a known case of petrous apex osseous haemangioma presenting with unstable gait and tingling sensation on one side of face leading to an incidental finding of a colloid cyst on petrous temporal bone through histological examination.

Differential Diagnosis of a Glenoid Cyst in Omarthrosis: Hemangioma of the Glenoid – Resection and Reconstruction Using Autologous Bone-Graft and Special Implant

Hemangiomas belong to the benign tumors, that can occur in any bone of the human body. The typical localization are the vertebral spine and the skull. There is no reported case of an intraarticular glenoidal hemangioma so far. The current paper presents a case of a 48-year-old female with joint pain that started 2 years before. The clinical manifestations included limited range of motion (ROM) and load dependent, non-load dependent and night pain. Roentgenogram and magnetic resonance imaging (MRI) of the left shoulder showed degenerative changes of the glenohumeral cartilage and a big (11.8mm x 10.3 mm) intraglenoidal mass affecting the joint line. The postoperative pathological diagnosis was that of a cavernous hemangioma. The aim of the present study was to present the imaging presentation of glenoidal hemangioma and to show therapeutic options in case of glenohumeral osteoarthritis (OA) with glenoidal bone loss due to hemangioma. In the present case no recurrence of the hemangioma and no complications of the implant in terms of loosening, infection or consisting were observed.

Vertebroplasty with Decompression for Epidural Extending Vertebral Hemangiomas: An Alternative Technique.

To document the effectiveness of an alternative surgical technique with concurrent vertebroplasty and decompression without instrumentation for patients with vertebral hemangioma presenting with neural compression symptoms. This study is a technical note and a retrospective clinical evaluation. We analyzed the data of 8 patients operated with our alternative surgical technique for vertebral hemangiomas with epidural extension and neural compression, between 2013 and 2018. The preoperative, postoperative 1st month and postoperative 12th-month Visual Analogue Scale (VAS) scores were assessed and compared. Five of the patients had lumbar and 3 had thoracic hemangiomas. The difference between preoperative and 1st and 12thmonth Visual Analogue Scale scores were statistically significant. None of the patients received additional intervention, stabilization, or needed a blood transfusion. This technique is a safe and minimally invasive approach for vertebral hemangiomas with epidural extension allowing decompression of the spinal cord without massive hemorrhage.

Solitary retinal capillary hemangioma with combined retinal detachment- rare presentation

Objective. To report a rare presentation of solitary retinal capillary hemangioma manifesting with combined retinal detachment as initial presentation and its successful management. Methods. A 35-year-old healthy Indian male presented with combined retinal detachment associated with solitary retinal capillary hemangioma as initial presentation; a clinical entity still not reported in literature. Patient was managed with pars plana vitrectomy combined with retinectomy, endolaser, & silicon oil tamponade with good visual & anatomical recovery. Results. Patient had good clinical outcome with final best-corrected visual acuity (BCVA) of 6/ 24 and well attached retina at last follow-up. Conclusion. Solitary retinal capillary hemangiomas can rarely present with advanced vitreo-retinal complications like combined retinal detachment as initial manifestation that can be effectively managed with skilled & appropriate surgical intervention.

Jejunal cavernous hemangioma presenting with small bowel obstruction in a toddler

Abstract Vascular malformations involving the gastrointestinal tract are uncommon and have a variety of clinical presentations. In this paper, we present a case of a jejunal vascular malformation presenting as a small bowel obstruction in a 2-year-old boy. After clinical and radiologic evaluation, the patient underwent an exploratory laparotomy during which a jejunal mass was identified as the cause of the obstruction and was removed. Pathologic diagnosis confirmed the mass as a benign cavernous hemangioma within the jejunum. The patient recovered well post-operatively.

Mediastinal Cavernous Hemangioma Presenting as a Cardiophrenic Angle Mass: A Case Report and Literature Review

Introduction: Mediastinal hemangiomas are uncommon benign vascular tumors. They are histologically classified into capillary, cavernous, and venous types, according to the size of their vascular spaces. Phleboliths, multiple enhanced vessels, and peripheral puddling of contrast enhancement are the typical diagnostic features on computed tomography (CT). The cardiophrenic angle (CPA) area is a particular area of mediastinum and diseases in this region are rare but various. This paper describes a case of cavernous hemangioma located in the right CPA, lacking the typical CT imaging findings, that was definitively diagnosed after surgery. Case Presentation: On March 20, 2017, a 38-year-old woman referred to Da-Ping hospital, which is a level III military hospital affiliated to the Army Medical University, Chongqing, China. She had a three-week history of intermittent cough, dull aching chest pain, and occasional palpitation. Her general physical examination and other routine lab tests and tumor markers were reported within the normal ranges. One day later, the chest plain CT showed a well-defined and non-invasive mass with soft-tissue density interspersed with a fatty ingredient in the right CPA with contrast agent. The tumor demonstrated non-enhancement neither in the arterial phase nor in the venous phase, and no apparent feeding vessels to the tumor were identified. It was initially suspected to be a benign ectopic thymoma. On March 27, 2017, the tumor was completely resected by video-assisted thoracoscopic surgery (VATS). Post-operative histological findings confirmed the diagnosis of cavernous hemangioma. The patient was in good condition at a five-month follow-up. Conclusions: Mediastinal cavernous hemangioma should be considered as an important differential diagnosis of mediastinal masses even though it is rare. Chest CT is useful in providing valuable information on the origin and invasiveness of the tumor, evaluating the relationship between tumors and intrathoracic vessels, and mapping the blood supply of tumors to select more suitable operative intervention.

A Rare Presentation of Colonic Hemangiomas and Varices

A Rare Presentation of Colonic Hemangiomas and Varices

A Case Report of a Tongue Ulcer as a Rare Presentation of Oral Hemangioma

Oral hemangioma is a rare benign vascular tumor. It may occur on lips, tongue, buccal mucosa, and palate. Hemangioma is a congenital hamartoma and its clinical presentations and patients’ history aid in its diagnosis. Histopathologically, hemangioma shows flatted endothelial cells and small capillary size space. In this report, we will describe a rare presentation of oral hemangioma as an asymptomatic tongue ulcer in a 32-year-old woman. The clinical presentation, differential diagnosis, and management will also be described in detail.

Hemangioma Presenting With Multiple Phleboliths: Case Report with CBCT Findings

Hemangiomas are benign tumors of infancy that display a rapid growth phase with endothelial cell proliferation. Phleboliths are calcified thrombi found in veins, venulae and sinusoidal vessels of hemangiomas. In the head and neck, phleboliths nearly always signal the presence of a hemangioma. Hemangioma with multiple phleboliths is described including its features on panoramic radiography and cone beam computed tomography images.

Verrucous hemangioma (also known as verrucous venous malformation): A vascular anomaly frequently misdiagnosed as a lymphatic malformation.

Verrucous hemangioma or verrucous venous malformation is a superficial venous malformation frequently misdiagnosed as a lymphatic malformation because of its classical hyperkeratotic appearance. Clinical characteristics of VVM were studied in patients with a histologically confirmed VVM, and validated in a prospective study of 18 patients. VVM was made of separated vascular elements with irregular shape, in a linear disposition, with variable thickness and keratosis. Its specific vascular pattern consisting of an erythematous patch with scattered small red to violet dots was easily identified using dermoscopy. In many cases, the typical clinical presentation of verrucous hemangioma is sufficient to establish the diagnosis and a biopsy may not be required.

Subglottic hemangioma: Understanding the association with facial segmental hemangioma in a beard distribution

ObjectiveA subglottic hemangioma (SGH) is a benign tumor of infancy that can cause severe obstruction of the airway. Infantile hemangiomas, in general, are the most common head and neck tumor in children, affecting 4–5% of the pediatric population. This retrospective cohort study characterizes subglottic infantile hemangiomas at a single vascular anomaly center over a 5-year period (2013–2017) during the era of propranolol treatment. MethodsQueried the Vascular Anomaly Database at Children's Hospital of Pittsburgh for all infantile hemangioma(s) and then identified case of subglottic hemangiomas. Characterized key features of presentation, natural history and management for subglottic hemangiomas. A secondary differentiation focused on differences between subglottic hemangiomas associated with Beard Distribution (BD) vs not (NBD). ResultsAnalysis of 761 cases of infantile hemangiomas demonstrated only 13 patients with subglottic hemangiomas (1.7%). Of those 13 patients, only 4 patients (30%) had BD while 2 patients (15%) had other cutaneous hemangiomas and 7 patients (55%) had no cutaneous hemangiomas. Secondarily, a total of 31 case of beard distribution cutaneous hemangiomas with 11 patients having oropharyngeal involvement (35%) but only 4 patients with subglottic hemangiomas (13%). Interestingly, 2 of the 4 BD patients had treatment failure on propranolol and required second line treatment with steroids or surgical excision while only 1 of 9 NBD patients failed propranolol treatment. As well the same 2 BD patients which failed propranolol also had PHACES syndrome. ConclusionSubglottic hemangiomas are a rare presentation of infantile hemangiomas but with significant morbidity. While the classic teaching that a segmental beard distribution hemangioma raises concern for a subglottic hemangioma, this cohort indicates subglottic hemangiomas occur in a NBD presentation (1.3%), and demonstrated only an approximate 10% incidence rate with a beard distribution. But more importantly, this study raises the question that beard distribution in setting of PHACES syndrome may herald a more recalcitrant and complicated natural history for a subglottic hemangioma. This is of significant concern as risk for CVA in setting of PHACES is highest with use of steroid treatment. None of our patients had high risk extra or intra cranial vascular arterial anomalies and no CVA were noted.

Large frontal osseous hemangioma with dural sinus involvement in a patient with Klippel-Trenaunay syndrome: A rare case report

Background:We present one of the first documented cases in the literature of an adult with Klippel-Trenaunay syndrome (KTS) with a large frontal osseous hemangioma.Case Description:A 30-year-old male presented with a rapidly enlarging frontal skull lesion that had developed in only 3 months. Radiological investigation revealed a highly vascular lesion attached to the frontal bone. The lesion was surgically resected with the patient making complete recovery. Histopathology was consistent with an osseous hemangioma.Conclusion:We report the clinical presentation and surgical management of a rare presentation of osseous hemangioma in a patient with KTS.

Hemangioma congénito rapidamente involutivo: um diagnóstico infrequente

Rapidly involuting congenital hemangiomas (RICH) are rare vascular tumors which are characterized for being fully developed at birth and involute completely and spontaneously within six to eighteen months. The diagnosis is mostly achieved by history and physical examination, sometimes aided by imaging studies and biopsy.It is described the case of a term newborn, from a surveilled pregnancy with normal prenatal ultrasounds, who presented at birth a mass of 5x4.5cm on the anterior surface of the left thigh that was soft, compressible, grayish, with some peripheral telangiectasia and pale peripheral halo, without palpable thrill or ulceration. Hemodynamically stable, without thrombocytopenia. The ultrasound and magnetic ressonance image suggested the clinical suspicion of RICH, which was supported by immunopathology. After 15 months there was a complete and spontaneous regression of the tumor.Knowledge of the clinical presentation, evolution and prognosis of this rare hemangioma is crucial for the diagnosis and appropriate follow-up, avoiding unnecessary clinical interventions, and providing reassurance of caregivers.

Role of imaging in the diagnosis of parotid infantile hemangiomas

ObjectivesTo review the clinical presentation, imaging and follow-up of parotid infantile hemangiomas (IH). MethodsOver a 15-year period, all patients with a clinical diagnosis of parotid IH were evaluated. Imaging was available in 35. The medical records, photographs, and radiology studies of these patients were reviewed. ResultsAll patients presented at less than 4 months of age (M:F, 13:21). 19 (55)% of tumors were on the left and were bilateral in 2 patients. The majority (29 patients) presented due to localized swelling or palpable mass; the remainder had a cutaneous lesion, but no palpable mass at the time of presentation. The referring diagnosis was incomplete or incorrect in 9 patients (26%).The imaging studies all demonstrated a well-defined homogeneous mass, with no abnormality of the surrounding subcutaneous fat. Sonography showed a uniformly vascular lesion with pulsatile fast-flow seen on Doppler. On MRI, the lesion was hyperintense on T2-weighted images, isointense on T1, with intense enhancement post-contrast.Oral therapy (propranolol or corticosteroids) was prescribed in 15 (45%). Follow-up in 28 patients demonstrated stability of the lesion in 11, regression in size in 11 and complete involution in 6. After involution 2 patients underwent resection of residual tissue and/or excess skin. ConclusionsTypical clinical presentation alone may be adequate to establish a diagnosis of parotid infantile hemangioma. However, in patients with no overlying cutaneous lesion, imaging can play a critical role in confirming the diagnosis. The sonographic findings are sufficiently characteristic to allow for a definitive diagnosis, obviating the need for further investigations. If diagnostic uncertainty remains or the full extent of the lesion cannot be appreciated, then MRI should be preferred over CT to avoid ionizing radiation.