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Sample records for hemangiomas

  1. Hemangioma

    MedlinePlus

    Cavernous hemangioma; Strawberry nevus; Birthmark - hemangioma ... About one third of hemangiomas are present at birth. The rest appear in the first several months of life. The hemangioma may be: In the ...

  2. Hemangioma

    MedlinePlus

    ... scan are often described as a "bag of worms." Angiogram. In this test, dye is injected into the surrounding blood stream making the hemangioma show up in an x-ray image. This MRI image of a patient's foot clearly shows the hemangioma (arrow). Biopsy. It may be difficult to distinguish hemangiomas ...

  3. Hemangiomas

    MedlinePlus

    ... reduce the superficial component along with the steroid injection. Larger hemangiomas require oral steroids . A fairly large dose is needed but infants seem to handle this very well. Many children who are put on steroids will ...

  4. Capillary Hemangioma

    MedlinePlus

    ... Why do capillary hemangiomas on the eyelids cause vision problems? Capillary Hemangiomas of the eyelid can cause ... a capillary hemangioma in the eye socket cause vision problems? A capillary hemangioma in the eye socket ( ...

  5. Subglottic hemangioma.

    PubMed

    O-Lee, T J; Messner, Anna

    2008-10-01

    Subglottic hemangioma is a rare condition that can be potentially life threatening because of airway obstruction. It is common for subglottic hemangioma to be misdiagnosed as croup initially. Infants with a subglottic hemangioma and cutaneous facial hemangiomas in a "beard" distribution should be evaluated for PHACE syndrome. Endoscopic laser resection is effective for subglottic hemangioma but carries a chance of subglottic stenosis, up to 25%. Open excision of subglottic hemangioma is an excellent option, particularly in patients with bilateral or circumferential subglottic hemangioma. It is a more extensive surgery when compared with endoscopic laser resection. Surgeons who do not have access to a pediatric intensive care unit staffed by experienced pediatric intensivists should not use this procedure.

  6. Congenital hemangiomas.

    PubMed

    Boull, Christina; Maguiness, Sheilagh M

    2016-09-01

    Congenital hemangiomas are rare solitary vascular tumors that do not proliferate after birth. They are characterized as either rapidly involuting congenital hemangiomas (RICHs) or noninvoluting congenital hemangiomas (NICHs) based on their clinical progression. NICHs have no associated complications, but are persistent. RICH, while usually asymptomatic, may ulcerate or bleed early in their presentation, but involute quickly during the first few months of life. Hepatic RICHs are not associated with cutaneous RICHs, but may result in high-output cardiac failure due to arteriovenous or portovenous shunting. In the following review, the clinical characteristics and current management specific to congenital hemangiomas is discussed.

  7. Liver Hemangioma

    MedlinePlus

    ... Make an appointment with your doctor if you experience any persistent signs and symptoms that worry you. Causes It's not clear what causes a liver hemangioma to form. Doctors believe liver hemangiomas are congenital — meaning that you're born with them. A liver ...

  8. [Vesical hemangioma].

    PubMed

    Martín Martín, S; Muller Arteaga, C; Gonzalo Rodríguez, V; García Lagarto, E; Egea Camacho, J; Fernández del Busto, E

    2007-01-01

    Bladder hemangiomas are mesenquimal tumors, generally benign and of difficult diagnosis, representing only 0.6% primary bladder tumors. Fundamental diagnosis is histological, since imaging test can't differenciate this from other bladder tumors. We present a case of a 60-year-old male who came to our service with macroscopic hematuria. RTU of one blue mass in the bladder was performed and the histological examination showed to be cavernous hemangioma. A review of literature was realized, commenting on the most typical clinical aspects, the diagnostic methods and the last therapeutic techniques in this type of lesions.

  9. Spinal hemangiomas.

    PubMed

    Healy, M; Herz, D A; Pearl, L

    1983-12-01

    Three new cases of spinal cord compression due to vertebral hemangioma are reported. The clinical presentation, with spinal pain, radicular radiation, and paraparesis, is similar to that of primary lymphoma, metastatic tumor, and disc disease. If the characteristic plain film changes of vertical trabeculations and striations are present, the preoperative diagnosis is facilitated, but in the majority of cases these are not seen. In some instances, vertebral body or pedicle erosion is present. A myelographic epidural block will be seen on further study. Spinal arteriography can prove helpful. Surgical decompression results in marked neurological improvement if intervention takes place before the onset of complete paralysis. The authors recommend that the diagnosis of vertebral hemangioma be considered in the differential diagnosis of epidural spinal cord compression whenever considered in the differential diagnosis of epidural spinal cord compression whenever a primary malignant neoplasm cannot be identified.

  10. Hemangioma of the fingers.

    PubMed

    Kodachi, K; Kojima, T; Shimbashi, T; Furusato, M

    1990-01-01

    Fingers often suffer trauma and the clinician is continuously faced with the difficult task of clarifying the distinction between a hemangioma and a traumatic lesion. This study was undertaken to examine ten cases in which a small skin mass located on a finger had been diagnosed preoperatively as hemangioma. Our results showed that seven masses were confirmed pathologically as hemangioma (five cavernous hemangiomas and two capillary hemangiomas), two as traumatic thrombosis and one varix. The clinical manifestations of the two cases of traumatic thrombosis were related to those of hemangioma. In the varix, endothelial proliferation was observed in the area of the thrombosis. This phenomenon is called "intravascular papillary endothelial hyperplasia", and can confuse the differential diagnosis between a vascular neoplasm and a traumatic thrombosis. Our findings demonstrate that since the traumatic lesions were firmer than the hemangiomas, hardness on physical examination may be a helpful indicator in the differential diagnosis of a hemangioma and a traumatic lesion.

  11. Hemangioma excision - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100114.htm Hemangioma excision - series—Indications To use the sharing features ... Go to slide 3 out of 3 Overview Hemangiomas are the most common type of benign blood- ...

  12. Hemangioma excision (image)

    MedlinePlus

    A hemangioma is a non-cancerous (benign) growth of blood vessels. They are the most common benign blood vessel ( ... time and occasionally with medication. Large or disfiguring hemangiomas may require surgical excision.

  13. Giant calvarial cavernous hemangioma

    PubMed Central

    Verma, Satish Kumar; Singh, Pankaj Kumar; Garg, Kanwaljeet; Satyarthee, Guru Dutta; Sharma, Mehar C.; Singh, Manmohan; Sharma, Bhawani Shankar

    2015-01-01

    Though hemangiomas of the bone are quite common, calvarial (skull) cavernous hemangiomas are relatively rare pathologies. Calvarial hemangiomas are usually small and asymptomatic. However, they may occasionally grow in size to achieve large sizes and can present as a palpable swelling. We present a child with massive temporo-parieto-occipital calvarial cavernous hemangioma, who was managed with a multimodal approach with excellent cosmetic and neurologic outcome. PMID:25878743

  14. [Hemangiomas in infancy].

    PubMed

    D'Auria, E; Ballista, P; Riva, E

    2006-01-01

    Hemangiomas are the most common tumors of childhood. Although most hemangiomas remain innocuous, a significant minority may be associated with important complications. The morphology and location of a hemangioma of infancy are critically important factors in determining potential risk for complications. Ongoing research on pathogenesis will provide new opportunities for interventional and preventive therapies.

  15. Hepatic hemangioma: atypical appearance

    SciTech Connect

    Mikulis, D.J.; Costello, P.; Clouse, M.E.

    1985-07-01

    Recent reports indicate that computed tomography (CT) after bolus injection of contrast material is diagnostically specific for hemangioma, replacing the need for angiography in a high percentage of patients. The authors report a unique hepatic hemangioma that showed early diffuse intense opacification by angiography and contrast-enhanced CT.

  16. Papillary hemangiomas and glomeruloid hemangiomas are distinct clinicopathological entities.

    PubMed

    Suurmeijer, Albert J H

    2010-02-01

    The author reviews and compares the clinicopathological features of papillary hemangiomas and glomeruloid hemangiomas, 2 rare, cutaneous intravascular capillary-type vascular lesions with overlapping morphological details. Immunostaining for collagen IV highlighted discriminating features in these lesions. Thin basement membranes and glomeruloid architecture are typical of glomeruloid hemangiomas, whereas papillae with thick mantles of a basement membrane- like matrix enveloping pericytes are prominent in papillary hemangiomas. Thus, collagen IV staining patterns provide further evidence that papillary and glomeruloid hemangiomas represent distinct histopathological entities. This additional technique should allow pathologists to readily distinguish between the lesions and make a proper diagnosis. What is important is that glomeruloid hemangiomas-often presenting in a spectrum of multiple cutaneous vascular lesions, including cherry hemangiomas-are a hallmark of POEMS (acronym for polyneuropathy, oganomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome and/or multicentric Castleman's disease, whereas papillary hemangiomas clinically present as innocent solitary cutaneous hemangiomas in otherwise healthy individuals.

  17. CD105 expression in oral capillary hemangiomas and cavernous hemangiomas.

    PubMed

    Matsumoto, Naoyuki; Tsuchiya, Motomi; Nomoto, Shouta; Matsue, Yasuyoshi; Nishikawa, Yohichi; Takamura, Tsuyoshi; Oki, Hidero; Komiyama, Kazuo

    2015-03-01

    Capillary hemangioma (capillary lobular hemangioma) and cavernous hemangioma (venous malformation) are relatively common oral tumors/malformations and are characterized by increased numbers of normal and abnormal blood vessels. However, the causes of these lesions are not well understood. CD105 (endoglin) is predominantly expressed in proliferating blood endothelial cells (ECs). We analyzed expressions of CD105, CD34, von Willebrand factor, Ki-67, cyclooxygenase-2 (COX-2), and vascular endothelial growth factor (VEGF)-A in 31 capillary hemangiomas and 34 cavernous hemangiomas. Staining scores were calculated as the product of the proportion score and intensity score. Morphologically normal oral mucosa specimens (n = 10) were simultaneously evaluated as normal controls. As compared with cavernous hemangiomas and normal controls, capillary hemangiomas had higher staining scores for CD105, VEGF-A, and COX-2. The Ki-67 labeling index was significantly higher in capillary hemangiomas than in cavernous hemangiomas and normal controls (P < 0.01). These findings suggest that the biological characteristics of capillary and cavernous hemangiomas are quite different. The ECs of capillary hemangiomas actively proliferated and were generally regulated by VEGF-A. In contrast, the ECs of cavernous hemangiomas lacked proliferative activity. These results suggest that angiogenesis and vasodilatation of pre-existing blood vessels are important in the development of capillary hemangioma and cavernous hemangioma, respectively.

  18. Propranolol for infantile hemangiomas.

    PubMed

    Bagazgoitia, Lorea; Torrelo, Antonio; Gutiérrez, Juan Carlos López; Hernández-Martín, Angela; Luna, Paula; Gutiérrez, Marta; Baño, Antonio; Tamariz, Amalia; Larralde, Margarita; Alvarez, Roser; Pardo, Nuria; Baselga, Eulalia

    2011-01-01

    Propranolol has been used successfully in a limited number of children with infantile hemangiomas. This multicenter retrospective study describes the efficacy and adverse effects of propranolol in infantile hemangioma. Seventy-one infants with infantile hemangiomas were treated with oral propranolol, 1 mg/kg/12 hours, for at least 12 weeks. A photograph based severity scoring assessment was performed by five observers to evaluate efficacy, utilizing a scoring system of 10 as the original infantile hemangioma before treatment and 0 as completely normal skin. The mean of the five independent measurements was used in the analysis. Propranolol was a rapid and effective treatment for infantile hemangiomas at 4 weeks (p < 0.001), at 8 weeks (p < 0.001 compared to the 4 wks value), at 12 weeks (p < 0.05 compared to the 8 wks value), and thereafter up to 32 weeks (p < 0.01 compared to the 16 wks value). The response of infantile hemangiomas to propranolol was similar regardless of sex, age at onset of treatment, type of involvement (segmental and nonsegmental), facial segments affected, special locations (eyelid, nasal tip, and parotid region), ulceration, and depth of infantile hemangiomas. Very few side effects were reported; mainly agitated sleep in 10 of 71 patients. In the series of patients in this study, oral propranolol 2 mg/kg/day was a well-tolerated and effective treatment for infantile hemangiomas. Prospective studies are needed to establish the exact role of propranolol in the treatment of infantile hemangiomas. © 2011 Wiley Periodicals, Inc.

  19. Guide to Understanding Hemangiomas

    MedlinePlus

    ... treatment options that will limit the growth and speed the resolution of a hemangioma during its early ... usually the preferred diagnostic test (rather than a CT scan or ultrasound). The MRI will give the ...

  20. Birthmarks and Hemangiomas

    MedlinePlus

    ... pediatrician may need to conduct further tests. Port Wine Stains Port wine stains are flat malformations of small blood vessels, ... although they may occur anywhere. Unlike hemangiomas, port wine stains don’t go away, although they sometimes ...

  1. Cardiac Cavernous Hemangioma Coexisting With Pulmonary Cavernous Hemangiomas and Giant Hepatic Hemangioma.

    PubMed

    Wang, Chunping; Chen, Hao; Sun, Lin; Mei, Yunqing

    2017-02-01

    We describe a case of cardiac cavernous hemangioma with coexisting pulmonary cavernous hemangiomas and hepatic hemangioma. A 35-year-old woman who had previously received a living donor liver transplant to cure giant hepatic hemangioma was seen because of chest pain. A cardiac neoplasm and multiple pulmonary nodules were detected. The tumor was surgically removed, and biopsy specimens were taken from the lung nodules. Histopathologic examination confirmed that both lesions were cavernous hemangiomas. The patient was discharged without adverse events postoperatively. Cardiac hemangioma is an extremely rare entity; the present case is unique for its multiorgan involvement. Suspicion of this entity should be aroused if the imaging manifestation suggests a vascular nature.

  2. Hepatic hemangioma -review-.

    PubMed

    Bajenaru, N; Balaban, V; Săvulescu, F; Campeanu, I; Patrascu, T

    2015-01-01

    Hepatic hemangiomas are benign tumors of the liver consisting of clusters of blood-filled cavities, lined by endothelial cells, fed by the hepatic artery. The vast majority of HH are asymptomatic, most often being discovered incidentally during imaging investigations for various unrelated pathologies. Typical hemangiomas, the so-called capillary hemangiomas, range from a few mm to 3 cm, do not increase in size over time and therefore are unlikely to generate future symptomatology. Small (mm-3 cm) and medium (3 cm-10 cm) hemangiomas are well-defined lesions, requiring no active treatment beside regular follow-ups. However, the so-called giant liver hemangiomas, of up to 10 cm (most commonly) and even 20+ cm in size (according to occasional reports) can, and usually will develop symptoms and complications that require prompt surgical intervention or other kind of therapy. HH belong to the class of hepatic "incidentalomas", so-called because they are diagnosed incidentally, on imaging studies performed as routine examinations or for other reasons than the evaluation of a possible liver mass. Less than half of HH present with overt clinical symptoms, consisting, most often, of upper abdominal pain (this is usually the case for large lesions, which cause the distension of Glisson's capsule). Hepatic hemangiomas require a careful diagnosis to differentiate from other focal hepatic lesions, co-occurring diagnoses are also possible.

  3. Management of nasal hemangiomas.

    PubMed

    Hochman, Marcelo; Mascareno, Alfredo

    2005-01-01

    Infantile hemangiomas commonly involve the nose. Because of the nose's prominence as an aesthetically and functionally sensitive area, management of these lesions has important implications. The available options including medical therapy, lasers, and surgery are reviewed with recommendations specific to nasal tip and lobule lesions based on the senior author's (M.H.) experience.

  4. Cardiac cavernous hemangioma and multiple pulmonary cavernous hemangiomas.

    PubMed

    Yang, Lili; Dai, Jun; Xiao, Ying; Cheng, Henghui; Ruan, Qiurong

    2014-02-01

    We describe for the first time a rare coexistence of a cardiac cavernous hemangioma with multiple pulmonary cavernous hemangiomas. Computed tomography revealed bilateral pulmonary nodules, left pleural effusion, and pericardial effusion. Positron emission tomography showed a pericardial neoplasm. Pathologically, multiple large dilated vascular spaces, lined by a single layer of endothelial cells and filled with blood, were revealed in both the cardiac tumor and the pulmonary nodules. Immunohistochemical examination of the lining cells showed positivity for CD31, FLI1, FVIII, and CD34. Taken together, these findings led to the diagnosis of cardiac cavernous hemangioma and multiple pulmonary cavernous hemangiomas.

  5. Targetoid hemosiderotic hemangioma - Case report*

    PubMed Central

    Kakizaki, Priscila; Valente, Neusa Yuriko Sakai; Paiva, Daniele Loureiro Mangueira; Dantas, Fernando Luiz Teixeira; Gonçalves, Sheila Viana Castelo Branco

    2014-01-01

    Targetoid Hemosiderotic Hemangioma, also known as Hobnail Hemangioma, is a lesion of vascular origin, probably lymphatic. The most common clinical feature is a solitary violaceous papule surrounded by a pale, thin area and a peripheral ecchymotic ring, simulating a target. Histopathologically, there is a biphasic pattern, with dilated vessels in the superficial dermis and pseudoangiosarcomatous pattern in the deep dermis, and endothelial cells with hobnail morphology. A simple excision is curative. We report a rare case of Targetoid Hemosiderotic Hemangioma. PMID:25387500

  6. Glomeruloid Hemangioma in Normal Individuals

    PubMed Central

    Gupta, Jyoti; Kandhari, Rajat; Ramesh, V; Singh, Avninder

    2013-01-01

    Glomeruloid hemangioma is a rare, histologically distinctive, cutaneous, benign vascular tumor, originally described by Chan et al. Glomeruloid hemangioma appears specific to polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome (POEMS), and is usually, but not always, related to Castleman's disease. We herein report two cases with glomeruloid hemangioma, without any features of the POEMS syndrome. Glomeruloid hemangioma requires a high index of suspicion for diagnosis. It could rarely present as a solitary finding, without any evidence of an underlying POEMS syndrome. PMID:23716835

  7. Prospective study of the frequency of hepatic hemangiomas in infants with multiple cutaneous infantile hemangiomas.

    PubMed

    Horii, Kimberly A; Drolet, Beth A; Frieden, Ilona J; Baselga, Eulalia; Chamlin, Sarah L; Haggstrom, Anita N; Holland, Kristen E; Mancini, Anthony J; McCuaig, Catherine C; Metry, Denise W; Morel, Kimberly D; Newell, Brandon D; Nopper, Amy J; Powell, Julie; Garzon, Maria C

    2011-01-01

    Multiple cutaneous infantile hemangiomas have been associated with hepatic hemangiomas. Screening of infants with five or more cutaneous infantile hemangiomas with abdominal ultrasound is often recommended. The aim of this study was to determine the frequency with which hepatic hemangiomas occur in infants with five or more cutaneous infantile hemangiomas compared to those with one to four cutaneous infantile hemangiomas and to characterize the clinical features of these hepatic hemangiomas. A multicenter prospective study of children with cutaneous infantile hemangiomas was conducted at pediatric dermatology clinics at Hemangioma Investigator Groups sites in the United States, Canada, and Spain between October 2005 and December 2008. Data were collected, and abdominal ultrasonography was performed on infants younger than 6 months old with five or more cutaneous infantile hemangiomas and those with one to four cutaneous infantile hemangiomas. Twenty-four (16%) of the 151 infants with five or more cutaneous infantile hemangiomas had hepatic hemangiomas identified on abdominal ultrasound, versus none of the infants with fewer than five (p = 0.003). Two of the 24 infants with hepatic hemangiomas received treatment specifically for their hepatic hemangiomas. Infants with five or more cutaneous infantile hemangiomas have a statistically significantly greater frequency of hepatic hemangiomas than those with fewer than 5. These findings support the recommendation of five or more cutaneous infantile hemangiomas as a threshold for screening infants younger than 6 months old for hepatic hemangiomas but also demonstrate that the large majority of these infants with hepatic hemangiomas do not require treatment.

  8. Signaling mechanisms in infantile hemangioma

    PubMed Central

    Boye, Eileen; Olsen, Bjorn R.

    2010-01-01

    Purpose of review Infantile hemangioma is a common vascular tumor with a unique lifecycle: rapid growth in infancy, followed by a period of involution, leading to complete regression. This review summarizes recent studies of molecular mechanisms of hemangioma formation and places new findings and hypotheses in the context of past accomplishments. Recent findings The new work identifies a novel signaling pathway for vascular growth factor and extracellular matrix regulation in vascular endothelial cells and provides a basis for novel therapeutic strategies. In hemangioma-derived endothelial cells defects in a vascular endothelial growth factor receptor/integrin complex reduce the expression of a vascular endothelial growth factor decoy receptor. As a consequence, hemangioma endothelial cells exhibit constitutive vascular endothelial growth factor signaling. Germ-line mutations in components of the growth factor receptor/integrin complex in some hemangioma patients, and somatic mutations in a phosphatase in sporadic hemangioma specimens, raise the possibility that hemangioma formation involves a combination of germline risk factor mutations and somatic mutations, similar to what recent studies have shown is the case for venous malformations. Summary Alterations in pathways that negatively control vascular endothelial growth factor signaling in vascular endothelial cells are responsible for the formation and rapid growth of infantile hemangiomas. PMID:19367160

  9. Scrotal Hemangioma: A Case Report

    PubMed Central

    Javalgi, Anita P

    2014-01-01

    We report a case of scrotal-hemangioma in a 14-year-old boy. Subcutaneous scrotal-perineal hemangioma may mimic an inguinal hernia, thus forming a diagnostic and therapeutic challenge. Histopathological study confirms the diagnosis. Definitive treatment by en bloc excision is recommended PMID:25653989

  10. Thyroid hemangiomas diagnosed on sonography.

    PubMed

    Park, Sung Hee; Kim, Soo Jin; Jung, Hyun Kyung

    2014-04-01

    Primary thyroid hemangiomas are extremely rare, and only a few cases have been previously reported. Primary hemangiomas are developmental anomalies resulting from the inability of the angioblastic mesenchyme to form canals. Thyroid hemangiomas are generally considered difficult to diagnose preoperatively because of their low incidence and nonspecific imaging findings. Here we report 2 cases of thyroid hemangiomas that were diagnosed correctly on preoperative sonography. Our cases showed similar sonographic findings, such as well-circumscribed hypoechoic lesions with internal channel-like linear lines, and bloody content was aspirated during fine-needle aspirations. Our report shows that thyroid hemangiomas can be diagnosed correctly by sonography with or without confirmation of bloody content in the lesions by fine-needle aspiration.

  11. Unusual intraosseous capillary hemangioma of the mandible.

    PubMed

    Dereci, Omur; Acikalin, Mustafa Fuat; Ay, Sinan

    2015-01-01

    Intraosseous hemangioma is a benign vascular neoplasm, which is mostly seen in vertebrae, maxillofacial bones, and long bones. Intraosseous hemangioma is rarely seen on jaw bones compared to other skeletal bones and usually occurs in the cavernous form. Capillary intraosseous hemangioma of jaws is an uncommon form of intraosseous hemangioma and has not been thoroughly described so far. In this study, a case of capillary intraosseous hemangioma of the mandible was presented with relevant literature review.

  12. Infantile Hemangioma: A Brief Review

    PubMed Central

    BOTA, MADALINA; POPA, GHEORGHE; BLAG, CRISTINA; TATARU, ALEXANDRU

    2015-01-01

    Infantile hemangiomas as frequent infancy tumors have been a controversial issue of medical scientists worldwide. Their clinical aspects are various and their physiopathology is yet to be fully understood. Numerous publications outline the characteristics, causes, evolution possibilities and therapeutic approaches. Deciding whether to treat or not is the main question of this kind of pathology. Hemangiomas that have complications or can cause irreversible damage need therapy. This is a brief review of up-to-date information regarding the presentation of infantile hemangiomas and target-therapies. PMID:26528043

  13. Hemangioma of the Zygomatic Bone.

    PubMed

    Aykan, Andaç; Keleş, Musa Kemal; Bayram, Yalçin; Çiçek, Ali Fuat; Uysal, Yusuf; Sanal, Hatice Tuba; Zor, Fatih

    2016-03-01

    Benign masses arising from facial bones have been reported several times in the literature. Hemangiomas are one of the uncommon benign tumors. In this study, the authors aimed to present a rare patient of zygomatic intraosseos hemangioma and their management. A 40-year-old woman with a mass in her left lateral cantus admitted to our clinic. Preoperative computed tomography and magnetic resonance imaging revealed an osseos mass in her left zygoma. The authors conclude that it should be kept in mind that although they are very rare benign tumors, intraosseos hemangiomas can cause facial masses. Meticulous radiologic examination can give important clues for differential diagnosis before the surgery.

  14. Spinal cord compression due to vertebral hemangioma.

    PubMed

    Aksu, Gorkem; Fayda, Merdan; Saynak, Mert; Karadeniz, Ahmet

    2008-02-01

    This article presents a case of multiple vertebral hemangiomas in a 58-year-old man with pain in the dorsal region and bilateral progressive foot numbness. Magnetic resonance imaging revealed multiple vertebral hemangiomas. One hemangioma at the T7 level demonstrated epidural extension, causing spinal cord compression. After treatment with radiotherapy, the patient's symptoms improved significantly.

  15. Hemangioma of the buccal fat pad

    PubMed Central

    Hassani, Ali; Saadat, Sarang; Moshiri, Roya; Shahmirzadi, Solaleh

    2014-01-01

    Hemangiomas are benign vascular neoplasms characterized by an abnormal proliferation of blood vessels. Buccal fat pad (BFP) is a rare place for hemangioma. In this report, clinical, radiographic, and histopathological findings are described in a rare case of hemangioma with phleboliths involving the BFP, and a review is made of the international literature on this subject. PMID:24963256

  16. Sclerotherapy of Intraoral Superficial Hemangioma

    PubMed Central

    Perjuci, Feriall; Gashi, Ali; Agani, Zana; Ahmedi, Jehona

    2016-01-01

    Hemangioma is the clinical term for a benign vascular neoplasm due to proliferation of the endothelial lining of blood vessels. Their most frequent location is the body skin and oral mucosa. One of the treatment modalities for hemangiomas is intralesional injection of sclerosing agents which cause the damage of blood vessels followed by their obliteration. The objective of the study was to describe the facility of application and evaluate the efficiency of sclerotherapy with aethoxysklerol 1%. Method. The case presented with intraoral submucosal hemangioma of the cheek was treated by intralesional injection of aethoxysklerol 3% diluted in water for injections at a 4 : 1 ratio (0.75%) at the first appointment and 3 : 1 (1%) at the second appointment. The effect of sclerotherapy was evaluated on the following visits in time intervals of two weeks. Results. The hemangioma disappeared without complications after the second injection of aethoxysklerol 1%. The successful results of the study were comparable to the data of literature with variations according to the used sclerosant agent, its concentration, the number of injections, and the intervals between each session. Conclusion. Since sclerotherapy is a very effective, inexpensive, and easy-to-apply treatment, it should be the treatment of choice, especially for intraoral superficial hemangiomas. PMID:27994889

  17. Bladder cavernous hemangioma. Case report.

    PubMed

    Rodriguez Collar, Tomás Lázaro; Casa de Valle Castro, Midalys; Báez Sarría, Felix; Trujillo Fernández, Reinerio

    2014-07-01

    To report a case of a bladder cavernous hemangioma, as well as the main features of its diagnosis and treatment. A 74 year old patient, regular smoker, presented with total macroscopic hematuria of moderate intensity with large rounded clots. On physical examination the patient's mucous membranes color was normal, and digital rectal examination showed a normal size prostate with fibroelastic consistency. An abdominal ultrasound was performed showing a slight bladder bottom thickening in addition to free clots and a homogeneous and normal prostate. Cystoscopy confirmed the presence of a sessile violet-colored rounded retrotrigonal tumor, 2 cm in diameter and 0.5 in height; it was immediately resected. The pathological study reported cavernous hemangioma. Patient's evolution has been satisfactory. Bladder cavernous hemangioma is a rare cause of hematuria, and transurethral resection of the small size lesions constitutes an effective option as a definitive surgical treatment.

  18. Symptomatic vertebral hemangiomas during pregnancy.

    PubMed

    Moles, Alexis; Hamel, Olivier; Perret, Christophe; Bord, Eric; Robert, Roger; Buffenoir, Kevin

    2014-05-01

    Symptomatic vertebral hemangiomas during pregnancy are rare, as only 27 cases have been reported in the literature since 1948. However, symptomatic vertebral hemangiomas can be responsible for spinal cord compression, in which case they constitute a medical emergency, which raises management difficulties in the context of pregnancy. Pregnancy is a known factor responsible for deterioration of these vascular tumors. In this paper, the authors report 2 clinical cases of symptomatic vertebral hemangiomas during pregnancy, including 1 case of spontaneous fracture that has never been previously reported in the literature. The authors then present a brief review of the literature to discuss emergency management of this condition. The first case was a 28-year-old woman at 35 weeks of gestation, who presented with paraparesis. Spinal cord MRI demonstrated a vertebral hemangioma invading the body and posterior arch of T-3 with posterior epidural extension. Laminectomy and vertebroplasty were performed after cesarean section, allowing neurological recovery. The second case involved a 35-year-old woman who presented with spontaneous fracture of T-7 at 36 weeks of gestation, revealing a vertebral hemangioma with no neurological deficit, but it was responsible for pain and local instability. Treatment consisted of postpartum posterior interbody fusion. With a clinical and radiological follow-up of 2 years, no complications and no modification of the hemangiomas were observed. A review of the literature reveals discordant management of these rare cases, which is why the treatment course must be decided by a multidisciplinary team as a function of fetal gestational age and maternal neurological features.

  19. Biology of Infantile Hemangioma

    PubMed Central

    Itinteang, Tinte; Withers, Aaron H. J.; Davis, Paul F.; Tan, Swee T.

    2014-01-01

    Infantile hemangioma (IH), the most common tumor of infancy, is characterized by an initial proliferation during infancy followed by spontaneous involution over the next 5–10 years, often leaving a fibro-fatty residuum. IH is traditionally considered a tumor of the microvasculature. However, recent data show the critical role of stem cells in the biology of IH with emerging evidence suggesting an embryonic developmental anomaly due to aberrant proliferation and differentiation of a hemogenic endothelium with a neural crest phenotype that possesses the capacity for endothelial, hematopoietic, mesenchymal, and neuronal differentiation. Current evidence suggests a putative placental chorionic mesenchymal core cell embolic origin of IH during the first trimester. This review outlines the emerging role of stem cells and their interplay with the cytokine niche that promotes a post-natal environment conducive for vasculogenesis involving VEGFR-2 and its ligand VEGF-A and the IGF-2 ligand in promoting cellular proliferation, and the TRAIL-OPG anti-apoptotic pathway in preventing cellular apoptosis in IH. The discovery of the role of the renin–angiotensin system in the biology of IH provides a plausible explanation for the programed biologic behavior and the β-blocker-induced accelerated involution of this enigmatic condition. This crucially involves the vasoactive peptide, angiotensin II, that promotes cellular proliferation in IH predominantly via its action on the ATIIR2 isoform. The role of the RAS in the biology of IH is further supported by the effect of captopril, an ACE inhibitor, in inducing accelerated involution of IH. The discovery of the critical role of RAS in IH represents a novel and fascinating paradigm shift in the understanding of human development, IH, and other tumors in general. PMID:25593962

  20. Myeloid Cells in Infantile Hemangioma

    PubMed Central

    Ritter, Matthew R.; Reinisch, John; Friedlander, Sheila Fallon; Friedlander, Martin

    2006-01-01

    Little is known about the pathogenesis of infantile hemangiomas despite the fact that they are relatively common tumors. These benign neoplasms occur in as many as 1 in 10 births, and although rarely life threatening, hemangiomas can pose serious concerns to the cosmetic and psychosocial development of the afflicted child. Ulceration, scarring, and disfigurement are significant problems as are encroachment of the ear and eye, which can threaten hearing and vision. The precise mechanisms controlling the rapid growth observed in the first months of life and the spontaneous involution that follows throughout the course of years remain unknown. In this report we demonstrate the presence of large numbers of hematopoietic cells of the myeloid lineage in proliferating hemangiomas and propose a mechanism for the observed evolution of these lesions that is triggered by hypoxia and involves the participation of myeloid cells. We report the results of experiments using myeloid markers (CD83, CD32, CD14, CD15) that unexpectedly co-labeled hemangioma endothelial cells, providing new evidence that these cells are distinct from normal endothelium. PMID:16436675

  1. Neonatal Abdominal Hemangiomatosis: Propranolol beyond Infantile Hemangioma.

    PubMed

    Nip, Siu Ying Angel; Hon, Kam Lun; Leung, Wing Kwan Alex; Leung, Alexander K C; Choi, Paul C L

    2016-01-01

    Hemangioma is the most common vascular tumor of infancy; presentation is often as cutaneous infantile hemangioma (IH). Cutaneous hemangioma is a clinical diagnosis. Most IHs follow a benign course, with complete involution without treatment in the majority of cases. Visceral hemangioma often involves the liver and manifests as a life-threatening disorder. Hepatic hemangiomas may be associated with high output cardiac failure, coagulopathy, and hepatomegaly which generally develop between 1 and 16 weeks of age. Mortality has been reportedly high without treatment. We report a rare case of a male infant with neonatal hemangiomatosis with diffuse peritoneal involvement, which mimicked a malignant-looking tumor on imaging, and discuss therapeutic options and efficacy. Propranolol is efficacious for IH but generally not useful for other forms of vascular hemangiomas, tumors, and malformations. In our case of neonatal peritoneal hemangiomatosis, propranolol appears to have halted the growth and possibly expedite the involution of the hemangiomatosis without other treatments.

  2. [Aggressive vertebral hemangiomas: optimization of management tactics].

    PubMed

    Kravtsov, M N; Manukovskiĭ, V A; Zharinov, G M; Kandyba, D V; Tsibirov, A A; Savello, A V; Svistov, D V

    2012-01-01

    Today vertebral hemangioma is not completely understood entity, neither its pathogenesis nor optimal treatment is determined. Nowadays in majority of clinics in this country ineffective radiotherapy remains the first-line treatment. We analyzed results of treatment of 205 patients (286 lesions) with aggressive hemangiomas operated in Department of Neurosurgery of Military Medical Academy and Department of Nuclear Medicine of of Russian Scientific Center of Radiological and Surgical Technologies (Saint-Petersburg, Russia) since 1999 till 2009. Percutaneus vertebroplasty was performed in 167 lesions, radiotherapy was applied in 119 aggressive hemangiomas. Vertebroplasty is more effective for treatment of aggressive hemangiomas in comparison with radiotherapy. Signs of hemangiomas aggression, indications for surgery, and tactics of management were determined. Use of percutaneous vertebroplasty for treatment of aggressive hemangiomas resulted in fast recovery of the patients. This procedure is minimally invasive, it reduces hospital stay and duration of recovery.

  3. Arterial Embolization of Giant Hepatic Hemangiomas

    SciTech Connect

    Giavroglou, Constantinos; Economou, Hippolete; Ioannidis, Ioannis

    2003-02-15

    Hepatic cavernous hemangiomas are usually small and asymptomatic. They are usually discovered incidentally and only a few require treatment. However, giant hemangiomas may cause symptoms,which are indications for treatment. We describe four cases of symptomatic giant hepatic hemangiomas successfully treated with transcatheter arterial embolization, performed with polyvinyl alcohol particles. There were no complications. Follow-up with clinical and imaging examinations showed disappearance of symptoms and decrease in size of lesions.

  4. An aesthetic approach to facial hemangiomas.

    PubMed

    Batniji, Rami K; Buckingham, Edward D; Williams, Edwin F

    2005-01-01

    Hemangiomas are the most common tumor of infancy and childhood, affecting approximately 10% of infants by the age of 1 year. The diagnosis can nearly always be made by the patient's history and findings on physical examination. Prior to the classification system outlined by Mulliken and Glowacki, the natural course of hemangiomas was poorly understood and treatment was inconsistent, ranging from benign neglect to deforming surgical intervention. However, with an improved understanding of the natural course of hemangiomas, as well as advances in anesthesia, laser technology, medical therapy, and surgical methods, an aesthetic approach to facial hemangiomas was developed by the senior author (E.F.W.) and is reviewed in this article.

  5. Aggressive hemangioma of the thoracic spine.

    PubMed

    Schrock, Wesley B; Wetzel, Raun J; Tanner, Stephanie C; Khan, Majid A

    2011-01-01

    Vertebral hemangiomas are common lesions and usually considered benign. A rare subset of them, however, are characterized by extra-osseous extension, bone expansion, disturbance of blood flow, and occasionally compression fractures and thereby referred to as aggressive hemangiomas. We present a case of a 67-year-old woman with progressive paraplegia and an infiltrative mass of T4 vertebra causing mass effect on the spinal cord. Multiple conventional imaging modalities were utilized to suggest the diagnosis of aggressive hemangioma. Final pathologic diagnosis after decompressive surgery confirmed the diagnosis of an osseous hemangioma.

  6. Glomeruloid hemangioma and POEMS syndrome.

    PubMed

    Hernández Aragüés, I; Pulido Pérez, A; Ciudad Blanco, C; Parra Blanco, V; Suárez Fernández, R

    2017-03-01

    POEMS syndrome is a paraneoplastic manifestation associated with hematopoietic disorders such as multiple myeloma and Castleman disease. POEMS is an acronym for the main clinical features of the syndrome, namely, Polyneuropathy, Organomegaly, Endocrinopathy, M protein, and Skin abnormalities. Glomeruloid hemangiomas are considered to be a specific clinical marker of POEMS syndrome. However, while they are not pathognomonic, their presence should raise suspicion of this syndrome or alert clinicians to its possible future development, as these lesions can appear years before the onset of the syndrome. We report the cases of 2 women with plasma cell dyscrasias and sudden onset of lesions with a vascular appearance and histologic findings consistent with glomeruloid hemangioma. Recognition of this vascular tumor is important for the early diagnosis of POEMS syndrome. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Verrucous Hemangioma Treated with Electrocautery

    PubMed Central

    Fatani, Mohammad; Al Otaibi, Homaid; Mohammed, Muath; Hegazy, Osama

    2016-01-01

    Verrucous hemangioma is a rare vascular malformation consisting of a proliferation of dilated blood vessels of different sizes that occupy the dermis and hypodermis. The epidermis of the affected area shows a strong proliferative reaction that presents as a warty appearance. Here, we report the case of a 17-year-old male who presented with an asymptomatic warty growth above the lateral malleolus on the right leg, which healed after electrocautery. PMID:27462218

  8. [Spasmodic torticollis and vertebral hemangioma].

    PubMed

    Durán, E; Chacón, J R

    Spasmodic torticollis in young patients should give rise to a clinical suspicion that this is secondary to another primary disorder. Therefore a series of diagnostic tests should be carried out before it is labelled as idiopathic. The patient was a thirty year old man who had had difficulty in writing with his right hand since childhood. At the age of 20 years he was diagnosed as having writer's cramp and idiopathic spasmodic torticollis. On general physical examination no abnormalities were found. On neurological examination he had: absence of reflexes of both arms, limited but painless rotation of the neck towards the left and hypertrophy of the left trapezius muscle. Laboratory, neurophysiological and neuroimaging investigations seeking a secondary cause for the torticollis were all normal. There were no Keyser-Fleischer rings. Chest X-ray showed, dorsal scoliosis with convexity to the left. CAT and MR of the spine showed a hemangioma in the body of T1. On arteriography of the supra-aortic and vertebral trunks a hemangioma was found at T1 which received contrast material via a branch of the right thyro-bi-cervico-scapular trunk. Various treatments were tried (diazepam, Botox, Dysport, tetrabenazine, baclofen, etc.) with no improvement. A definite diagnosis of secondary torticollis could not be made since the hemangioma was supplied by a very narrow vascular pedicle, so embolization was contraindicated. Cervical spinal cord alterations may cause focal dystonia due to increased excitability of the spinal motor neurone, due to dysfunction of the disinhibitory descending reciprocal paths.

  9. Dorsal spinal epidural cavernous hemangioma.

    PubMed

    Sanghvi, Darshana; Munshi, Mihir; Kulkarni, Bijal; Kumar, Abhaya

    2010-07-01

    A 61-year-old female patient presented with diffuse pain in the dorsal region of the back of 3 months duration. The magnetic resonance imaging showed an extramedullary, extradural space occupative lesion on the right side of the spinal canal from D5 to D7 vertebral levels. The mass was well marginated and there was no bone involvement. Compression of the adjacent thecal sac was observed, with displacement to the left side. Radiological differential diagnosis included nerve sheath tumor and meningioma. The patient underwent D6 hemilaminectomy under general anesthesia. Intraoperatively, the tumor was purely extradural in location with mild extension into the right foramina. No attachment to the nerves or dura was found. Total excision of the extradural compressing mass was possible as there were preserved planes all around. Histopathology revealed cavernous hemangioma. As illustrated in our case, purely epidural hemangiomas, although uncommon, ought to be considered in the differential diagnosis of spinal epidural soft tissue masses. Findings that may help to differentiate this lesion from the ubiquitous disk prolapse, more common meningiomas and nerve sheath tumors are its ovoid shape, uniform T2 hyperintense signal and lack of anatomic connection with the neighboring intervertebral disk or the exiting nerve root. Entirely extradural lesions with no bone involvement are rare and represent about 12% of all intraspinal hemangiomas.

  10. Dorsal spinal epidural cavernous hemangioma

    PubMed Central

    Sanghvi, Darshana; Munshi, Mihir; Kulkarni, Bijal; Kumar, Abhaya

    2010-01-01

    A 61-year-old female patient presented with diffuse pain in the dorsal region of the back of 3 months duration. The magnetic resonance imaging showed an extramedullary, extradural space occupative lesion on the right side of the spinal canal from D5 to D7 vertebral levels. The mass was well marginated and there was no bone involvement. Compression of the adjacent thecal sac was observed, with displacement to the left side. Radiological differential diagnosis included nerve sheath tumor and meningioma. The patient underwent D6 hemilaminectomy under general anesthesia. Intraoperatively, the tumor was purely extradural in location with mild extension into the right foramina. No attachment to the nerves or dura was found. Total excision of the extradural compressing mass was possible as there were preserved planes all around. Histopathology revealed cavernous hemangioma. As illustrated in our case, purely epidural hemangiomas, although uncommon, ought to be considered in the differential diagnosis of spinal epidural soft tissue masses. Findings that may help to differentiate this lesion from the ubiquitous disk prolapse, more common meningiomas and nerve sheath tumors are its ovoid shape, uniform T2 hyperintense signal and lack of anatomic connection with the neighboring intervertebral disk or the exiting nerve root. Entirely extradural lesions with no bone involvement are rare and represent about 12% of all intraspinal hemangiomas. PMID:21572634

  11. Quiescent Volcano-Chest Wall Hemangioma.

    PubMed

    Saldanha, Elroy; Martis, John J S; Kumar, B Vinod; D'Cunha, Rithesh J; Vijin, V

    2017-08-01

    Chest wall hemangiomas are rare tumors that may originate within the soft tissue or from the ribs. Intramuscular hemangioma is infrequent, representing less than 1 % of all hemangiomas, and the localization in the chest wall is even less frequent. They are typically cutaneous in location, large, and poorly circumscribed and can be locally destructive. We present a case of a 34-year-old lady presented with firm lump 3 × 3 cm in left upper and inner quadrant of left breast well defined borders, non-pulsatile and restricted mobility. Sono-mammogram was suggestive of ill-defined lesion at 10 o'clock position. CT chest was conclusive of chest wall hemangioma. The patient underwent excision of the lump. HPE was suggestive of cavernous hemangioma. Cavernous hemangioma typically manifest at birth or before the age of 30 years. CT is more sensitive than plain radiography in detecting phleboliths, which are present in approximately 30 % of cavernous hemangiomas. Surgical excision would be treatment of choice. In this case, the site of the lesion was in the breast clinically mimicking that of a fibroadenoma which warrants hemangioma as a differential diagnosis.

  12. Maxillary sinus hemangioma: MR and CT studies.

    PubMed

    Kulkarni, M V; Bonner, F M; Abdo, G J

    1989-01-01

    A maxillary sinus hemangioma was detected as an incidental finding during magnetic resonance imaging of the head. The CT findings are more characteristic for the diagnosis of this lesion. Preoperative diagnosis of maxillary sinus hemangioma is important since these lesions can frequently cause a large amount of hemorrhage during surgery.

  13. Tufted hemangioma: clinical case and literature review

    PubMed Central

    Kazlouskaya, Viktoryia; Lytvynenko, Bohdan; Blochin, Elen

    2014-01-01

    Tufted hemangiomas are relatively rare benign vascular proliferations that are congenital or appear during the first years of life. Herein we present an additional case of tufted hemangioma that appeared one year after birth and discuss its histopathological criteria and differential diagnosis with malignant vascular proliferations including sarcoma Kaposi, angiosarcoma and kaposiform hemangioendothelioma. PMID:24855571

  14. Management of giant liver hemangiomas: an update.

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2013-03-01

    Liver hemangiomas are the most common benign liver tumors and are usually incidental findings. Liver hemangiomas are readily demonstrated by abdominal ultrasonography, computed tomography or magnetic resonance imaging. Giant liver hemangiomas are defined by a diameter larger than 5 cm. In patients with a giant liver hemangioma, observation is justified in the absence of symptoms. Surgical resection is indicated in patients with abdominal (mechanical) complaints or complications, or when diagnosis remains inconclusive. Enucleation is the preferred surgical method, according to existing literature and our own experience. Spontaneous or traumatic rupture of a giant hepatic hemangioma is rare, however, the mortality rate is high (36-39%). An uncommon complication of a giant hemangioma is disseminated intravascular coagulation (Kasabach-Merritt syndrome); intervention is then required. Herein, the authors provide a literature update of the current evidence concerning the management of giant hepatic hemangiomas. In addition, the authors assessed treatment strategies and outcomes in a series of patients with giant liver hemangiomas managed in our department.

  15. The role of embolization for hemangiomas.

    PubMed

    Mavrogenis, Andreas F; Rossi, Giuseppe; Calabrò, Teresa; Altimari, Guglielmo; Rimondi, Eugenio; Ruggieri, Pietro

    2012-08-01

    We retrospectively studied 31 patients with painful bone (15 patients) and soft-tissue (16 patients) hemangiomas treated with 39 embolizations using N-2-butyl cyanoacrylate from 2003 to 2010. The mean tumor size before embolization was 6 cm for bone and 7 cm for soft-tissue hemangiomas. The technique of embolization was the same for bone and soft-tissue lesions. Preoperative embolization was done in six patients, while the remaining patients had embolization as only treatment. The mean follow-up was 47 months (11-89 months). The clinical and imaging effect of treatment was evaluated at follow-up with a pain score scale, tumor size, and ossification. In four patients, embolization was not feasible because of the inability to catheterize and low blood flow of the feeding vessels. Nine patients with bone and 10 with soft-tissue hemangiomas experienced complete pain relief. Four patients with bone and four with soft-tissue hemangiomas experienced recurrence of pain and were treated with repeat embolization. Re-recurrences were not observed in any of the patients with soft-tissue hemangiomas until the period of this study. Ossification and tumor size reduction were higher for bone hemangiomas. Embolization-related complications were more common for soft-tissue hemangiomas.

  16. Radiation therapy communication: equine hemangioma.

    PubMed

    Kleiter, Miriam; Velde, Karsten; Hainisch, Edmund; Auer, Ulrike; Reifinger, Martin

    2009-01-01

    A 13-month-old Standardbred Colt had a recurrent hemangioma at the level of the coronary band. Multiple excisions had led to a nonhealing skin and hoof defect. Using 14 MV electrons, a total dose of 36 Gy was administered, given as six fractions of 6 Gy twice a week. Wound healing by second intention was achieved over the next 4 months and the colt began race training 6 months after the end of therapy. Twenty months later the colt is sound and there is no evidence of tumor recurrence.

  17. Intramedullary spindle cell hemangioma: case report.

    PubMed

    Nasser, Rani; Ashayeri, Kimberly; Legatt, Alan D; Houten, John K

    2016-09-01

    The authors describe the case of a 48-year-old man found to have the first reported intramedullary spinal cord spindle cell hemangioma. Previous research indicates that spindle cell hemangiomas are rarely found in the spine. Only 3 previous cases exist, all in the intradural, extramedullary space. In the present case, gross-total resection of the tumor was possible with no loss of function from baseline. This report presents the successful resection of the first reported intramedullary spindle cell hemangioma and reports 4-month follow-up, demonstrating the biological behavior of this rare tumor.

  18. Extra-Axial Cavernous Hemangioma

    PubMed Central

    Kanaan, Imad; Jallu, Ashraf; Alwatban, Jehad; Patay, Zoltan; Hessler, Richard

    2001-01-01

    Two patients with extra-axial cavernous hemangioma who presented with headache and oculovisual disturbances were investigated with computed tomography and magnetic resonance imaging. The lesions masqueraded as basal meningioma, but this diagnosis was not supported by magnetic resonance spectroscopy in one patient. Cerebral angiography with embolization was indicated in one patient, but embolization was not justified in the other. Both patients underwent a pterional craniotomy. The lesions were extradural and highly vascular, necessitating excessive transfusion in one patient in whom gross total resection was achieved, and precluding satisfactory removal in the other. There was no mortality. Transient ophthalmoplegia, the only complication in one patient, was due to surgical manipulation of the cavernous sinus; it resolved progressively over 3 months. Extra-axial skull base cavernous hemangiomas are distinct entities with clinical and radiological characteristics that differ from those of intraparenchymal cavernous malformations. They can mimic meningiomas or pituitary tumors. In some cases, magnetic resonance spectroscopy may narrow the differential diagnoses. Surgical resection remains the treatment of choice, facilitated by preoperative embolization to reduce intraoperative bleeding and by the application of the principles of skull base surgery. Fractionated radiotherapy is an alternative in partial or difficult resections and in high-risk and elderly patients. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:17167631

  19. MR and CT appearance of cardiac hemangioma

    SciTech Connect

    Kemp, J.L.; Kessler, R.M.; Raizada, V.; Williamson, M.R.

    1996-05-01

    We present a case of cardiac hemangioma in a symptomatic patient. MR and CT each have specific characteristics that should make one consider including or excluding this in the differential diagnosis of a cardiac tumor. 7 refs., 3 figs.

  20. Treatment of choroid hemangioma with argon laser

    NASA Astrophysics Data System (ADS)

    Yang, Chuanzhu; Song, Man

    1993-03-01

    The treatment effects of 7 cases of choroid hemangioma are reported. Of them, 4 cases were men and 3 cases were women. Ages varied from 34 to 52 years. The mean age was 43 years. All of their eyesight was between 0.01 and 0.4. Six of the seven cases were solitary hemangioma, the other one was Sturge-Weber syndrome. After treatment photography, the color of the hemangioma body gradually got weak and the local presented pigmentation. The results of the fluorescein fundus angiography indicated that the hemangioma body reduced, then got atrophy and fibrosis. In five cases eyesight increased, and it didn't in the other two cases.

  1. Pathogenesis of human hemangiosarcomas and hemangiomas.

    PubMed

    Liu, Liping; Kakiuchi-Kiyota, Satoko; Arnold, Lora L; Johansson, Sonny L; Wert, David; Cohen, Samuel M

    2013-10-01

    Hemangiosarcomas are uncommon aggressive vascular tumors that have recently become the focus of attention because several chemicals and pharmaceuticals increase their incidence in mice. The relevance of these mouse vascular tumors to humans is unclear. In the present study, we semiquantitatively evaluated the expression profiles of hematopoietic stem cell markers (CD117 [c-kit], CD133, CD34, and CD45), endothelial cell markers (vascular endothelial growth factor receptor 2, CD31, and factor VIII-related antigen), and a myeloid lineage cell marker (CD14) in human hemangiosarcoma (n = 12) and hemangioma (n = 10) specimens using immunohistochemistry. CD133 was completely negative in almost all cases of hemangiosarcomas and hemangiomas. Most hemangiosarcomas, but not hemangiomas, stained for CD117 and CD45. Both groups diffusely expressed CD34, vascular endothelial growth factor receptor 2, and factor VIII-related antigen; however, hemangiomas had more intense and diffuse CD34 and factor VIII-related antigen expression compared with hemangiosarcomas, whereas CD31 was positive in all hemangiosarcomas but only half of the hemangiomas. CD14 staining was negative in most hemangiosarcoma and hemangioma cases. Our results indicate that multipotential bone marrow-derived hematopoietic stem cells or early endothelial progenitor cells (EPCs) expressing CD117, CD34, and CD45 are involved in hemangiosarcoma formation, whereas hemangiomas originate from late EPCs or differentiated endothelial cells, which have lost the expression of most hematopoietic stem cell markers. This contrasts with our previous results that demonstrated that both hemangiosarcomas and hemangiomas in mice may be derived from early EPCs that are not completely differentiated. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Radiotherapy in the treatment of vertebral hemangiomas

    SciTech Connect

    Faria, S.L.; Schlupp, W.R.; Chiminazzo, H. Jr.

    1985-02-01

    Symptomatic vertebral hemangiomas are not common. Although radiotherapy has been used as treatment, the data are sparse concerning total dose, fractionation and results. The authors report nine patients with vertebral hemangioma treated with 3000-4000 rad, 200 rad/day, 5 fractions per week, followed from 6 to 62 months. Seventy-seven percent had complete or almost complete disappearance of the symptoms. Radiotherapy schedules are discussed.

  3. An immunohistochemical study of verrucous hemangiomas.

    PubMed

    Trindade, Felicidade; Torrelo, Antonio; Requena, Luis; Tellechea, Oscar; Del Pozo, Jesus; Sacristán, Felipe; Esteve-Martínez, Altea; de Unamuno, Blanca; de Miquel, Víctor Alegre; Colmenero, Isabel

    2013-05-01

    According to the International Society for the study of vascular Anomalies, vascular anomalies are classified as vascular neoplasms and vascular malformations. In some vascular lesions, categorization as a neoplasm or malformation has not been established with confidence so far. In order to further clarify the nosology of verrucous hemangioma, we studied 13 cases. To analyze immunohistochemical characteristics of verrucous hemangiomas in order to gain further insight in its histogenesis. We carried out a retrospective review. Immunohistochemical expression for Wilms tumor 1 (WT1), Glut-1 and D2-40 was performed in 13 cases. Immunohistochemistry performed with Glut-1 and WT1 showed positive staining in all lesions. All verrucous hemangiomas lacked D2-40 immunostaining. This is the first report in the literature investigating WT1 in verrucous hemangioma in order to further clarify the nosology of this vascular anomaly. Despite the clinical features of verrucous hemangioma, which are similar to those seen in vascular malformations, verrucous hemangioma exhibited an immunoprofile similar to vascular neoplasms, according to WT1 and Glut-1 positivity. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  4. Nadolol for the treatment of infantile hemangioma.

    PubMed

    Villalba-Moreno, Angela M; Cotrina-Luque, Jesus; Del Vayo-Benito, Concepcion Alvarez; Flores-Moreno, Sandra; Bautista-Paloma, Francisco J

    2015-01-01

    The successful use of nadolol as an alternative to propranolol therapy in three cases of infantile hemangioma is reported. Infantile hemangioma is a benign vascular neoplastic disorder that affects up to 10% of newborns and can lead to deformity or local complications in severe cases. Propranolol, administered alone or in combination with corticosteroids, is increasingly used to treat infantile hemangioma, but its ability to cross the blood-brain barrier and potentially cause central nervous system adverse effects has prompted research on alternative β-blocker therapies for the disorder that have more favorable safety profiles, including nadolol. This article describes the use of nadolol to treat three pediatric patients with a buccal or genital hemangioma who developed adverse reactions (mainly, irritability and sleep disturbances) or resistance to initial treatment with propranolol. The patients were 10 months, 12 months, and 4 years of age, respectively, when hemangioma treatment was initiated. The results of nadolol therapy were favorable, with involution of lesions and gradual disappearance of propranolol-associated adverse effects occurring in all three cases. As with any use of β-blocker therapy in a pediatric patient, a cardiac workup is advised before the start of nadolol therapy; blood pressure and heart rate monitoring should be performed at one and two hours after the first dose and continued during dose escalation. Nadolol was an effective alternative to propranolol in three pediatric patients with hemangiomas. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Association of cutaneous red-to-purple hemangiomas with leptomeningeal hemangiomas. a clinical study of two patients.

    PubMed

    Pascual-Castroviejo, I; Pascual-Pascual, S I; Velazquez-Fragua, R; García-Guereta, L; López-Gutiérrez, J-C; Olivares, P; Tovar, J

    2010-02-01

    Cutaneous hemangioma is a benign vascular tumor of infancy with an initial proliferating period that appears between 1 to 2 weeks of life, extends during 18 months to 2 years of life, and then slowly regresses during several years until it disappears completely. They are characterized by endothelial cell proliferation followed by diminishing hyperplasia and progressive fibrosis. Vascular malformations are present at birth, grow commensurately with the child, and are characterized histologically by a normal rate of endothelial cell turnover, flat endothelium, thin (normal) basal membrane and normal mast cells. These cutaneous anomalies are commonly associated with cerebellar malformations, main cerebral arteries anomalies, congenital cardiac anomalies and/or coarctation of the aorta and persistence of embryonic arteries. Cutaneous hemangiomas can be associated with intracranial or extracranial hemangiomas that regress at the same time as the cutaneous hemangiomas. Cutaneous hemangiomas may show different types of color. Cutaneous red-to-purple hemangiomas are uncommon and their bright-red color is evident from the first weeks of life and remains unaltered until the hemangioma disappears. The intracranial angiographic studies in our series of more than 50 cases with facial hemangioma showed that patients with red-to-purple hemangiomas are commonly associated with localized leptomeningeal hemangiomas either in the ipsilateral or contralateral side. These leptomingeal hemangiomas were visualized only by MR enhanced with gadolinium. Involution of the cutaneous and leptomeningeal hemangiomas seems to occur simultaneously as in other types of external and internal hemangiomas.

  6. Children with Rare Chronic Skin Diseases: Hemangiomas and Epidermolysis Bullosa.

    ERIC Educational Resources Information Center

    Jones, Sheila Dove; Miller, Cynthia Dieterich

    The paper reports on studies involving children having the rare chronic skin diseases of hemangiomas and epidermolysis bullosa (characterized by easy blistering). One study compared the self-concept and psychosocial development of young (mean age 46 months) children (N=19) with hemangiomas with 19 children without hemangiomas. Findings indicated…

  7. Children with Rare Chronic Skin Diseases: Hemangiomas and Epidermolysis Bullosa.

    ERIC Educational Resources Information Center

    Jones, Sheila Dove; Miller, Cynthia Dieterich

    The paper reports on studies involving children having the rare chronic skin diseases of hemangiomas and epidermolysis bullosa (characterized by easy blistering). One study compared the self-concept and psychosocial development of young (mean age 46 months) children (N=19) with hemangiomas with 19 children without hemangiomas. Findings indicated…

  8. Propranolol for Treatment of Genital Infantile Hemangioma.

    PubMed

    Tran, Christine; Tamburro, Joan; Rhee, Audrey; Golden, Alex

    2016-03-01

    Genital infantile hemangiomas are vascular anomalies that often require complex management and interdisciplinary care. Propranolol was first used to treat patients with infantile hemangiomas in 2008 and has since gained acceptance as first-line therapy. We review the presentation, course, management and outcomes of all cases of genital infantile hemangiomas managed by propranolol administration at a single institution from April 2010 to July 2014. During the study period 9 patients with genital infantile hemangiomas were referred to our hemangioma treatment clinic. Propranolol was initially administered under careful outpatient monitoring at a dose of 1 mg/kg daily in 8 patients. One patient, a 700 gm premature infant, was started on therapy in the inpatient setting at 0.5 mg/kg daily, given the history of prematurity. All patients underwent successful increase of dose to at least 2 mg/kg for the observation phase after tolerating the starting doses. One patient discontinued propranolol prematurely per parental request due to concern regarding peripheral vasoconstriction. Otherwise, no patient demonstrated significant hypotension, symptomatic bradycardia, hypoglycemia or other major side effect requiring treatment discontinuation. All patients who continued the treatment protocol had excellent response to therapy. Propranolol therapy for genital infantile hemangiomas was successfully initiated and the dosage increased in 9 young children without significant side effects and with marked improvement in all patients who continued on treatment. Propranolol is the only Food and Drug Administration approved therapy for treatment of patients with this vascular anomaly and should be considered first-line therapy for genital infantile hemangiomas. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Cardiac evaluation in children with hemangiomas.

    PubMed

    Erdoğan, İlkay; Sarıalioğlu, Faik

    2016-09-01

    Hemangiomas are tumors most commonly encountered in pediatric patients, and are frequently treated with propranolol. However, there are currently no standard methods for evaluating cardiac function in patients prior to propranolol treatment. The present study was designed to aid in the evaluation of pretreatment cardiac and effects of propranolol on vital signs in pediatric hemangioma patients. A pediatric oncology specialist and a pediatric cardiology specialist examined all patients prior to initiation of propranolol treatment. All patients were examined by the same 2 physicians. Cardiac evaluation included complete echocardiogram and electrocardiography. From September 2009 to January 2014, 146 patients aged 4 days to 10 years were screened. No patient had cardiac contraindication to propranolol. The effect of hemangioma on left ventricle size was examined, but left ventricle dilatation was found in only 3 patients. However, 68 patients had abnormal echocardiogram: 17 had patent foramen ovale, 4 had ventricular septal defect, 9 had atrial septal defect (associated with right heart enlargement), 8 had patent ductus arteriosus, 6 had physiologic pulmonary stenosis, and 1 had an aortic coarctation. No contraindications to propranolol or side effects were observed. However, cardiac anatomic defects were more common in this patient group than in the general population. Hemangiomas in infants or children, even in small or premature infants, can be treated with propranolol without significant cardiac side effects. In addition, large dermal hemangiomas were not found to affect ventricular size in pediatric patients.

  10. Urethral hemangioma in a prepubertal female patient

    PubMed Central

    Li, Chiao-Ching; Li, Chiao-Zhu; Yen, Ching-Heng; Tsai, Wen-Chuan; Wu, Sheng-Tang; Cha, Tai-Lung; Meng, En

    2017-01-01

    Abstract Rationale: Urethral hemangiomas commonly occur in men or elderly women. We presented a rare case of urethral hemangioma in a prepubertal female patient. Patients concerns: An 8-year-old girl had the complaints of bloody staining of clothing, a foul perineal odor, and urethral pain. She was brought to our genitourinary outpatient department for survey and a single, 1-cm compressible reddish nodule at the 10-2 o’clock position in the distal urethra was found. Diagnoses: Urethral hemangioma in a prepubertal girl was diagnosed after excision of the urethral nodule. Interventions: Excision with 8 “stay” sutures in the protruding urethral mucosa was performed. Outcomes: Normal micturition without symptom recurrence was noted at the 3-month follow-up. Lessons: Urethral hemangioma is also found in prepubertal female patient. Increased physician awareness and early recognition of a urethral hemangioma can avoid unnecessary examinations and patient anxiety. The procedure of excision with 8 “stay” sutures in the protruding urethral mucosa facilitates mobilization from the distal urethra and provides a good surgical view of abnormal proliferative blood vessels. Therefore, the lesion can be removed as clean as possible. PMID:28353601

  11. PHACE syndrome with intracerebral hemangiomas, heterotopia, and endocrine dysfunction.

    PubMed

    Poindexter, Gabriele; Metry, Denise W; Barkovich, A James; Frieden, Ilona J

    2007-06-01

    PHACE is an acronym to describe the association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta, cardiac defects, and eye abnormalities. More than 200 cases have been reported. The present report presents the cases of two female infants with PHACE syndrome, both of whom had additional congenital defects of subependymal gray matter heterotopia, craniofacial arterial anomalies, and pituitary dysfunction. One had an extensive segmental facial hemangioma with ipsilateral intracranial hemangiomas. The other had multiple cutaneous hemangiomas, but no segmental facial hemangioma. These two cases suggest a further expansion of the spectrum of PHACE to include other forms of disordered cerebral development and endocrine dysfunction.

  12. Mucosal cavernous hemangioma of the maxillary sinus.

    PubMed

    Dutta, Mainak; Kundu, Sohag; Barik, Sabyasachi; Banerjee, Shoham; Mukhopadhyay, Subrata

    2015-02-01

    Mucosal cavernous hemangiomas of maxillary sinus and the lateral nasal wall are seldom encountered and difficult to diagnose with misleading radiologic features like bone erosion and heterogeneity due to patchy contrast uptake. The overall picture mimicking sinonasal malignancy, it is unclear whether there is true breach in the bone or remodeling due to the lesion's chronicity. Interestingly, it often does not bleed as expected during surgery, questioning the use of therapeutic embolization and pre-intervention vascular shrinkage. The clinical presentation and management protocol of sinonasal cavernous hemangiomas seem greatly individualized. We here present a patient with cavernous hemangioma of maxillary sinus and discuss the distinguishing clinical, histologic and imaging characteristics and subsequent management options, and attempt to establish the findings as the basis of considering it as an important differential diagnosis of radiologically heterogeneous sinonasal mass with suspected bone erosions presenting with nasal obstruction and epistaxis, mostly in young women.

  13. Nuclear magnetic resonance imaging of liver hemangiomas

    SciTech Connect

    Sigal, R.; Lanir, A.; Atlan, H.; Naschitz, J.E.; Simon, J.S.; Enat, R.; Front, D.; Israel, O.; Chisin, R.; Krausz, Y.

    1985-10-01

    Nine patients with cavernous hemangioma of the liver were examined by nuclear magnetic resonance imaging (MRI) with a 0.5 T superconductive magnet. Spin-echo technique was used with varying time to echo (TE) and repetition times (TR). Results were compared with /sup 99m/Tc red blood cell (RBC) scintigraphy, computed tomography (CT), echography, and arteriography. Four illustrated cases are reported. It was possible to establish a pattern for MRI characteristics of cavernous hemangiomas; rounded or smooth lobulated shape, marked increase in T1 and T2 values as compared with normal liver values. It is concluded that, although more experience is necessary to compare the specificity with that of ultrasound and CT, MRI proved to be very sensitive for the diagnosis of liver hemangioma, especially in the case of small ones which may be missed by /sup 99m/Tc-labeled RBC scintigraphy.

  14. Intraneural capillary hemangioma of the cauda equina.

    PubMed

    Mastronardi, L; Guiducci, A; Frondizi, D; Carletti, S; Spera, C; Maira, G

    1997-01-01

    A case of intraneural capillary hemangioma involving the dorsal root of a spinal nerve of the cauda equina is reported. The patient was a 41-year-old man with a 3-month history of intermittent left lumbosciatalgia. MRI and CT myelography showed a space-occupying mass at the level of the cauda equina. Laminectomy of L5 and complete removal of the lesion were performed without neurological problems. The clinical, diagnostic, and therapeutic aspects of hemangiomas of the cauda equina are analyzed.

  15. [A case of right ventricular hemangioma].

    PubMed

    Oda, K; Tamiya, T; Yamamoto, A; Toki, T; Hirose, K; Izumi, S

    1991-02-01

    We report a case of right ventricular hemangioma which is extremely rare. It was situated on the anterior wall of the right ventricle and protruded into the out flow tract. Aortography revealed that the main feeding artery was the conus brunch. Operation was done under cardiopulmonary bypass. The tumor was situated between LAD and RCA and resected incompletely, because of the fear that complete removal would occlude blood flow of both LAD and RCA. Histological examination disclosed intramuscular hemangioma. The postoperative course was uneventful. To our knowledge, this is the second resected case in the Japanese literature and the eighth case in the world literature.

  16. Uncommon scintigraphic findings of multiple hepatic hemangiomas

    SciTech Connect

    el-Desouki, M.; Joharjy, I.A.; al-Muzrakchi, A.M.; Bashi, S.A. )

    1991-03-01

    Tc-99m labeled red blood cell scintigraphy is a valuable, noninvasive technique for differentiating hepatic hemangioma from other lesions by demonstrating a 'perfusion blood pool mismatch.' The characteristic finding on dynamic CT scan of peripheral and subsequent central enhancement is not usually seen on Tc-99m RBC angiography, probably due to rapid mixing and dilution of the radionuclide and low resolution of the gamma camera. A case of multiple hepatic hemangioma is presented in which Tc-99m RBC dynamic angiography demonstrated peripheral enhancement with subsequent central filling. In addition, delayed static images showed more hepatic lesions.

  17. Pathognomonic scintigraphic finding of hepatic cavernous hemangioma

    SciTech Connect

    Kim, S.M.; Park, C.H.; Yang, S.L.; Rosato, F.

    1987-01-01

    Hemangioma is the most common benign tumor of the liver. An accurate diagnosis of such tumor is essential for proper management of patients with hepatic cavernous hemangioma (HCH). Noninvasive diagnosis of HCH can be made using sequential Tc-99m RBC scintigraphy by demonstrating a perfusion-blood pool mismatch. In addition, a case of HCH was observed which demonstrated peripheral enhancement with subsequent central enhancement on a sequential Tc-99m RBC blood pool scintigraphy. It is felt that this scintigraphic finding is pathognomonic for HCH.

  18. Response to propranolol in infantile hemangioma.

    PubMed

    Sirachainan, Nongnuch; Lekanan, Wasuthida; Thammagasorn, Yuwaluk; Wanitkun, Suthep; Kadegasem, Praguywan; Chunharas, Amornsri

    2016-07-01

    Propranolol, 2 mg/kg/day, is effective in the treatment of infantile hemangioma. We report the response to propranolol in infants with hemangioma at a dose of 1 mg/kg/day. Sixteen infants with newly diagnosed infantile hemangioma were given propranolol at a dose titrated from 0.5 mg/kg/day then increased to 1 or 2 mg/kg/day based on response to treatment until the lesions showed clinical stability for 3 consecutive months. Five out of 16 patients (31.2%) responded to propranolol at 1 mg/kg/day, while the remainder required 2 mg/kg/day for response. Vascular endothelial growth factor significantly decreased after treatment (median, 117.8 pg/mL; range, 35.3-468.7 pg/mL vs 59.2 pg/mL; range, 26.3-133.0 pg/mL; P = 0.016). Therefore, we recommend initiating treatment at 0.5 mg/kg/day for 2 days, then 1 mg/kg/day for 1 month. If the hemangioma has not decreased in size by 1 month follow up, the dose is subsequently increased to 2 mg/kg/day. © 2016 Japan Pediatric Society.

  19. Case report of lumbar intradural capillary hemangioma.

    PubMed

    Unnithan, Ajaya Kumar Ayyappan; Joseph, T P; Gautam, Amol; Shymole, V

    2016-01-01

    Capillary hemangioma is a rare tumor in spinal intradural location. Despite the rarity, early recognition is important because of the risk of hemorrhage. This is a case report of a woman who had capillary hemangioma of cauda equina. A 54 -year-old woman presented with a low backache, radiating to the left leg for 2 months. She had left extensor hallucis weakness, sensory impairment in left L5 dermatome, and mild tenderness in lower lumbar spine. Magnetic resonance imaging (MRI) LS spine showed L4/5 intradural tumor, completely occluding canal in myelogram, enhancing with contrast, s/o benign nerve sheath tumor. L4 laminectomy was done. Reddish tumor was seen originating from a single root. It was removed preserving the root. Postoperatively, she was relieved of symptoms. MRI showed no residue. Histopathology showed lobular proliferation of capillary-sized blood vessels and elongated spindle cells. Immunohistochemistry showed CD34 positivity in endothelial cell lining of blood vessel and smooth muscle actin positivity in blood vessel muscle cells. HPR-capillary hemangioma. Although rare, capillary hemangioma should be in the differential diagnosis of intradural tumors. It closely mimics nerve sheath tumor.

  20. SPECT in the diagnosis of hepatic hemangioma

    SciTech Connect

    Brunetti, J.C.; Van Heertum, R.L.; Yudd, A.P.

    1985-05-01

    Tc99m labeled red blood cell blood flow and delayed static blood pool imaging is widely accepted as a reliable, accurate method for the diagnosis of hepatic hemangiomata. The purpose of this study is to assess the relative value of SPECT blood pool imaging in the evaluation of hepatic hemangionata. A total of 68 patients, including 21 patients with proven hepatic cavernous hemangiomas, were studied using both planar and SPECT imaging techniques. All patients underwent multi-phase evaluation which included a hepatic flow study, immediate planar images of the liver, followed by a 360/sup 0/ tomographic (SPECT) study and subsequent 60 minute delayed static planar hepatic blood pool images. All 21 patients with proven hepatic hemangiomas had a positive SPECT exam and 17 of the 21 (81%) patients had a positive planar exam. In the 21 patients, there were a total of 36 hemangiomas ranging in size from .7 cm to 13 cm. The SPECT imaging technique correctly identified all 36 lesions (100%) where as planar imaging detected 25 of the 36 lesions (69.4%). In all the remaining patients (10-normal, 17-metastatic disease, 12-hepatocellular disease, 6-hepatoma, 2-liver cysts), both the planar and SPECT imaging techniques were interpreted as showing no evidence of focal sequestration of red blood cells. SPECT hepatic blood pool imaging represents an improvement in the evaluation of hepatic hemangioma as a result of a reduction in imaging time (less than thirty minutes), improved spatial resolution and greater overall accuracy.

  1. Cavernous hemangioma of Meckel's cave. Case report.

    PubMed

    Fehlings, M G; Tucker, W S

    1988-04-01

    A case of a cavernous hemangioma located within Meckel's cave and involving the gasserian ganglion is described in a patient presenting with facial pain and a trigeminal nerve deficit. Although these lesions have been reported to occur in the middle fossa, this is believed to be the first case of such a vascular malformation arising solely from within Meckel's cave.

  2. Cavernous Hemangioma of the Rib: A Case Report.

    PubMed

    Young Park, Joon; Gyoon Park, Jin; Jin Lee, Seung

    2016-07-01

    Hemangioma of the rib is a rare benign vascular tumor. Herein, we report a 63-year-old man presenting with hemangioma of the left sixth rib. An osteolytic eccentric expansive mass with calcification and focal cortical disruption was detected on chest computed tomography (CT). The mass showed low 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) avidity on positron emission tomography. The patient underwent resection of the left sixth rib. Based on the histopathology findings, a diagnosis of cavernous hemangioma was made. Rib hemangiomas and malignant lesions appear similar on CT scans; therefore, most cases of rib hemangiomas reported in the literature were treated with rib resection. However, rib hemangiomas should be included in the differential diagnosis of an asymptomatic patient if an osteolytic expansive lesion containing sunburst calcifications with low 18F-FDG avidity is observed on a CT scan.

  3. Urethral hemangioma: case report and review of the literature.

    PubMed

    Regragui, Souhail; Slaoui, Amine; Karmouni, Tarik; El Khader, Khalid; Koutani, Abdelatif; Attya, Ahmed Ibn

    2016-01-01

    Hemangiomas are benign vascular tumors. They are the prerogative of the liver and skin. And genitourinary localizations are rare and have only been rarely reported in the prostat, bladder, ureter or the perineum. In the light of published cases, urethral hemangiomas are mostly found in males. Few cases of hemangioma in the female urethra were reported. We report a cavernous hemangioma of the urethra in a 61 years old patient who presented bleeding from the urethra and micturition disorders. Physical examination revealed a tumor 3 cm x 2 polyploid arising from the terminal urethra (urethral hemangioma). We performed surgical resection of the tumor, along with bladder drainage. The postoperative course was simple. We update through a review of the literature aspects of the diagnostic and therapeutic care of the urethral hemangioma.

  4. Spinal epidural arteriovenous hemangioma mimicking lumbar disc herniation.

    PubMed

    Kim, Kyung Hyun; Song, Sang Woo; Lee, Soo Eon; Lee, Sang Hyung

    2012-10-01

    A spinal epidural hemangioma is rare. In this case, a 51 year-old female patient had low back pain and right thigh numbness. She was initially misdiagnosed as having a ruptured disc with possible sequestration of granulation tissue formation due to the limited number of spinal epidural hemangiomas and little-known radiological findings. Because there are no effective diagnostic tools to verify the hemangioma, more effort should be put into preoperative imaging tests to avoid misdiagnosis and poor decisions).

  5. Treatment of retinal hemangiomas with dye yellow laser.

    PubMed

    Tokumaru, G K

    1993-02-01

    Retinal capillary hemangioma (angiomatosis retinae; von Hippel's disease) is a relatively uncommon vascular tumor. When seen in association with systemic angiomas, it is known as von Hippel-Lindau disease. Untreated, these tumors can cause numerous sight threatening sequelae, including exudative and tractional retinal detachment. Recently, the dye yellow laser has been demonstrated to be a safe and effective method of ablating retinal hemangiomas. This paper discusses the case of a retinal hemangioma that was successfully treated with the dye yellow laser. The current treatment modalities of retinal hemangiomas are reviewed, as well as recent literature on the tunable organic dye laser and its utilization in the treatment of retinal vascular disorders.

  6. Comprehensive management of symptomatic and aggressive vertebral hemangiomas.

    PubMed

    Acosta, Frank L; Sanai, Nader; Chi, John H; Dowd, Christopher F; Chin, Cynthia; Tihan, Tarik; Chou, Dean; Weinstein, Philip R; Ames, Christopher P

    2008-01-01

    Conservative surgical strategies are appropriate for most symptomatic hemangiomas causing cord compression without instability or deformity. Even so, complete intralesional spondylectomy following embolization of aggressive vertebral hemangiomas with circumferential vertebral involvement can be safely accomplished. Such a spondylectomy can also prevent recurrence of hemangiomas. Transarterial embolization without decompression is an effective treatment for painful intraosseous hemangiomas. Vertebroplasty is useful for improving pain symptoms, especially when vertebral body compression fracture has occurred in patients without neurological deficit, but is less effective in providing long-term pain relief.

  7. Surgical treatment of aggressive vertebral hemangiomas.

    PubMed

    Vasudeva, Viren S; Chi, John H; Groff, Michael W

    2016-08-01

    OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of "hemangioma" between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3-65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the

  8. PHACE without face? Infantile hemangiomas of the upper body region with minimal or absent facial hemangiomas and associated structural malformations.

    PubMed

    Nabatian, Adam S; Milgraum, Sandy S; Hess, Christopher P; Mancini, Anthony J; Krol, Alfons; Frieden, Ilona J

    2011-01-01

    Infantile hemangiomas can be associated with congenital anomalies such as PHACE syndrome with facial hemangiomas and genitourinary and spinal anomalies in the setting of lower body hemangiomas. We describe five infants in whom segmental hemangiomas involving the upper torso and extremities with absent or small facial hemangiomas were associated with structural anomalies similar to those reported with PHACE syndrome, including three with structural arterial anomalies of the subclavian arteries, three with aortic arch anomalies (right sided or narrowed arch), two with congenital heart disease (atrial septal defect and ventricular septal defect; tetralogy of Fallot), one with a retinal scar, and one with a sternal defect (scar). Two of five had small facial hemangiomas of the lower lip, but none had large segmental hemangiomas of the face. Three of five would have met diagnostic criteria for PHACE but lacked a facial hemangioma of 5 cm in diameter or greater. Patients with segmental arm and thorax hemangiomas may have associated structural abnormalities with overlapping features of PHACE, suggesting that a similar syndrome can occur in this clinical setting.

  9. [Giant infantile hepatic hemangioma: which therapeutic options?].

    PubMed

    Gonçalves, Cristina; Lobo, Luisa; Anjos, Rui; Salgueiro, Carlos; Lopes, Ana Isabel

    2013-01-01

    Infantile hepatic hemangioma is the third most frequent liver tumor in children and the most common below 6 months of age. Therapeutic options depend on clinical manifestations and should be tailored on an individual patient basis. We present the case of a 4 year old boy with neonatal diagnosis of large vascularized liver tumor with imagiological criteria of infantile hepatic hemangioma. We highlight the occurrence of heart failure and Kasabach-Merrit syndrome (thrombocytopenia, anemia) that have spontaneously regressed. During follow up, sequential imaging (ultrasound with Doppler, magnetic resonance imaging, dynamic contrast enhancement computed tomography) confirmed the hypothesis of IHH, allowing vascular mapping of the lesion. From the first year on, we observed a favorable course with progressive tumor regression. In the present case, a conservative approach has been maintained, but the best therapeutic option remains unclear. We highlight the specific features of this case, discussing the most cost-effective approach.

  10. Cavernous hemangioma of the right atrium.

    PubMed

    Contrafouris, Constantinos; Kanakis, Meletios; Milonakis, Michael; Azariadis, Prodromos; Chatzis, Andrew

    2016-11-01

    A 42-year-old woman was diagnosed during the 3rd month of pregnancy with a large right atrial tumor. Three weeks after successful completion of a full-term pregnancy, she was admitted and underwent surgical removal of the tumor. Postoperative course was uneventful and pathology showed cavernous hemangioma. These neoplasms should be removed in order to prevent severe arrhythmias as also potential malignant transformation.

  11. Mimicry of lyme arthritis by synovial hemangioma.

    PubMed

    Hospach, Toni; Langendörfer, M; Kalle, T V; Tewald, F; Wirth, T; Dannecker, G E

    2011-12-01

    To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports

  12. Maxillary sinus cavernous hemangioma: a rare entity.

    PubMed

    Jammal, H; Barakat, F; Hadi, U

    2004-04-01

    Vascular lesions of the sinonasal tract are rare. These lesions do not have typical signs or symptoms. They may present insidiously with minimal symptoms. A high index of suspicion and a good preoperative evaluation are needed for diagnosis. No standard surgical approach is indicated. We report a case of cavernous hemangioma of the maxillary sinus in an adult male. We present the diagnostic work-up and discuss the differential diagnosis and potential therapeutic approaches.

  13. Multimodality Imaging of a Silent Cardiac Hemangioma

    PubMed Central

    Cresti, Alberto; Chiavarelli, Mario; Munezero Butorano, Marie Aimèe Gloria; Franci, Luca

    2015-01-01

    A 74-year-old man underwent echocardiographic exam for hypertension screening. A fixed plurilobulated mass originating from the right ventricular lateral wall and occupying half of the cavity was incidentally diagnosed. On cardiac magnetic resonance (CMR) it appeared homogeneous, intermediate-to-high signal on T1-weighted, and diffusely hyperintense on T2-weighted images. First pass enhancement was late and heterogeneous and no late gadolinium enhancement was present. Computed tomography (CT) showed no extracardiac infiltration, the feeding artery was a branch of therightcoronary artery. The tumor was excised and histological examination demonstrated a hemangioma of the cavernous type. The postoperative course was uneventful. From 1998 to 2014, four cardiac hemangiomas have been diagnosed in our Department, accounting for 8.7% of all primary cardiac tumors and for 9.5% of all benign forms; estimated population prevalence was 0.11/100.000 inhabitants/year. The hemodynamic consequences of unoperated cardiac hemangiomas cannot be predicted and therefore, resection is recommended. PMID:28465926

  14. Cytogenetic study of a pulmonary sclerosing hemangioma.

    PubMed

    Pareja, María J; Vargas, María T; Sánchez, Ana; Ibáñez, José; González-Cámpora, Ricardo

    2009-11-01

    Pulmonary sclerosing hemangioma (PSH) is an uncommon benign tumor that presents as a solitary asymptomatic and slow-growing nodule. It occurs in both young and old persons; peak incidence is in the fifth decade. Both sexes are affected by this tumor, but women more frequently than men. On histological examination, PSH shows prominent sclerotization and vascularization of the tissue. Recent studies conclude that PSH derives from type II pneumocytes, but the potential for progression and histogenesis remains controversial. We report a case of pulmonary sclerosing hemangioma in a 61-year-old woman with a neoplastic node 1 cm in diameter. The karyotype was 46,XX,t(8;18),der(14;15),+14 in all the cells analyzed. PTEN (10q23) and IgH (14q32) probes were analyzed in interphase nuclei and paraffin-embedded tissues of tumor cells. These chromosome abnormalities could provide information about the relationship of genetic changes to the biological properties of sclerosing hemangioma tumors.

  15. Giant cavernous hemangioma of the adrenal gland

    PubMed Central

    Quildrian, Sergio Damián; Silberman, Ezequiel Aníbal; Vigovich, Felix Alberto; Porto, Eduardo Agustín

    2012-01-01

    INTRODUCTION Cavernous hemangioma of the adrenal gland is a rare non-functioning benign neoplasm. PRESENTATION OF CASE A 62-year-old woman with chronic obstructive pulmonary disease was diagnosed as having an incidental non-functioning adrenal tumor. Because of the impossibility of ruling out the presence of malignancy, conventional surgical resection was carried out. The histopathology revealed a 12.5 cm × 11.5 cm × 8 cm adrenal mass with large and lacunae vascular spaces lined with mature endothelial cells. These findings were compatible with cavernous hemangioma. DISCUSSION The majority of patients in the literature underwent surgical resection due to the impossibility of excluding malignancy, because of related symptoms in patients with large masses, or because of the risk of spontaneous tumoral rupture. CONCLUSION These tumors are quite infrequent. Due to the low frequency and the lack of specific symptoms, most adrenal hemangiomas are diagnosed postoperatively. PMID:23287064

  16. Spontaneous Rupture of Splenic Hemangioma in a Neonate

    PubMed Central

    Martinez-Leo, Bruno; Vidal-Medina, Jorge; Cervantes-Ledezma, Jesús; Díaz De León-Rivera, Arid; Díaz-Velasco, Edith

    2016-01-01

    Spleen vascular tumors such as hemangiomas, albeit rare, can present during neonatal period with unexplained circulatory shock. We present a case of a newborn with refractory hypovolemic shock and acute abdomen that underwent emergency splenectomy due to spontaneous rupture of a splenic hemangioma. PMID:27433454

  17. Spontaneous rupture of a liver hemangioma. A case report.

    PubMed

    Guillén-Paredes, María Pilar; Martínez Fernández, Josefa; Morales González, Álvaro; Pardo-García, José Luis

    2016-07-01

    Spontaneous rupture of a liver hemangioma is a very uncommon disease, but extremely seriousness because it is associated to a 75% of mortality caused by hipovolemic shock. A case of an spontaneous rupture of liver hemangioma, which was previously unknow, is presented.

  18. Intracranial Hypertension Caused by Occipital Calvarial Hemangioma: Case Report.

    PubMed

    Srinivasan, Visish M; Karas, Patrick J; Sen, Anish N; Fridley, Jared S; Gopinath, Shankar P

    2016-07-01

    Primary intraosseous calvarial hemangiomas (PICHs) are generally rare and predominate (3:1) in women. Occurrence in the frontal and parietal bones is most common, but involvement of the occipital bone is exceedingly rare, representing 3 of 125 cases in a series of PICHs studied by Heckl et al. in 2000. Histopathology establishes the diagnosis of cavernous hemangioma, which represents the most common subtype of intraosseous hemangiomas. Others include sclerosing, cellular, and capillary. When they do occur in the calvarium, they are most often asymptomatic and discovered incidentally or due to a palpable defect in the skull. In this case, a calvarial hemangioma was found to be the cause of elevated intracranial pressure in a 35-year-old woman. Resection of the hemangioma and reconstruction of the calvarium provided a complete cure for her symptoms. Primary intraosseous hemangiomas are rarely symptomatic but must be considered in the differential for calvarial lesions as part of safe surgical planning. Formulating an accurate differential diagnosis by acquiring proper imaging studies and specifically recognizing the classical "starburst" appearance, as well as considering the highly vascular pathology to avoid excess blood loss, is important. This unique case of a hemangioma-induced venous sinus compression and subsequent elevated intracranial pressure illustrates that hemangiomas can arise from any part of the calvarium and cause a wide variety of clinical symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Infantile hemangiomas: the revolution of beta-blockers].

    PubMed

    Leaute-Labreze, Christine

    2014-12-01

    Infantile hemangioma is the consequence of both postnatal vasculogenesis and angiogenesis. Hypoxia appears to play an important role as a contributory factor. Infantile hemangiomas have variable clinical features: superficial, deep or mixed. They can be localized or segmental involving a large skin area. Localized infantile hemangiomas are usually benign, unless they are located near a noble structure (airway orbit...), while segmental infantile hemangioma may be associated with complex underlying birth defects (PHACES and SACRAL syndromes). Clinical follow-up of infants with infantile hemangioma must be particularly careful in the first weeks of life since 80% of all infantile hemangiomas have reached their final size at age 5 months. A majority of infantile hemangiomas are mild and do not required any treatment. Main indications for treatment are: vital risk (heart failure, respiratory distress), functional risk (amblyopia, swallowing disorders...), painful ulceration and disfigurement (face involvement of nose, lips...). Propranolol, has been quickly adopted as the first line medical treatment for complicated infantile hemangioma; and it is the only treatment to have a marketing authorization in this indication. It is recommended to begin the treatment as early as possible before three months of age to minimize the risk of complications and sequelae.

  20. Cavernous hemangioma. Why is peripheral filling at scintigraphy so rare

    SciTech Connect

    Drane, W.E.; Weatherby, E. III

    1987-10-01

    Peripheral filling at dynamic CT occurs frequently with cavernous hemangiomas, yet this phenomenon is a rare finding on Tc-99m RBC imaging. A case of peripheral filling of a cavernous hemangioma with scintigraphy is reported and the rationale for its infrequent occurrence is discussed.

  1. Hemangioma of the prostatic urethra: holmium laser treatment.

    PubMed

    de León, Javier Ponce; Arce, Jacobo; Gausa, Luís; Villavicencio, Humberto

    2008-01-01

    Urethral hemangiomas are benign vascular tumors that are found in perimontanal prostatic localization and less frequently in the urethra. Although different urethral procedures have been postulated for its treatment, the best results are achieved using lasers. A patient who underwent endoscopic holmium laser treatment for such hemangiomas is presented. Total disappearance of the lesions without any complications was achieved.

  2. [Head and neck hemangiomas: how and when to treat].

    PubMed

    Zheng, Jia-wei; Wang, Yan-an; Zhou, Guo-yu; Zhu, Han-guang; Ye, Wei-min; Zhang, Zhi-yuan

    2007-08-01

    Hemangiomas are common benign vascular tumors of infancy characterized by a proliferative growth phase followed by very slow inevitable regression (involutive phase) between one to ten years of age, about 60% to 70% of the lesions are found in the head and neck region. There are many treatment modalities reported in the literature for head and neck hemangiomas, including wait and see policy, drug therapy, sclerotherapy (steroids, bleomycin), cryotherapy, isotope radiotherapy, laser therapy, and surgical therapy. There still exist many controversies over the optimal treatment options for individual patient. Based on our clinical experience on 250 cases and literature review, a rational treatment regime for head and neck hemangioma was proposed in this study: (1) As it is not possible to predict, whether a hemangioma will remain small and unproblematic or grow into a very large lesion, early therapy is the only way out of this dilemma. A white or pink macule, a port-wine stain-like lesion initially appearing in the children can be effectively and easily removed by laser, thus preventing a growth in the size in the early stage. (2) The term of "wait and see" should be substituted by "close observation", and this approach should only be reserved for hemangiomas which are without visible growth or in the involutive phase. (3) Systematic drug therapy (steroids, interferon alpha-2a ) should be considered for large hemangioma, multiple hemangiomas, life-threatening hemangiomas and hemangiomas with complications such as ulceration, infection, bleeding, dysfunction, etc. Congestive heart failure, consumptive coagulopathy, and thrombocytopenia are also urgent indications for the institution of corticoid therapy. (4) Growing hemangioma can be treated effectively by systematic drug therapy, sclerotherapy, laser therapy or combined therapy. The argon laser (514 nm in wavelength, 0.5 mm in depth) is useful in the treatment of superficial telangiectasias and small, flat cutaneous

  3. Infantile Hemangiomas: Pathogenesis and Review of Propranolol Use.

    PubMed

    Laken, Patricia Ann

    2016-04-01

    Infantile hemangiomas are complex benign vascular tumors that present after birth. Hemangioma lesions have a predictable course of growth, but little is understood about the mechanism behind their development. Infantile hemangiomas are considered proliferative lesions of the endothelial cells. To effectively manage infants with infantile hemangiomas, a clear understanding of the pathogenic pathways is important and can assist the healthcare provider with effective treatment. This understanding will facilitate a relationship of support with the families of affected infants. EBSCO host and Ovid database search for key words of infantile hemangiomas, propranolol, vascular lesion, and proliferative lesion was utilized. Articles on pathophysiology along with recent research studies were include in the search. The use of propranolol is a recent development in the treatment of infantile hemangiomas, which has shown a high rate of response in decreasing the size and reducing the potential for life-long complications. Different studies have shown the same success rate with the use of propranolol but with different variables. As a healthcare team member, better identification and customized care of these patients can reduce the rare but devastating complications of infantile hemangiomas. Future research can help identify the most effective dose and course of propranolol administration.

  4. Cavernous hemangioma of the parotid gland in adults

    PubMed Central

    Peral-Cagigal, Beatriz; Madrigal-Rubiales, Beatriz; Verrier-Hernández, Alberto

    2014-01-01

    Hemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, nevertheless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults. Key words:Cavernous hemangioma, parotid gland, superficial parotidectomy, pleomorphic adenoma. PMID:25674332

  5. Primary Intraosseous Cavernous Hemangioma in the Skull

    PubMed Central

    Yang, Yi; Guan, Jian; Ma, Wenbin; Li, Yongning; Xing, Bing; Ren, Zuyuan; Su, Changbao; Wang, Renzhi

    2016-01-01

    Abstract Primary intraosseous cavernous hemangiomas (PICHs) are benign vascular tumors that may involve any part of the body. PICH occurs more frequently in the spine and less commonly in skull. The earliest description in the English literature was in 1845 by Toynbee, who reported a vascular tumor arising in the confines of the parietal bone. Skull PICHs do not always have typical radiologic features and should always be considered in the differential diagnosis of malignant skull lesions. We now reviewed and analyzed related literatures in detail with reporting a rare case of PICH in the left front bone that was surgically resected. PMID:26986133

  6. Primary cavernous hemangioma of the thyroid gland.

    PubMed

    Michalopoulos, Nikolaos V; Markogiannakis, Haridimos; Kekis, Panagiotis B; Papadima, Artemisia; Lagoudianakis, Emmanuel; Manouras, Andreas

    2010-07-01

    A 78-year-old euthyroid patient presented for evaluation of a symptomatic, slowly growing neck mass. Ultrasound scan revealed a multinodular goiter and a hypoechoic nodule of the right thyroid lobe. Total thyroidectomy was performed and the lesion was completely excised. Definite diagnosis was obtained after histological examination of the surgical specimen. Cavernous hemangiomas of the thyroid gland are infrequent lesions which may escape diagnosis preoperatively. An effort should be made not to rupture these lesions in order to ensure a bloodless procedure.

  7. Lobular capillary hemangioma of the tracheobronchial tree

    PubMed Central

    Qiu, Xiaojian; Dong, Zhiwu; Zhang, Jie; Yu, Jin

    2016-01-01

    Abstract Rationale: Lobular capillary hemangioma (LCH) of the tracheobronchial tree is a rare benign tumor, whose characteristics and treatments remain relatively unknown. Patient concerns: A 39-year-old man with hemoptysis caused by neoplasm in the bronchus intermedius was admitted to our hospital. Diagnoses: The patient was diagnosed with LCH. Interventions: The lesions were removed with biopsy forceps, and cryotherapy was performed. Outcomes: After follow up for more than 2 years, no recurrence was found. Lessons: Airway LCH can be treated by excisional biopsy, cryotherapy, APC, laser, radiotherapy, and surgery. Cryotherapy is worthy of recommendation. PMID:27902613

  8. Evidence-Based Medicine in the Treatment of Infantile Hemangiomas.

    PubMed

    Keller, Robert G; Patel, Krishna G

    2015-08-01

    Over the past decade, the treatment of infantile hemangiomas has undergone dramatic breakthroughs. This review critically evaluates the latest literature that supports the myriad treatment options for infantile hemangiomas. It chronicles the fading role of steroid therapy and evolution of propranolol use as the major treatment modality. Although propranolol is helping this disease become more of a medical disease and less of a surgical dilemma, the report also reveals a continued search to find nonsystemic treatment options. In summary, this is an evidence-based medicine review for the treatment of infantile hemangiomas.

  9. Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

    PubMed Central

    Zeng, Jennifer; Zhou, Fang; Wei, Xiao-Jun; Kovacs, Sandor; Simsir, Aylin; Shi, Yan

    2016-01-01

    Sclerosing hemangioma of the lung is a benign neoplasm with a widely debated histogenesis. It has a polymorphic histomorphology characterized by a biphasic cell population of “surface cells” and “round cells” arranged in four general patterns: Papillary, solid, angiomatous, and sclerotic. This variability in histomorphology makes it difficult to diagnose sclerosing hemangioma by fine needle aspiration (FNA). We present a case of sclerosing hemangioma diagnosed on FNA with immunohistochemistry performed on an accompanied cell block. The clinical presentation, cytomorphology, immunohistochemistry, and differential diagnoses are discussed. PMID:27168758

  10. Diagnosis and management of cavernous hemangioma of the liver

    SciTech Connect

    Takagi, H.

    1985-01-01

    Cavernous hemangiomas are the most common benign tumors of the liver, which are now seen more often thanks to common use of newer imaging techniques. A review of the literature on cavernous hemangiomas of the liver, including the author's experience with 14 cases, provides data as a touchstone for discussion of the incidence, etiology, symptoms, pathology, diagnosis including ultrasound, radionuclide imaging, computed tomography and angiography, management including resection, hepatic artery ligation, radiation and corticosteroid, and the natural history of these lesions. The author concludes that surgical resection of cavernous hemangiomas should be undertaken with due concern for the relation between the severity of symptoms and the operative risks involved.

  11. [Establishment of human infancy hemangioma-derived endothelial cell line XPTS-1 and animal model of human infancy hemangioma].

    PubMed

    Li, Peng; Xiao, Xiao-e; Xu, Quan; Guo, Zheng-tuan

    2011-03-01

    To establish an immortalized human infancy hemangioma-derived endothelial cell line (HemEC) and animal model of human infancy hemangioma. Hemangioma-derived endothelial cells from specimen of human infancy hemangioma were cultured in vitro and monocloed, and then its growth curve was made, karyomorphism of chromosome analyzed, morphologic characteristics observe, factor VIII related antigen identified by immunohistochemical method.Vascular endothelial growth factor receptor 2 (VEGFR-2) was detected by flow cytometry. HemEC were inoculated subcutaneously in athymic mouse to establish animal model of infancy hemangioma. The animal model was observed closely and its pathological characteristic was also studied. The cultural cells grew active, and immortalized spontaneously when they were subcultured on sixteenth generation. This cell line was cultivated for more than 70 times within one year and in good condition after freezing and resuscitating once and again, and had the morphologic character of HemEC. The cell population doubling time was 22 h. Factor VIII and VEGFR-2 were expressed positively. Karyo type analysis of the cell line showed abnormal diploid with the modal chromosomal number varying between diploid and triploid. The cell line was then named XPTS-1. The animal model of infancy hemangioma was successfully established and its character of histopathology was similar with that of infancy hemangioma. The cell line of HemEC was successfully established and immortalized spontaneously, and had the morphologic and biological character of HemEC. The animal model of infancy hemangioma was successfully established and showed the character of histopathology similar with that of infancy hemangioma.

  12. [Intramuscular hemangioma of the forearm: seven cases].

    PubMed

    Fnini, S; Messoudi, A; Benjeddi, Y; Elandaloussi, Y; Hassoun, J; Garche, A; Ouarab, M; Largab, A

    2013-06-01

    The authors reexamined the files of seven patients dealt with for intramuscular hemangioma of forearm. It concerns five women and two men, between 16 and 39 years old. The average time of consultation was 13 months. The clinical signs were dominated by the development of a generally painless soft mass over the anterior compartment of the forearm and/or the elbow. Two patients presented nervous lesions signs of the ulnar or median nerves. The feeder pedicle was the ulnar artery in five cases and radial artery in two cases. The excision was incomplete in two cases because of the invasion of the ulnar nerve by the hemangioma. With four years average follow-up, the five patients having undergone a complete excision do not present a recurrence and the hand function is excellent. The authors insist on the interest of a preoperative diagnosis with the IRM, which permits to envisage surgical difficulties due to the proximity of vascular and nervous pedicles.

  13. Hemangioma of the Interatrial Septum: CT and MRI Features

    SciTech Connect

    Hrabak-Paar, Maja; Huebner, Marisa; Stern-Padovan, Ranka; Lusic, Mario

    2011-02-15

    Hemangioma of the heart is a rare primary benign tumor mainly appearing as enhancing, homogenous, well-circumscribed mass. We report a case of a 61-year-old asymptomatic woman, whose echocardiography showed a cardiac mass, which was described as the atypical myxoma of the right atrium. For further imaging, contrast-enhanced computed tomography and cardiac magnetic resonance imaging were undertaken, which showed a tumor located in the interatrial septum with imaging characteristics of hemangioma. In the literature, cardiac hemangioma is usually described as an intensely enhancing mass. In our opinion, early peripheral puddling of contrast material with filling in on delayed images is a typical pattern of its enhancement. This characteristic, in addition to high signal intensity on T2-weighted images, allows differentiation of a hemangioma from other benign and malignant tumors.

  14. MR demonstration of extensive pelvic involvement in vulvar hemangiomas.

    PubMed

    O'Neal, M F; Amparo, E G

    1988-01-01

    Magnetic resonance imaging of two patients with vulvar hemangiomas noninvasively demonstrated unexpected pelvic involvement. Magnetic resonance is an excellent method for initial evaluation and follow-up of these lesions.

  15. Imaging diagnosis--spinal cord hemangioma in two dogs.

    PubMed

    Jull, Philip; Walmsley, Gemma L; Benigni, Livia; Wenzlow, Nanny; Rayner, Emma L; Summers, Brian A; Cherubini, Giunio B; Schöniger, Sandra; Volk, Holger A

    2011-01-01

    Intramedullary masses are a dilemma due to the limited access for a nonsurgical biopsy, thus, accurate imaging characterization is crucial. Magnetic resonance imaging findings of two confirmed canine thoracic intramedullary hemangiomas are described. A capillary hemangioma was of mixed intensity but predominantly T2-hyperintense and mildly T1-hyperintense to spinal cord with strong contrast enhancement. A cavernous hemangioma had a target-like appearance in both T1-weighted (T1w) and T2-weighted (T2w) images. In T2w images there was a small isointense center surrounded by a relatively large hyperintense area. In T1w images, there was a large isointense centre with a relatively small hyperintense periphery. Such characteristics should prioritize hemangioma as a consideration in a progressive myelopathy due to an intramedullary mass.

  16. [Giant cavernous hemangioma of the orbit (case report)].

    PubMed

    Grusha, Ia O; Ismailova, D S; Eksarenko, O V; Fedorov, A A; Kharlap, S I

    2014-01-01

    The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

  17. Hemorrhagic hemangioma in the liver: A case report.

    PubMed

    Kim, Jeong Min; Chung, Woo Jin; Jang, Byoung Kuk; Hwang, Jae Seok; Kim, Yong Hoon; Kwon, Jung Hyeok; Choi, Mi Sun

    2015-06-21

    Hemangioma is the most common type of benign tumor that arises in the liver. Although rupture and hemorrhage of hepatic hemangioma are rare complications, they can be the cause of mortality. The authors report a case of hemorrhagic hepatic hemangioma: in a 54-year-old woman who was admitted with epigastric pain. She had taken oral contraceptives several weeks prior. The results of a blood examination were normal. An abdominal computed tomography scan revealed a tumor in hepatic segment 4, and a hemorrhage inside the cystic mass was suspected. The mass was removed laparoscopically to confirm the tumor properties and control the hemorrhage. The pathologic findings of the resected mass were consistent with hepatic hemangioma with intratumoral hemorrhage. The patient was discharged 8 d after the surgery, without further complications or complaints, and the patient's condition was found to have improved during follow-up.

  18. Congenital hemangioma in spondylocostal dysostosis: a novel association*

    PubMed Central

    Salinas-Torres, Victor Michael

    2016-01-01

    Congenital hemangioma is a benign tumor caused by dysfunction in embryogenesis and vasculogenesis, which progresses during fetal life to manifest as fully developed at birth. Although hemangiomas are the most common tumor of infancy, rapidly involuting congenital hemangioma has not been described in spondylocostal dysostosis. I report the novel association of congenital hemangioma and spondylocostal dysostosis in a Mexican newborn female patient with neural tube defects. Given the embryological relationship between skin and nervous system, I surmise that this association is not coincidental. I also propose that these morphologic alterations be incorporated to the spondylocostal dysostosis phenotype and specifically looked for in other affected children, in order to provide appropriate medical management and genetic counseling. PMID:28300884

  19. Hemangioma of the tongue demonstrating a perfusion blood pool mismatch

    SciTech Connect

    Front, D.; Groshar, D.; Israel, O.; Robinson, E.

    1986-02-01

    Perfusion blood pool mismatch using Tc-99m labeled red blood cells (RBCs) in a hemangioma of the tongue is described. The method is useful in the evaluation of size of the residual blood pool after irradiation of the tumor.

  20. Orbital Hemangioma with Intracranial Vascular Anomalies and Hemangiomas: A New Presentation of PHACE Syndrome?

    PubMed

    Antonov, Nina K; Spence-Shishido, Allyson; Marathe, Kalyani S; Tlougan, Brook; Kazim, Michael; Sultan, Sally; Hess, Christopher P; Morel, Kimberly D; Frieden, Ilona J; Garzon, Maria C

    2015-01-01

    We present two cases of infants with a similar constellation of clinical findings: retro-orbital infantile hemangioma (IH), internal carotid artery (ICA) arteriopathy, and intracranial IH. In both cases, intracranial vascular anomalies and hemangiomas were found incidentally during evaluation of unilateral proptosis. Neither infant had evidence of cutaneous segmental IH of the face or neck, which might have provided a clue to the diagnosis of PHACE syndrome or of intracranial hemangiomas. In one case, intracranial involvement was particularly extensive and function threatening, with mass effect on the brain parenchyma. These cases serve to highlight the fact that clinical findings of proptosis, globe deviation, and strabismus should prompt immediate imaging to confirm the presence of orbital IHs and to exclude other diagnoses. Moreover, based on our cases and the embryologic origin of the orbit as a unique developmental unit, patients with confirmed retro-orbital IHs should undergo evaluation for anomalies associated with PHACE syndrome. Patients with orbital IHs and an additional major criterion for PHACE syndrome should be considered to have definite, and not just possible, PHACE syndrome.

  1. [Rapidly involuting congenital hemangiomas: twenty five case series].

    PubMed

    Larralde, Margarita; Solé, Juan Javier; Luna, Paula Carolina; Mosquera, Tomás; Abad, María Eugenia

    2014-04-01

    Rapidly involuting congenital hemangiomas are very rare vascular tumours, that are characterized for being completely developed at birth and for involuting in a short period of time after birth. We describe a case series of 25 patients with rapidly involuting congenital hemangiomas. Twelve patients were male and 13 female; they were all born at term. Lesions were small in 17 cases and big in 8. No patient needed active intervention and all lesions showed a rapid initial involution.

  2. Cavernous Hemangioma of Tongue: Management of Two Cases

    PubMed Central

    Puppala, Niharika; Deshmukh, Sudhanwa N; B, Jagadesh; S, Anuradha

    2014-01-01

    Hemangiomas are benign tumours of infancy and childhood, most commonly located in the head and neck region and occur more frequently in the lips, tongue and palate. The treatment depends upon lesion location, size and evolution stage and the patient’s age. This paper describes the management of cavernous hemangioma in a 2 -year -old child and 14 -year -old child using different approaches. PMID:25478463

  3. Current concepts in the management of periocular infantile (capillary) hemangioma.

    PubMed

    Ni, Nina; Guo, Suqin; Langer, Paul

    2011-09-01

    To review and evaluate the medical literature on new treatments for periocular infantile (capillary) hemangioma. Recent studies have shown a promising new therapy for infantile hemangioma using nonselective β-blockers, including oral propranolol and topical timolol. Conventional treatments for infantile hemangioma include the use of corticosteroids, laser, surgery, and immunomodulator therapy. Recently, systemic and topical β-blockers have been used to successfully treat infantile hemangioma. The drugs' mechanism of action remains uncertain, but plausible theories include vasoconstriction, modulation of pro-survival signal transduction pathways, and endothelial cell apoptosis. Whereas no life-threatening adverse events from β-blocker treatment have been described, there have been reports of bradycardia, hypotension, bronchospasm, hypoglycemia, and electrolyte disturbances resulting from systemic use of propranolol to treat infantile hemangioma. Sleep and gastrointestinal disturbances have also been frequently reported. Topical timolol application for localized, superficial tumors may confer similar efficacy as oral propranolol while reducing systemic effects. Despite the recent explosion of interest surrounding this novel treatment, current treatment and protocol-monitoring recommendations are based largely on the experience of individual centers. Several randomized controlled studies are currently underway, the results of which will guide future standard-of-care treatment for infantile hemangioma.

  4. Adult cutaneous hemangiomas are composed of nonreplicating endothelial cells.

    PubMed

    Tuder, R M; Young, R; Karasek, M; Bensch, K

    1987-12-01

    Thirty-four human "cherry" dermal hemangiomas were studied by electron microscopy, immunohistochemistry, and cell culture to assess the neoplastic nature of these lesions. Electron microscopy of nine hemangiomas revealed a pronounced thickening of the basement membrane (0.6 to 14 micron) in 93% of the total 158 vascular structures examined within the lesions. This increase was caused mainly by multiple layers of basal lamina, which were irregular in outline and frequently associated with pericytes. Basement membrane changes were present both in the periphery of the hemangiomas, as well as in the center of the lesions. Immature vessels could not be identified and mitoses were absent in all endothelial cells. Using an immunohistochemical marker (Ki67) specific for proliferating cells in G2 and S phases, positive staining was not found in the endothelial cells lining the hemangiomatous vessels, whereas basal epidermal keratinocytes in the same preparations and cultured microvascular endothelial cells expressed the antigen. Endothelial cells of nine hemangiomas did not stain with an activation-related antibody (E12) specific for endothelial cells. When endothelial cells from 14 hemangiomas were isolated and cultured under conditions that support the growth of normal human skin microvascular endothelial cells, the cells of hemangiomatous origin failed to grow. We conclude that the adult hemangiomas may not be true neoplasms, but a tissue overgrowth composed of mature vessels resembling dermal venules, lined by endothelial cells with virtually no turnover.

  5. Angiogenesis characteristics of infantile hemangioma and feasibility observation of transplantation model of human hemangioma on mice.

    PubMed

    Fu, Y; Yang, Z-G; Zhao, L-Y

    2017-03-01

    To study pathogenic features of pediatric hemangiomas, we successfully established a model in mice, by transplanting human hemangioma tissues. The hemangioma from the leg of a two-month-old infant was dissected and sliced into several pieces. During a careful surgical procedure, the hemangioma tissues were individually transplanted into skin incisions in anesthetized mice. The volume of the transplanted tumors was measured and the changes in shape recorded at 1 day, and at 1, 2, 3, 4, 5 and 6 months after the transplantation. HE dyeing, CD31 and Glut1 IHC were applied to tumors in the proliferation and involuting phases. Also, 10 survival tumors and 10 normal tissues from infants undergoing circumcisions (control tissues) were used to determine their Angiotensin 1 (Ang1), Angiotensin 2 (Ang2), Tie2, and endothelium growth factor (VEGF) expression levels by IHC method. We observed all the tumors going through the same stages, where after two months their volumes increased sharply and then after 4 months they all began to recede. During the proliferative phase, newly born capillaries could be seen and the tumor elasticity increased (bright red color). During the involuting phase, the color faded away and the tumors became harder and were almost gone by 6 months. During the first two months after transplantation, HE dyeing showed hypertrophied and proliferating endothelial cells accumulating inside the tumors with irregular cavities inside blood vessels being filled by them. During the involuting phase (at 4 months), the lumen in blood vessels was distinctly enlarged while fiber and adipose tissue had significantly deposited. The transplanted and original tumors tested positive for CD31 and Glut1 dyeing, without significant differences. Compared with control samples, the Ang1 expression of the transplanted tumor in both the hyperplasia and proliferative phases was stably low (p<0.05), while expressions of Ang2 and Tie2 were both stably high (p<0.05). The VEGF

  6. Thoracoscopic Resection of a Rare Case of Hemangioma of the Azygos Venous Arch

    PubMed Central

    Yixin, Cai; Ni, Zhang; Wenxin, Wang

    2017-01-01

    Hemangioma of the azygos venous arch is an exceedingly rare incident. This is a case of a thoracoscopic complete resection of a hemangioma of the azygos venous arch in a 37-year-old woman. PMID:28367348

  7. Spontaneous resolution of an infantile hemangioma in a dorsal root ganglion.

    PubMed

    Hervey-Jumper, Shawn L; McKeever, Paul E; Gebarski, Stephen S; Muraszko, Karin M; Maher, Cormac O

    2011-12-01

    Infantile hemangiomas are tumors commonly seen in children. Few authors have reported infantile hemangiomas affecting the CNS, and there are no prior reports detailing spontaneous resolution of a histologically proven juvenile hemangioma within a dorsal root ganglion. The authors report the case of a newborn boy with a large cutaneous hemangioma in the midline of his back. Spinal MR images were obtained to rule out associated spinal cord tethering, and an intradural spinal lesion was unexpectedly discovered. Biopsy revealed an intradural infantile hemangioma within the dorsal root ganglion, and, based on this diagnosis, no resection was performed. Sixteen months following the biopsy, the cutaneous hemangioma had become involuted and the intradural hemangioma had completely resolved. The behavior of the intradural component in this case follows the natural history of many cutaneous infantile hemangiomas.

  8. Varied appearances of hepatic cavernous hemangiomas with sonography, computed tomography, magnetic resonance imaging and scintigraphy

    SciTech Connect

    Bree, R.L.; Schwab, R.E.; Glazer, G.M.; Fink-Bennett, D.

    1987-11-01

    The incidental detection of an hepatic cavernous hemangioma may create a problem in differential diagnosis. The authors here review the characteristics of hemangiomas as recorded by various types of imaging.

  9. Percutaneous Pediculoplasty for Vertebral Hemangioma Involving the Neural Arch: A Case Report

    SciTech Connect

    Fuwa, Sokun Numaguchi, Yuji; Kobayashi, Nobuo; Saida, Yukihisa

    2008-01-15

    Vertebral hemangiomas occasionally involve the neural arch and they can be symptomatic. We report a case of symptomatic vertebral hemangioma mainly involving the unilateral neural arch which was successfully treated with percutaneous pediculoplasty using a single-needle technique.

  10. Control for laser hemangioma treatment system

    SciTech Connect

    Muckerheide, M.C.

    1982-02-23

    A laser is disclosed for directing a nominally 5 micron wavelength beam at a hemangioma or other variegated lesion. A fiber optic bundle for intercepting radiation reflected from the lesion at an intensity corresponding with the color intensity of the region at which the beam is directed. The output beam from the fiber optic bundle modulates a photodetector stage whose amplified output drives a galvanometer. The galvanometer shaft is coupled to the shaft of a potentiometer which is adjustable to regulate the laser power supply and, hence, the laser output energy level so laser beam energy is reduced when high absorption regions in the lesion are being scanned by the beam and increased as low absorption regions are being scanned.

  11. Radiological evaluation of hepatic cavernous hemangioma

    SciTech Connect

    Brant, W.E.; Floyd, J.L.; Jackson, D.E.; Gilliland, J.D.

    1987-05-08

    Cavernous hemangiomas of the liver are sufficiently common that they will often be incidentally discovered during hepatic imaging by ultrasound, computed tomography, or radiocolloid scintigraphy. The differentiation of these benign tumors from primary or metastatic hepatic malignancy is mandatory, but often it is not possible on the study in which the lesion was originally detected. There are several routes by which to arrive at the correct diagnosis, but the optimum study or sequence of studies may elude the physician caring for the patient. Knowledge of the imaging options, and the strengths and weaknesses of each of these options, will facilitate a rapid diagnosis and ensure proper treatment, with maximum patient safety and minimum expenditure of resources. This article examines these radiological options.

  12. Importance of SPECT/CT in detecting multiple hemangiomas on 99mTc-labeled RBC blood pool scintigraphy.

    PubMed

    Roy, Shambo Guha; Karunanithi, Sellam; Agarwal, Krishan Kant; Bal, Chandrasekhar; Kumar, Rakesh

    2015-04-01

    Vascular malformations and hemangiomas are common in children, but gastric hemangioma is extremely rare with less than 15 reported cases in the pediatric age group. Gastric hemangioma accounts for only 0.05% of all gastrointestinal neoplasms, and intra-abdominal hemangiomas are rarely found outside of the liver. We present a unique case of gastric hemangioma, and multiple hemangiomas were detected in a single scan by 99mTc-labeled RBC blood pool imaging. This case also depicts the incremental role of SPECT/CT over planar acquisition for detecting multiple hemangiomas, especially for those lesions located adjacent to physiological blood pool activity.

  13. Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma

    PubMed Central

    2015-01-01

    Background Anastomosing hemangioma (AH) of the kidney is a recently described morphological variant of hemangioma. It poses a diagnostic dilemma for clinicians because of its rarity and the overlapping features it shares with other renal vascular tumors. The aim of this paper is to review all the cases of AH of the kidney in the literature. Methods The literature was extensively searched for case reports of AH of the kidney and the clinical and pathological characteristics of the tumor were extracted. Results A total of 45 cases were reviewed. The mean age of presentation was 50 years (range, 15-83 years) and male sex accounted for 68.8% of the cases reviewed. AH of the kidney was mostly unilateral with only 4 cases of bilateral involvement of the kidney. The average size of the tumor is 1.5 cm (range, 0.1-7 cm). Incidental finding of AH of the kidney accounted for 62% of the cases reviewed. The ultrasound findings demonstrated varying echogenicity and the tumor appeared as solid and well demarcated heterogeneous masses on CT. The average follow up of the patients in this review was 26 months (range, 1-156 months). Conclusions AH of the kidney is a rare vascular tumor and a morphological variant of hemangioma. It has a characteristic sinusoidal architecture with a semblance of splenic sinusoids. It has overlapping clinical and imaging features with other vascular tumors of the kidney. Histological review and immunohistochemical studies are essential for accurate diagnosis. AH runs a benign course without evidence of disease recurrence during follow up. PMID:26244138

  14. Assessment of angiogenic markers in oral hemangiomas and pyogenic granulomas.

    PubMed

    Freitas, Tarsila M C; Miguel, Márcia C C; Silveira, Ericka J D; Freitas, Roseana A; Galvão, Hébel C

    2005-08-01

    The purpose of this research was to evaluate the immunohistochemical expression of the vascular endothelial growth factor (VEGF-C1) and measuring the angiogenic activity by the staining for von Willebrand factor (vWF) and CD31 in oral pyogenic granulomas and hemangiomas. The results showed that there was no statistically significant difference in the angiogenesis index between the lesions evaluated. The average microvessel density determined for MVC (microvessel count) using CD31 was 60.64 for hemangiomas and 59.64 for pyogenic granulomas, while angiogenic index determined using vWF was 64.24 and 62.20 in these lesions. The results showed that the cells highlighted by staining for vWF were more uniform than in those stained for CD31. There was no statistically significant difference between the lesions for the number of cells highlighted by staining for VEGF-C1. However, the mean number of cells highlighted in pyogenic granuloma specimens was higher (153.23) when compared to oral hemangioma specimens (115.17). The VEGF-positive cells were endothelial cells and fibroblasts in hemangiomas and macrophages and fibroblasts in pyogenic granulomas. These results effort the role of the angiogenic factors in the etiopathogenesis of the hemangiomas and pyogenic granulomas, however, it showed that microvessel quantification is not useful in the differential diagnosis of these lesions.

  15. Verrucous hemangioma: a clinicopathological and immunohistochemical analysis of 74 cases.

    PubMed

    Wang, Lei; Gao, Tianwen; Wang, Gang

    2014-11-01

    Verrucous hemangioma is a rare form of vascular malformation. Previous studies have reported positive expression of Wilms tumor 1 (WT-1) and Glut-1 and negative expression of lymphatic markers such as D2-40 and Prox1 in verrucous hemangioma cases. However, the sample sizes of these studies were usually small. We analyzed 74 cases of verrucous hemangioma diagnosed in a single dermatology department and performed immunohistochemical analysis of vascular and lymphatic markers in all cases. Verrucous hemangioma was usually located on the extremities. Most lesions presented as solitary or multiple hyperkeratotic plaques or nodules with various diameters. Histopathologically, the lesions showed proliferation of small- to medium-sized vessels from the papillary dermis to subcutaneous tissue. The density of the proliferated vessels varied between cases. The vessels were positive for CD31 in 74 cases, focally positive for Prox1 in 63 cases, focally positive for D2-40 in 10 cases, negative for lymphatic vessel endothelial hyaluronan receptor-1 in 74 cases, negative for WT-1 in 60 cases, and positive for Glut-1 in 49 cases. Verrucous hemangioma is a vascular malformation with an incomplete lymphatic immunophenotype, as indicated by positive staining for Prox1 and negative staining for WT-1 in the majority of instances. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review.

    PubMed

    Powers, David B; Fisher, Elda; Erdmann, Detlev

    2017-03-01

    Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.

  17. Vertebral hemangioma coincident with metastasis of colon adenocarcinoma.

    PubMed

    Zapałowicz, Krzysztof; Bierzyńska-Macyszyn, Grażyna; Stasiów, Bartłomiej; Krzan, Aleksandra; Wierzycka, Beata; Kopycka, Anna

    2016-03-01

    The authors report on colon cancer metastasis to the L-3 vertebra, which had been previously found to be involved by an asymptomatic hemangioma. A 61-year-old female patient was admitted after onset of lumbar axial pain and weakness of the right quadriceps muscle. Her medical history included colon cancer that had been diagnosed 3 years earlier and was treated via a right hemicolectomy followed by chemotherapy. Presurgical imaging revealed an asymptomatic hemangioma in the L-3 vertebral body. Computed tomography and MRI of the spine were performed after admission and revealed a hemangioma in the L-3 vertebral body as well as a soft-tissue mass protruding from the L-3 vertebral body to the spinal canal. Treatment consisted of vertebroplasty of the hemangioma, left L-3 hemilaminectomy, and removal of the pathological mass from the spinal canal and the L-3 vertebral body. Histopathological examination revealed the presence of colon cancer metastasis and a hemangioma in the same vertebra.

  18. Diode laser for the treatment of telangiectasias following hemangioma involution.

    PubMed

    Cerrati, Eric W; O, Teresa M; Chung, Hoyun; Waner, Milton

    2015-02-01

    Infantile hemangiomas are well known for their rapid growth during the first 6 to 9 months of life, followed by a spontaneous but slow involution. The standard of care is to treat these lesions at an early age with propranolol to expedite the involution process; however, surgery still remains an active component in the management. Medical treatment with propranolol or natural involution will often result in residual telangiectasias. We evaluated the efficacy of using a diode laser as a treatment for telangiectasias following cervicofacial infantile hemangioma involution. Case series with chart review. Tertiary care hospital and practice specializing in the care of vascular anomalies. Twenty patients, aged 4 months to 11 years (average 2.69 years), underwent treatment with a 532-nm diode laser to treat the residual telangiectasias following hemangioma involution. All procedures were performed in the operating room. To assess the efficacy, we independently evaluated pre- and posttreatment digital photographs and ranked them on a 0- to 4-point scale (0 = no change and 4 = complete response). Adverse reactions were also recorded. The telangiectasias showed considerable improvement following treatment. In more than half of the patients treated, the affected area demonstrated a complete response. No adverse reactions were noted. A 532-nm diode laser effectively treats the remaining telangiectasias following hemangioma involution. Whether used independently or in conjunction with other treatment modalities, the diode laser should be part of the surgical armamentarium when treating infantile hemangiomas. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  19. Intraosseous Cavernous Hemangioma: A Rare Presentation in Maxilla

    PubMed Central

    Işılgan, Servet Elçin; Çerkez, Cem; Otrakçı, Volkan; Serel, Savaş

    2014-01-01

    Objective: Hemangiomas are benign vascular lesions mostly arising from soft tissues. However, intraosseous hemangioma is a rare entity, comprising only 1% of benign bone tumors. We describe here the presentation, diagnosis, and treatment of a 42-year-old woman with a painless hard swelling—diagnosed to be intraosseous hemangioma via orbital magnetic resonance imaging—localized on the left infraorbital margin. Methods: After en bloc excision of the mass with safety margins through a subciliary incision, the defect was reconstructed via Medpor, which was fixed to the drilled bones with polypropylene sutures. Results: Histopathological diagnosis of the specimen revealed intraosseous cavernous hemangioma. There seems to be no recurrence or any cosmetic deformity 3 months postoperatively. Conclusion: Total surgical excision is the preferred method of treatment for intraosseous hemangiomas with reconstruction. In this patient, we used Medpor for reconstruction of orbital floor, the infraorbital orbital rim and anterior wall of maxillary sinus. We think that Medpor is a good option since a natural smooth malar contour and adequate orbital rim can be achieved and there is no any other scar. PMID:25328568

  20. [Differential therapy of hemangiomas--when cryotherapy, laser therapy or operation?].

    PubMed

    Grantzow, R

    2001-01-01

    Hemangiomas are the most common soft tissue tumours in childhood, which arise after birth, grow for several months and regress spontaneously. Serious problems can occur with closure of the eye resulting in amblyopia or with psychologica problems due to disfiguring of the face. Therapeutic possibilities are cryo therapy, laser therapy and surgical removal. Cryotherapy can be used for small and flat hemangiomas. Bigger hemangiomas are treated with the Nd-YAG laser. Its effect is an acceleration of involution. Typical residues of hemangiomas must be secondarily corrected surgically. Indications for primary surgical therapy are hemangiomas of the eye lid and in the scalp.

  1. Laser statistical polarimetry optical anisotropy of blood plasma of the patients with hemangioma

    NASA Astrophysics Data System (ADS)

    Boychuk, T. M.; Bodnar, B. M.; Vatamanesku, L. I.

    2012-01-01

    Proposed in this work is a novel method of early laser polarimetric diagnostics of vessels pathologies and hemangioma formation. The generalized model of formation processes of polarization inhomogeneous laser images of experimental samples of biological tissues is presented. It was performed the experimental measurements of polarization states of both biological tissues laser images points and the hemangioma liquids. The results of investigating the interrelation between statistical moments of the 1st-4th order are presented that characterize the coordinate distributions of polarization azimuth of laser images of histological sections of hemangioma, hemangioma blood smears and blood plasma with vascular system pathologies. The diagnostic criteria of hemangioma nascency are determined.

  2. Laser statistical polarimetry optical anisotropy of blood plasma of the patients with hemangioma

    NASA Astrophysics Data System (ADS)

    Boychuk, T. M.; Bodnar, B. M.; Vatamanesku, L. I.

    2011-09-01

    Proposed in this work is a novel method of early laser polarimetric diagnostics of vessels pathologies and hemangioma formation. The generalized model of formation processes of polarization inhomogeneous laser images of experimental samples of biological tissues is presented. It was performed the experimental measurements of polarization states of both biological tissues laser images points and the hemangioma liquids. The results of investigating the interrelation between statistical moments of the 1st-4th order are presented that characterize the coordinate distributions of polarization azimuth of laser images of histological sections of hemangioma, hemangioma blood smears and blood plasma with vascular system pathologies. The diagnostic criteria of hemangioma nascency are determined.

  3. Multiple Verrucous Hemangiomas: A Case Report with New Therapeutic Insight

    PubMed Central

    Singh, Jasmeet; Sharma, Preeti; Tandon, Sidharth; Sinha, Surabhi

    2017-01-01

    Verrucous hemangioma is an uncommon congenital vascular malformation, which may clinically masquerade angiokeratoma, lymphangioma circumscriptum, or malignant melanoma. Differentiation is essential owing to varied therapeutic and prognostic implications. We present a rare case of multiple verrucous hemangiomas in a teenage girl who presented with multiple warty lesions over the dorsal aspect of the left foot since birth. Magnetic resonance imaging (MRI) scan was suggestive of a vascular malformation, and skin biopsy showed ectatic blood vessels extending from the papillary dermis into the subcutaneous tissue, diagnostic of verrucous hemangioma. A combination of 0.05% halobetasol propionate with 3% salicylic acid ointment was advised. This therapeutic intervention resulted in significant resolution of the warty lesions over a period of 2 months, following which surgical excision was performed. The implication is that we can use a combination of super potent topical steroid with salicylic acid as an adjunct to surgical resection. PMID:28761841

  4. Multiple Verrucous Hemangiomas: A Case Report with New Therapeutic Insight.

    PubMed

    Singh, Jasmeet; Sharma, Preeti; Tandon, Sidharth; Sinha, Surabhi

    2017-01-01

    Verrucous hemangioma is an uncommon congenital vascular malformation, which may clinically masquerade angiokeratoma, lymphangioma circumscriptum, or malignant melanoma. Differentiation is essential owing to varied therapeutic and prognostic implications. We present a rare case of multiple verrucous hemangiomas in a teenage girl who presented with multiple warty lesions over the dorsal aspect of the left foot since birth. Magnetic resonance imaging (MRI) scan was suggestive of a vascular malformation, and skin biopsy showed ectatic blood vessels extending from the papillary dermis into the subcutaneous tissue, diagnostic of verrucous hemangioma. A combination of 0.05% halobetasol propionate with 3% salicylic acid ointment was advised. This therapeutic intervention resulted in significant resolution of the warty lesions over a period of 2 months, following which surgical excision was performed. The implication is that we can use a combination of super potent topical steroid with salicylic acid as an adjunct to surgical resection.

  5. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    PubMed Central

    Kazimi, Mircelal; Ulas, Murat; Ibis, Cem; Unver, Mutlu; Ozsan, Nazan; Yilmaz, Funda; Ersoz, Galip; Zeytunlu, Murat; Kilic, Murat; Coker, Ahmet

    2009-01-01

    Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding. PMID:19178725

  6. Consequences of Facial Hemangioma with Regard to Dental Treatment.

    PubMed

    Santin, Gabriela Cristina; Guimarães, Késsia Suênia Fidelis de Mesquita; de Oliveira, Sara Silva; da Silva, Raquel Assed Bezerra; Nelson-Filho, Paulo; Palma-Dibb, Regina Guenka; de Queiroz, Alexandra Mussolino

    2017-01-01

    Hemangioma is a benign vascular tumor that affects 3%-10% of the population and usually does not require specific treatment due to spontaneous regression. The purpose of this paper is to present a case report of a child having been born prematurely and diagnosed with hemangioma in the head and neck, emphasizing the dentofacial changes and treatment used to provide care. Severe fibrous scars were found in the perioral region and below the ear that limited the patient's ability to open her mouth. The child exhibited anterior open bite as well as dental caries in the lower jaw, hypomineralization, and enamel hypoplasia. Treatment consisted of dietary and oral hygiene orientations, dental prophylaxis, topical 1:23% acidulated phosphate fluoride gel, removal of the carious tissue, sealing with glass ionomer cement, and extraction. Dentists need to have knowledge on hemangioma for a proper diagnosis and the optimization of dental treatment.

  7. Cavernous hemangioma of the orbit: an unusual acute presentation

    PubMed Central

    Louisraj, Sophia; Ponnudurai, Thendral; Rodriguez, Dominic; Thomas, Philip A; Nelson Jesudasan, Christadoss Arul

    2017-01-01

    We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE) on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medications, blurring of vision developed in the LE. When seen 10 days later, the patient’s LE showed axial proptosis. Magnetic resonance imaging revealed an intraconal soft tissue mass in the superomedial quadrant of the left orbit. Superior orbitotomy with mass excision was done; histopathological examination of the excised mass revealed a cavernous hemangioma. The patient had complete visual recovery following surgery. To our knowledge, an acute presentation of an orbital cavernous hemangioma with subconjunctival hemorrhage and periorbital ecchymosis has not previously been reported. PMID:28769595

  8. Transcatheter Arterial Embolization Alone for Giant Hepatic Hemangioma

    PubMed Central

    Zhang, Yue-Lin; Zhou, Guan-Hui; Ai, Jing; Zhou, Tan-Yang; Zhu, Tong-Yin; Zhang, Ai-Bin; Wang, Wei-Lin; Zheng, Shu-Sen

    2015-01-01

    Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the “early leaving but late returning, hanging nut on a twig” sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients’ condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma. PMID:26287964

  9. Symptomatic hemangioma of oral cavity treated with CO2 laser

    NASA Astrophysics Data System (ADS)

    Nicola, Ester M. D.; Coutinho, Adriana A.; Nicola, Jorge H.; Gusmao, Reinaldo J.

    1995-05-01

    The CO2 laser has been used by our group as a secure and efficient tool for the treatment of symptomatic oral cavity hemangiomas which can be responsible for disturbance for swallowing, phonation and in hygienic, besides discomfort and bleeding to patients. During the last four years, twelve patients with symptomatic oral cavity hemangioma were treated at the Laser Unit of our University. The treatment consisted in the application of CO2 laser at medium to low intensity according to characteristics and location of the lesions. For hemangiomas located at sites of easy surgical access such as anterior 1/3 of the tongue, lips, bucal vestibule we use 10 to 37 J/mm2 over the surface of the lesion. When the hemangioma was located at difficult surgical access sites, such as, tonsils, posterior 1/3 of tongue, or at pharyngeal wall we used 3.0 to 4.0 J/mm2 encircling the whole hemangioma. This causes reduction in the size of the lesion throughout sclerosis of nutrition vessels. After this initial procedure we applied 0.8 to 1.0 J/mm2 over the whole extent of the lesion. For both procedures we observed no significant bleeding or inflammatory reaction. The patients referred minimal post-operative discomfort with good cicatricial evolution. The evident reduction in the vascularization and size could be confirmed by photographic documentation. The good results described above, with disappearance of symptoms lead to the conclusion that CO2 laser is an efficient and secure method of treatment for symptomatic hemangioma of the oral cavity.

  10. Therapeutic Effect of Propranolol in Mexican Patients with Infantile Hemangioma.

    PubMed

    Castaneda, Saul; Garcia, Esbeydy; De la Cruz, Hermelinda; Ramirez, Oscar; Melendez, Samuel; Sanchez-Palacio, Jose

    Infantile hemangiomas are the most common childhood vascular tumors, occurring in 10 % of children aged less than 1 year. Propranolol, a β-adrenergic blocker mainly indicated for hypertension, has proven effective in treating these types of tumors. To evaluate the efficacy and adverse effects of propranolol in Mexican pediatric patients diagnosed with infantile hemangioma, treated with an extemporaneously compounded solution of propranolol. An open prospective observational study at the Children's Hospital of the Californias in Tijuana, Mexico was performed on ambulatory pediatric patients between the ages of 3 and 12 months diagnosed with infantile hemangioma. Patients were treated with an oral solution of propranolol in doses ranging from 0.5 to 2.5 mg/kg/day. Children were monitored monthly by the physician in charge, at which time clinical and treatment data were collected. Over a period of 20 months, 31 patients were treated (36 % male and 64 % female).The majority of hemangiomas were superficial (55 %), located mainly on the face. Treatment had an average duration of 10.5 months. Ninety-six percent responded to the treatment, showing decreases in size and coloration of the hemangioma. Children who started therapy before 5 months of age had a significantly better response and shorter duration of treatment. The average therapeutic dose was 1.5 mg/kg/day. Five patients experienced mild adverse effects during the first month of therapy. Treatment with propranolol in this group of Mexican pediatric patients proved to be safe and effective at an average dose of 1.5 mg/kg/day, reducing the size and coloration of hemangioma with a minimum incidence of adverse effects.

  11. Therapeutic Effect of Propranolol in Mexican Patients with Infantile Hemangioma.

    PubMed

    Castaneda, Saul; Garcia, Esbeydy; De la Cruz, Hermelinda; Ramirez, Oscar; Melendez, Samuel; Sanchez-Palacio, Jose

    2016-03-01

    Infantile hemangiomas are the most common childhood vascular tumors, occurring in 10 % of children aged less than 1 year. Propranolol, a β-adrenergic blocker mainly indicated for hypertension, has proven effective in treating these types of tumors. To evaluate the efficacy and adverse effects of propranolol in Mexican pediatric patients diagnosed with infantile hemangioma, treated with an extemporaneously compounded solution of propranolol. An open prospective observational study at the Children's Hospital of the Californias in Tijuana, Mexico was performed on ambulatory pediatric patients between the ages of 3 and 12 months diagnosed with infantile hemangioma. Patients were treated with an oral solution of propranolol in doses ranging from 0.5 to 2.5 mg/kg/day. Children were monitored monthly by the physician in charge, at which time clinical and treatment data were collected. Over a period of 20 months, 31 patients were treated (36 % male and 64 % female).The majority of hemangiomas were superficial (55 %), located mainly on the face. Treatment had an average duration of 10.5 months. Ninety-six percent responded to the treatment, showing decreases in size and coloration of the hemangioma. Children who started therapy before 5 months of age had a significantly better response and shorter duration of treatment. The average therapeutic dose was 1.5 mg/kg/day. Five patients experienced mild adverse effects during the first month of therapy. Treatment with propranolol in this group of Mexican pediatric patients proved to be safe and effective at an average dose of 1.5 mg/kg/day, reducing the size and coloration of hemangioma with a minimum incidence of adverse effects.

  12. When to stop propranolol for infantile hemangioma

    PubMed Central

    Chang, Lei; Gu, Yifei; Yu, Zhang; Ying, Hanru; Qiu, Yajing; Ma, Gang; Chen, Hui; Jin, Yunbo; Lin, Xiaoxi

    2017-01-01

    There is no definitive conclusion regarding the optimal timing for terminating propranolol treatment for infantile hemangioma (IH). A total of 149 patients who underwent detailed color Doppler ultrasound examination were included in this study. The characteristics and propranolol treatment of all patients were summarized and analyzed. Patients were divided into two groups according to the lesion regression rate. Among the 149 patients, 38 were assigned to the complete regression group, and 111 were assigned to the partial regression group. The age at which propranolol treatment started, duration of follow-up after treatment discontinuation and rate of adverse events were not significantly different between the two groups. The duration of oral propranolol treatment was shorter in the complete regression group. The age at which propranolol was terminated was younger in the complete regression group, and this group had a lower recurrence rate. Propranolol is safe and effective for the treatment of IHs that require intervention, but it should be stopped at an appropriate time, which is determined primarily by the lesion regression rate after propranolol treatment. Ultrasound is helpful in determining when to stop propranolol for IH. PMID:28225076

  13. Aggressive intramuscular hemangiomas in the upper extremity

    PubMed Central

    Lu, Hui; Chen, Qiang; Yang, Hu; Shen, Hui

    2017-01-01

    Abstract Introduction: Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us. Clinical Findings: This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. On physical examination, the tumor and skin flap complex was seen with a size of 14 cm_12 cm in his right hand, and the multiple postoperative scars were shown on his right hand and forearm. The patient was not able to raise his right shoulder, and the ranges of motion of his right elbow, wrist, and finger were almost zero degrees. Interventions: Considering that the tumor had been surgically excised for several times and the multiple recurrences had affected adversely his daily life, an amputation of his right hand, forearm, and the part of his right arm was performed. Diagnoses: The pathological examination confirmed the diagnosis of IMH. Outcomes: After the amputation surgery, the patient gained a functional recovery and the tumor did not recur during the 2 years after the surgery. Conclusion: A treatment of choice should be personalized according to an IMH patient's overall situation. For an IMH patient like our case with a history of multiple tumor recurrences, we suggest that an amputation surgery should be performed as early as possible to avoid the repeated, but ineffective surgical excisions and the unnecessary sufferings. PMID:28099360

  14. Gamma Knife Radiosurgery for Choroidal Hemangioma

    SciTech Connect

    Kim, Yun Taek; Kang, Se Woong; Lee, Jung-Il

    2011-12-01

    Purpose: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Methods and Materials: Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm{sup 3} (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). Results: The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p = .018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Conclusion: Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.

  15. When to stop propranolol for infantile hemangioma.

    PubMed

    Chang, Lei; Gu, Yifei; Yu, Zhang; Ying, Hanru; Qiu, Yajing; Ma, Gang; Chen, Hui; Jin, Yunbo; Lin, Xiaoxi

    2017-02-22

    There is no definitive conclusion regarding the optimal timing for terminating propranolol treatment for infantile hemangioma (IH). A total of 149 patients who underwent detailed color Doppler ultrasound examination were included in this study. The characteristics and propranolol treatment of all patients were summarized and analyzed. Patients were divided into two groups according to the lesion regression rate. Among the 149 patients, 38 were assigned to the complete regression group, and 111 were assigned to the partial regression group. The age at which propranolol treatment started, duration of follow-up after treatment discontinuation and rate of adverse events were not significantly different between the two groups. The duration of oral propranolol treatment was shorter in the complete regression group. The age at which propranolol was terminated was younger in the complete regression group, and this group had a lower recurrence rate. Propranolol is safe and effective for the treatment of IHs that require intervention, but it should be stopped at an appropriate time, which is determined primarily by the lesion regression rate after propranolol treatment. Ultrasound is helpful in determining when to stop propranolol for IH.

  16. Propranolol Promotes Accelerated and Dysregulated Adipogenesis in Hemangioma Stem Cells

    PubMed Central

    England, Ryan W.; Hardy, Krista L.; Kitajewski, Alex M.; Wong, Alvin; Kitajewski, Jan K.; Shawber, Carrie J.; Wu, June K.

    2014-01-01

    Background Infantile hemangiomas are the most common tumor of infancy, yet there are no FDA-approved therapeutics to date. Recently, the non-selective beta-adrenergic-blocker propranolol has been shown to be a safe and effective means of treating infantile hemangiomas, though its mechanism has yet to be elucidated. We have previously demonstrated that propranolol induces early and incomplete adipogenesis in stem cells derived from hemangiomas. We hypothesize that propranolol promotes dysregulated adipogenesis via the improper regulation of adipogenic genes. Methods Hemangioma stem cells isolated from resected infantile hemangioma specimens were treated with adipogenic medium for 1 or 4 days in either propranolol or vehicle. Cell death was measured by the incorporation of annexin V and propidium iodide by flow cytometry. Adipogenesis was assessed by visualizing lipid droplet formation by Oil Red O staining. Pro-adipogenic genes C/EBPβ, C/EBPβ, C/EBPδ, PPARδ, PPARγ, RXRα, and RXRγ were analyzed by quantitative reverse transcription and polymerase chain reaction. Results Hemangioma stem cells treated with propranolol increased lipid droplet formation compared to vehicle-treated cells indicating increased adipogenesis. Cell death as measured by FACS analysis indicated that the propranolol-treated cells died due to necrosis and not apoptosis. During adipogenesis, transcript levels of PPARδ, PPARγ, C/EBPβ, and C/EBPδ were significantly increased (p < 0.01) in propranolol-treated cells relative to control cells. In contrast, RXRα and RXRγ levels were significantly decreased (p < 0.05), and C/EBPα, a gene required for terminal adipocyte differentiation, was strongly suppressed by propranolol when compared to vehicle-treated cells (p < 0.01). Conclusions In hemangioma stem cells, propranolol accelerated dysregulated adipogenic differentiation characterized by improper adipogenic gene expression. Consistent with accelerated adipogenesis, propranolol

  17. [Primary intraosseous cavernous hemangioma in anterior clinoid process].

    PubMed

    Yamashita, Taro; Mikami, Takeshi; Minamida, Yoshihiro; Baba, Takeo; Houkin, Kiyohiro

    2006-08-01

    Primary intraosseous cavernous hemangiomas (PICHs) are rare tumors, and there are no previous reports of cases with a tumor at the anterior clinoid process. We report a case of a PICH at the anterior clinoid process in a 66-year-old female presenting with headaches and visual impairment. CT and MR imaging showed a mass in the anterior clinoid process. The lesion showed hyperintensity on T1- and T2-weighted imaging, and gadolinium was homogenously enhanced. The lesion was removed surgically, and histologically confirmed as a cavernous hemangioma. Preoperative examinations could not provide a definitive diagnosis. A brief clinical and radiological review of the literature is presented.

  18. [De novo growth of a capillary hemangioma of the conjunctiva].

    PubMed

    Fernández-Vega Cueto, L; Tresserra, F; de la Paz, M F

    2014-03-01

    A 22-year-old woman patient, diagnosed with an inclusion cyst of the conjunctiva in the nasal sector of the left eye, who after 2 shot/needle injections in the lesion came to our clinic with a dense subconjunctival hemorrhage in four quadrants and with severe pain. After excision biopsy, a capillary hemangioma of the conjunctiva was diagnosed. Conjunctival capillary hemangioma is mainly a benign lesion, asymptomatic and mostly congenital in origin, its progression or de novo growth is rare in adulthood. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  19. Hemangioma of the sphenoid and ethmoid sinuses: two case reports.

    PubMed

    Kilde, John D; Rhee, John S; Balla, Andre A; Smith, Michelle M; Smith, Timothy L

    2003-03-01

    Hemangiomas of the paranasal sinuses are rare, particularly those of the sphenoid and ethmoid sinuses. Although imaging of the sinuses is key to determining the extent of involvement, the diagnosis is based on the lesion's histologic appearance. Obtaining an adequate biopsy can be difficult in light of the risk of bleeding and the relative inaccessibility of lesions in this region. These obstacles can make the diagnosis and management of these lesions particularly challenging. We describe two new cases of sinonasal hemangioma--one in the ethmoid sinus and one in the ethmoid and sphenoid sinuses--and we discuss the diagnostic and therapeutic interventions that are needed to manage these lesions.

  20. Nasal tip infantile hemangioma, a case of mistaken identity.

    PubMed

    Gaines, Sara A; Blum, Craig; Chiu, Ernest S

    2013-01-01

    Infantile hemangioma is the most common vascular tumor in the pediatric population, and the majority of cases are diagnosed only on history and physical examination. This report highlights a case in which a 3-year-old girl undergoes surgical removal of what was thought to be an infantile hemangioma. Immunohistochemical staining, however, showed the absence of GLUT-1 marker, which discredited the original diagnosis. The vascular tumor was found to be a unique presentation of a pyogenic granuloma. When the clinical diagnosis is in question, referral for biopsy may prevent unnecessary medical interventions.

  1. Surgical removal of retrobulbar hemangioma in a goldfish (Carassius auratus).

    PubMed

    O'Hagan, Bradley J; Raidal, Shane R

    2006-09-01

    The surgical removal of retrobulbar hemangioma is described in a mature fantail goldfish (Carassius auratus) with a 6-week history of a swollen right eye. The fish was anesthetized using alfaxalnone at a concentration in the water of 5 mg/L to facilitate fine-needle aspiration and surgical removal of the eye. The fish was treated with enrofloxacin 5 mg intraperitoneally and recovered with major buoyancy deficits that corrected 20 minutes after treatment with methadone at a dose of 0.4 mg intramuscularly. Histologic examination of the excised tissue demonstrated that the tumor was a compact hemangioma.

  2. Hepatic hemangioma with normal angiograms: Three case reports

    SciTech Connect

    Davis, W.D.; Ferrante, W.A.; Tutton, R.H.; Bowen, J.C. )

    1990-02-16

    Three cases of symptomatic cavernous hemangioma of the liver are reported. All three patients have normal angiograms. A review of the literature shows that the diagnosis of hemangioma may be made noninvasively with a high degree of accuracy. Technetium Tc 99m-labeled red blood cell scanning is very specific, while dynamic computed tomography may be more sensitive for small lesions. A combination of the two modalities makes the diagnosis in greater than 90% of cases. Magnetic resonance imaging is also sensitive and specific. Angiography, as shown in these cases, may not only be questionably indicated, but may be misleading. The treatment for symptomatic lesions is resection, and secondary alternatives are discussed.

  3. Corticosteroid Suppression of VEGF-A in Infantile Hemangioma-Derived Stem Cells

    PubMed Central

    Greenberger, Shoshana; Boscolo, Elisa; Adini, Irit; Mulliken, John B.; Bischoff, Joyce

    2010-01-01

    BACKGROUND Corticosteroids are commonly used to treat infantile hemangioma, but the mechanism of action of this therapy is unknown. We investigated the effect of corticosteroids in a previously described in vivo model of infantile hemangioma and in cultured hemangioma-derived cells. METHODS We tested hemangioma-derived stem cells for vasculogenic activity in vivo after implantation into immune-deficient (nude) mice. We studied dexamethasone treatment of both the cells before implantation and the mice after implantation. We also tested hemangioma-derived stem cells for expression of vascular endothelial growth factor A (VEGF-A) in vitro and studied the inhibition of VEGF-A expression, using short hairpin RNA (shRNA) in vivo and in vitro. RESULTS Systemic treatment with dexamethasone led to dose-dependent inhibition of tumor vasculogenesis in the murine model. Pretreatment of hemangioma-derived stem cells in vitro before implantation also inhibited vasculogenesis. Dexamethasone suppressed VEGF-A production by hemangioma-derived stem cells in vitro but not by hemangioma-derived endothelial cells or human umbilical-vein endothelial cells. Silencing VEGF-A in hemangioma-derived stem cells reduced vasculogenesis in vivo. VEGF-A was detected in hemangioma specimens in the proliferating phase but not in the involuting phase and was shown by immunostaining to reside outside of vessels. Corticosteroid treatment suppressed other proangiogenic factors in hemangioma-derived stem cells, including urokinase plasminogen activator receptor, interleukin-6, monocyte chemoattractant protein 1, and matrix metalloproteinase 1. CONCLUSIONS In a murine model, dexamethasone inhibited the vasculogenic potential of stem cells derived from human infantile hemangioma. The corticosteroid also inhibited the expression of VEGF-A by hemangioma-derived stem cells, and silencing of VEGF-A expression in these cells inhibited vasculogenesis in vivo. PMID:20237346

  4. VIIIth nerve cavernous hemangioma mimicking a stage 1 acoustic schwannoma.

    PubMed

    Bonfort, G; Veillon, F; Debry, C; Kehrli, P; Chibbaro, S

    2015-10-01

    To report a case of VIIIth nerve cavernous hemangioma, a very rare differential diagnosis among the various pathologies presenting as small enhancing entities into the internal auditory canal. It is one of the most challenging when imaging is not able to differentiate it from an intrameatal vestibular schwannoma. We report a cavernous hemangioma extruding from the internal auditory canal, diagnosed after a left translabyrinthine resection in a 45-year-old man complaining of profound sensorineural hearing loss, with no facial paresis or dizziness. The preoperative differential diagnosis of a vestibular schwannoma was impossible, due to the absence of calcifications that usually characterize temporal bone hemangiomas. Clinical presentation, radiological features and treatment considerations are discussed along with up-to-date review of pertinent literature. When considering an apparent small intra-auditory canal schwannoma, otoneurologists should be aware of the rare possibility of a cavernous hemangioma. Early diagnosis and surgical treatment may improve the functional outcome, possibly preserving neural integrity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Pulmonary Hilar Tumor: An Unusual Presentation of Sclerosing Hemangioma

    PubMed Central

    Hung, Jui-Hung; Ho, Shang-Yun

    2016-01-01

    Pulmonary sclerosing hemangioma is an uncommon benign tumor of the lung; however, on rare occasions it can arise from the pulmonary hilar region. Herein, we report a 53-year-old female patient who presented with a round opacity in the right upper lung field on a radiograph. Chest computed tomography scanning revealed a 3.1 cm mass in the right pulmonary hilum. Thoracoscopic tumor excision was subsequently performed. On pathohistologic study, the tumor was well defined and composed of round stromal cells and surface cells arranged in a papillary, sclerotic, solid, and hemorrhagic pattern. In immunochemical study, the round cells were positive for thyroid transcription factor-1 (TTF-1) and epithelial membrane antigen (EMA) and negative for cytokeratin. The surface cells were positive for TTF-1, EMA, and cytokeratin. Therefore, a final diagnosis of sclerosing hemangioma was confirmed. In conclusion, pulmonary sclerosing hemangioma is uncommon and rare in the pulmonary hilar region. CT scanning is useful to determine its benignity, although imaging features are not specific for a definite differential diagnosis from other pulmonary tumors. Therefore, tissue diagnosis is usually necessary, and pulmonary sclerosing hemangioma should be listed in the differential diagnoses of pulmonary hilar tumors. PMID:27761142

  6. Early growth of infantile hemangiomas: what parents' photographs tell us.

    PubMed

    Tollefson, Megha M; Frieden, Ilona J

    2012-08-01

    Infantile hemangiomas (IH) are recognized as growing rapidly during the first months of life, but details of early growth before 3 months of age have not been well-characterized. Our goal was to study early IH growth by using parental photographs of infant children with facial IHs to better understand early hemangioma growth, with the aim of improving guidance for physicians and parents of infants with high-risk IH. Serial images of 30 infants showing IH at intervals of 1 to 2 weeks up to 6 months were analyzed for characteristics of color, thickness, and distortion of anatomic landmarks. The presence or absence of an IH precursor at birth was noted. Mean scores per age interval were compiled. Results were analyzed by using signed rank test. An assessment of "optimal time for referral" was made. IH growth was nonlinear; most rapid growth occurred between 5.5 and 7.5 weeks of age. The mean "optimal age for referral" was 4 weeks of age. Hemangioma precursors were present at birth in 65% of patients. The most rapid hemangioma growth occurs before 8 weeks of age, much earlier than previously appreciated. Specialty evaluation and initiation of treatment, however, typically occur after the age of most rapid growth. Our findings suggest a need for a paradigm shift in the timing of referral and initiation of treatment of high-risk IH so that therapy can be initiated before or early in the course of most rapid growth, rather than after it is already completed.

  7. [Infantile hemangioma and propranolol: a therapeutic "revolution". Literature review].

    PubMed

    Yilmaz, L; Dangoisse, C; Semaille, P

    2013-01-01

    Infantile hemangioma (IH) is the most common benign vascular tumour affecting children. Most infantile hemangiomas are self-limiting, but some require specific treatment. Propranolol has been proposed for the treatment of infantile hemangiomas. The aim of this study is to explore the mechanism of action of propranolol for the treatment of infantile hemangiomas and to demonstrate its safety and efficacy through a review of the literature. The non cardioselective bêta-blocker propranolol has been used in a pediatric setting for 40 years and, since 2008, has a new indication. A clearly significant improvement has been observed in the condition of children with complicated IH (10%) treated with propranolol. This new indication has been widely described in the international literature. Various explanations have been put forward for the mechanism of action including a vasoconstrictor, antiangiogenic and apoptotic effect of propranolol on the different cells making up an IH. Overall tolerance is good and the efficacy markedly superior to that of any other treatments used for this purpose. In conclusion, with its good tolerance profile and superior efficacy versus all the other available therapies, propranolol can be considered to be a first-line treatment for complicated IH.

  8. [Intramedullary spinal cord cavernous hemangiomas: clinical features and surgical treatment].

    PubMed

    Ishii, Ken; Nakamura, Masaya

    2011-01-01

    Intramedullary spinal cord cavernous hemangiomas (angiomas) are occult vascular malformations characterized by rare lesions consisting of closely packed capillary-like vessels. In general, patients with this disease become symptomatic because of hemorrhage leads to progressive neurological deficits. Therefore, surgical tumor resection should be considered for symptomatic patients should be considered a surgical tumor resection.

  9. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report.

    PubMed

    Elif, Bilgir; Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct.

  10. Durable response of intracranial cellular hemangioma to bevacizumab and temozolomide.

    PubMed

    Yeo, Kee Kiat; Puscasiu, Elena; Keating, Robert F; Rood, Brian R

    2013-06-01

    Cellular hemangioma is a subtype of hemangioma that is associated with cellular immaturity and the potential for recurrence. Intracranial location of these lesions is extremely rare, and definitive treatment often requires radical neurosurgical resection. The authors report a case of a 12-year-old boy with a subtemporal cellular hemangioma. He underwent gross-total resection of the tumor, but within 1.5 months the tumor recurred, necessitating a second resection. Because of its proximity to vascular structures, only subtotal resection was possible. Repeat MRI 1 month after the second surgery showed significant tumor recurrence. Given the tumor's demonstrated capacity for recurrence and its proximity to the vein of Labbé and sigmoid sinus, further resection was not indicated. In an effort to limit radiation therapy for this young patient, treatment with bevacizumab and temozolomide was chosen and achieved a complete response that has proven durable for 36 months after cessation of therapy. This is the first report of the successful use of chemotherapy to treat an intracranial hemangioma, a rare condition with limited therapeutic options.

  11. Infantile hemangioma: pulsed dye laser versus surgical therapy

    NASA Astrophysics Data System (ADS)

    Remlova, E.; Dostalova, T.; Michalusova, I.; Vranova, J.; Jelinkova, H.; Hubacek, M.

    2014-05-01

    Hemangioma is a mesenchymal benign tumor formed by blood vessels. Anomalies affect up to 10% of children and they are more common in females than in males. The aim of our study was to compare the treatment efficacy, namely the curative effect and adverse events, such as loss of pigment and appearance of scarring, between classical surgery techniques and laser techniques. For that reason a group of 223 patients with hemangioma was retrospectively reviewed. For treatment, a pulsed dye laser (PDL) (Rhodamine G, wavelength 595 nm, pulsewidth between 0.45 and 40 ms, spot diameter 7 mm, energy density 9-11 J cm-2) was used and the results were compared with a control group treated with classical surgical therapy under general anesthesia. The curative effects, mainly number of sessions, appearance of scars, loss of pigment, and relapses were evaluated as a marker of successful treatment. From the results it was evident that the therapeutic effects of both systems are similar. The PDL was successful in all cases. The surgery patients had four relapses. Classical surgery is directly connected with the presence of scars, but the system is safe for larger hemangiomas. It was confirmed that the PDL had the optimal curative effect without scars for small lesions (approximately 10 mm). Surgical treatment under general anesthesia is better for large hemangiomas; the disadvantage is the presence of scars.

  12. Experience with Holter monitoring during propranolol therapy for infantile hemangiomas.

    PubMed

    Jacks, Stephanie K; Kertesz, Naomi J; Witman, Patricia M; Fernandez Faith, Esteban

    2015-08-01

    Although adverse events in children treated with propranolol have proven rare, the appropriate methods of assessing cardiovascular risk and monitoring for toxicity when the medication is used for infantile hemangiomas remain unclear. We sought to analyze Holter monitor reports of otherwise healthy patients on propranolol for infantile hemangiomas to determine the incidence of sustained arrhythmias and to evaluate the utility of Holter monitoring in the outpatient setting. We retrospectively reviewed the charts of patients with infantile hemangioma who underwent 24-hour Holter monitoring after initiation or dose escalation of propranolol between 2011 and 2014. In all, 43 patients aged 1.8 to 36.2 months, with 44 Holter monitor reports, were included in the study. No sustained arrhythmias were revealed. The treatment plan was not altered in any patient based on the Holter monitor report. This was a retrospective study design. Our study suggests that Holter monitoring may be unnecessary in otherwise healthy patients with infantile hemangioma older than 12 weeks who are treated with propranolol in the outpatient setting. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report

    PubMed Central

    Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct. PMID:28149481

  14. Difficult preoperative diagnosis of a patient with sclerosing splenic hemangioma

    SciTech Connect

    Edoute, Y.; Ben-Haim, S.A.; Ben-Arie, Y.; Fishman, A.; Barzilai, D.

    1989-07-01

    We present a young asymptomatic woman with splenomegaly and a large isolated splenic mass demonstrated by ultrasonography, /sup 99m/Tc sulfur colloid, and gallium scintigraphy studies. Computerized tomography (CT) and three-phase 99mTc-labeled red blood cell imaging suggested a malignant lesion. Repeated sonographically guided fine needle aspiration (FNA) obtained only blood, suggesting the possible vascular nature of the tumor. Splenectomy established the diagnosis of splenic hemangioma (SH) with marked sclerotic changes. We conclude from this case that (1) the sclerotic and cystic changes in the SH and the abdominal lymphadenopathy could explain why the three-phase red blood cell and CT scanning, respectively, suggested that the lesion was malignant rather than benign; (2) guided FNA of a splenic mass suspected to be hemangioma may be an additional safe and useful diagnostic procedure. Multiple aspirations yielding blood alone suggest hemangioma and may prevent an unnecessary operation. To the best of our knowledge, this is the first reported case in the literature of FNA of splenic hemangioma.

  15. Umbilical cord and visceral hemangiomas diagnosed in the neonatal period

    PubMed Central

    Iglesias-Deus, Alicia; Pérez-Muñuzuri, Alejandro; Urisarri, Adela; Bautista-Casasnovas, Adolfo; Couce, Maria-Luz

    2016-01-01

    Abstract Background: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, it should be considered in differential diagnosis with other umbilical masses because it can cause significant morbidity. Methods: We report the case of a newborn referred with suspected omphalitis and umbilical hernia. Results: Physical examination showed an irreducible umbilical tumor, the size of olive, with dubious secretion. The initial suspected diagnosis was urachal or omphalomesenteric duct remnants. Abdominal ultrasound and magnetic resonance imaging showed an umbilical and a mesenteric mass. Tumor markers were negative. A definitive diagnosis of umbilical cord and intestinal hemangioma was established after surgical excision and histologic examination of the umbilical mass. Propranolol was prescribed due to the extent of the intestinal lesion. Conclusion: This report highlights the diagnostic challenges of hemangiomas in unusual locations. Apart from the rarity of these tumors, few tests are available to guide diagnosis, and surgery and histologic examination are generally required for a definitive diagnosis. Finally, it is essential to rule out associated malformations and hemangiomas in other locations. PMID:27759656

  16. Role of pigment epithelium-derived factor in the involution of hemangioma: Autocrine growth inhibition of hemangioma-derived endothelial cells

    SciTech Connect

    Kim, Kyung-Jin; Yun, Jang-Hyuk; Heo, Jong-Ik; Lee, Eun Hui; Min, Hye Sook; Choi, Tae Hyun; Cho, Chung-Hyun

    2014-11-14

    Highlights: • PEDF was expressed and induced during the involuting phase of IH. • PEDF inhibited the cell growth of the involuting HemECs in an autocrine manner. • PEDF suppression restored the impaired cell growth of the involuting HemECs. - Abstract: Hemangioma is a benign tumor derived from abnormal blood vessel growth. Unlike other vascular tumor counterparts, a hemangioma is known to proliferate during its early stage but it is followed by a stage of involution where regression of the tumor occurs. The critical onset leading to the involution of hemangioma is currently not well understood. This study focused on the molecular identities of the involution of hemangioma. We demonstrated that a soluble factor released from the involuting phase of hemangioma-derived endothelial cells (HemECs) and identified pigment epithelium-derived factor (PEDF) as an anti-angiogenic factor that was associated with the growth inhibition of the involuting HemECs. The growth inhibition of the involuting HemECs was reversed by suppression of PEDF in the involuting HemECs. Furthermore, we found that PEDF was more up-regulated in the involuting phase of hemangioma tissues than in the proliferating or the involuted. Taken together, we propose that PEDF accelerates the involution of hemangioma by growth inhibition of HemECs in an autocrine manner. The regulatory mechanism of PEDF expression could be a potential therapeutic target to treat hemangiomas.

  17. Cardiac screening in infants with infantile hemangiomas before propranolol treatment.

    PubMed

    Blei, Francine; McElhinney, Doff B; Guarini, Ascanio; Presti, Salvatore

    2014-01-01

    There is no uniform pretreatment cardiac evaluation for infants treated with oral propranolol, which is now the drug of choice for hemangiomas of infancy requiring systemic medical intervention. The aim of this study was to report and evaluate the findings of pretreatment cardiac evaluation. Data were reviewed for patients evaluated by a single hemangioma specialist and a single pediatric cardiologist prior to initiation of propranolol for infantile hemangioma. Cardiac evaluation included a complete echocardiogram. From July 2009 through January 2013, 239 consecutive patients 12 months of age or younger (median 2.7 months) were screened. No patients had cardiac contraindications to propranolol. However, 50 patients (21%) had an abnormal echocardiogram: 39 atrial septal defects (5 associated with right heart enlargement), 6 ventricular septal defects, 2 patent ductus arteriosus, 1 aortic coarctation, 1 pulmonary valve stenosis, and 1 aberrant subclavian artery. Overall, 69 patients had an audible heart murmur, 44 of which were not associated with pathologic findings on echocardiogram. All patients with a ventricular septal defect and 16 of 39 with an atrial septal defect had a murmur. Two of seven patients with PHACE syndrome had cardiac anomalies. None of the findings precluded the use of propranolol. Assisted reproductive technologies were used in 18% of pregnancies, including in vitro fertilization in 12%. Cardiac contraindications to propranolol treatment are uncommon in patients with infantile hemangioma. However, anatomic abnormalities were more common than reported in the general population. Further study is necessary to determine whether there is a pathogenic relationship between cardiac defects and nonsyndromic infantile hemangioma. © 2014 Wiley Periodicals, Inc.

  18. Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran.

    PubMed

    Barzin, M; Maleki, I

    2009-03-15

    The incidence of vertebral hemangiomas as the most common benign spinal neoplasms has been differently reported from 10 to 27% based on autopsy series, plain X-rays and MRI reviews. In this study, we reviewed consecutive 782 standard spinal MRI with axial and sagital T1 weighted and T2 weighted images looking for hemangiomas. In this study, the incidence of hemangioma was 26.9%, more common in females (30%) than males (23%), in older age group and in lumbar spine. Most hemangiomas (65%) were less than 10 mm in diameter. Multiple hemangiomas were seen in 33% of cases. The results of this study are similar to another Mediterranean study reported based on MRI findings, but differ from other reports using X-ray or autopsy as diagnostic tool, suggesting the influence of either the race or the sensitivity of the diagnostic tool on the incidence of vertebral hemangioma.

  19. CT findings of a thoracic vertebral hemangioma presenting with acute neurological symptoms.

    PubMed

    Tan, Sinan; Kurt, Aydın; Okutan, Ozerk; Keskin, Suat

    2011-01-01

    Vertebral body hemangiomas are benign lesions and account for 4% of all spinal tumors. The most common histological type is cavernous hemangioma. These tumors generally locate in the vertebral body as a solitary lesion. Multiple lesions are seen in approximately 25-30% of vertebral hemangiomas. Mostly they are asymptomatic and incidentally found with radiological studies. Symptomatic vertebral hemangiomas are rare and represent < 1% of all hemangiomas; however, if untreated, they may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis. In this case we aim to present preoperative and postoperative Computed Tomography findings of a cavernous hemangioma that caused sudden motor deficit and was localised to the thoracic vertebra corpus and posterior elements.

  20. Mixed capillary-cavernous extramedullary intradural hemangioma of the spinal cord mimicking meningioma: Case report.

    PubMed

    Alobaid, Abdullah; Bennardo, Michael Ross; Cenic, Aleksa; Lach, Boleslaw

    2015-06-01

    Hemangiomas are customarily described as low-grade vascular tumors most often located in the head and neck, but on rare occasions occurring in the intradural space of the spine. The different subtypes of hemangiomas can be distinguished histologically as capillary, cavernous, or mixed types. We describe a rare case of a mixed capillary-cavernous extramedullary intradural hemangioma of the thoracic spinal cord, mimicking meningioma radiologically.

  1. Pharmacologic blockade of angiopoietin-2 is efficacious against model hemangiomas in mice.

    PubMed

    Perry, Betsy N; Govindarajan, Baskaran; Bhandarkar, Sulochana S; Knaus, Ulla G; Valo, Monika; Sturk, Celina; Carrillo, Carol O; Sohn, Allie; Cerimele, Francesca; Dumont, Dan; Losken, Albert; Williams, Joseph; Brown, Lawrence F; Tan, Xiaolian; Ioffe, Ella; Yancopoulos, George D; Arbiser, Jack L

    2006-10-01

    Hemangioma of infancy is the most common neoplasm of childhood. While hemangiomas are classic examples of angiogenesis, the angiogenic factors responsible for hemangiomas are not fully understood. Previously, we demonstrated that malignant endothelial tumors arise in the setting of autocrine loops involving vascular endothelial growth factor (VEGF) and its major mitogenic receptor vascular endothelial growth factor receptor 2. Hemangiomas of infancy differ from malignant endothelial tumors in that they usually regress, or can be induced to regress by pharmacologic means, suggesting that angiogenesis in hemangiomas differs fundamentally from that of malignant endothelial tumors. Here, we demonstrate constitutive activation of the endothelial tie-2 receptor in human hemangioma of infancy and, using a murine model of hemangioma, bEnd.3 cells; we show that bEnd.3 hemangiomas produce both angiopoietin-2 (ang-2) and its receptor, tie-2, in vivo. We also demonstrate that inhibition of tie-2 signaling with a soluble tie-2 receptor decreases bEnd.3 hemangioma growth in vivo. The efficacy of tie-2 blockade suggests that either tie-2 activation or ang-2 may be required for in vivo growth. To address this issue, we used tie-2-deficient bEnd.3 hemangioma cells, which, surprisingly, were fully proficient in in vivo growth. Previous studies from our laboratory and others have implicated reactive oxygen-generating nox enzymes in the angiogenic switch, so we examined the effect of nox inhibitors on ang-2 production in vitro and on bEnd.3 tumor growth in vivo. We then inhibited ang-2 production pharmacologically using novel inhibitors of nox enzymes and found that this treatment nearly abolished bEnd.3 hemangioma growth in vivo. Signal-transduction blockade targeting ang-2 production may be useful in the treatment of human hemangiomas in vivo.

  2. Capillary Hemangioma of Thoracic Spinal Cord: PET/CT and MR Findings.

    PubMed

    Shen, Guohua; Su, Minggang; Zhao, Junyi; Liu, Bin; Kuang, Anren

    2017-02-13

    Capillary hemangiomas are frequently encountered superficially in the cutaneous, subcutaneous, or mucosal tissues during the childhood and early adulthood, but the occurrence of spinal intradural capillary hemangioma is relatively rare. Herein, we report a case with capillary hemangioma of the thoracic spine. MR and PET/CT features of this lesion are presented, and awareness of this entity may help differentiate it from other spinal intradural tumors.

  3. [The role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution].

    PubMed

    Yuan, Si-Ming; Chen, Rong-Liang; Chen, Hai-Ni; Shen, Wei-Min; Zhou, Xiao-Jun

    2013-01-01

    To investigate the role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution. Routine immunohistochemistry staining of Perilipin A, the marker antigen of adipocytes, was performed to observe the adipogenesis in hemangioma. Immunofluorescence staining of PPAR-gamma, the important transcription factor in promoting adipogenesis, was carried out to observe its location in hemangioma tissue, with the co-staining of alpha-SMA and CD31. And RT-PCR was used to examine the expression of PPAR-gamma gene in hemangioma in different stages. In the evolution of hemangioma, the number of adipocytes increased continuously. And the tumor was replaced by fibrofatty tissue finally. PPAR-gamma was located in the nuclei of perivascular cell in hemangioma tissue. The expression of PPAR-gamma gene in hemangioma increased in the evolution of hemangioma, but still was lower than that in normal fat tissue from children. The expression of PPAR-gamma in the perivascular cells suggests that they may contribute to the adipogenesis in hemangioma involution.

  4. Long-term follow up of renal anastomosing hemangioma mimicking renal angiosarcoma.

    PubMed

    Heidegger, Isabel; Pichler, Renate; Schäfer, Georg; Zelger, Bernhard; Zelger, Bettina; Aigner, Friedrich; Bektic, Jasmin; Horninger, Wolfgang

    2014-08-01

    Anastomosing hemangioma of the kidney is a very rare neoplasm, currently 19 cases have been reported in the literature. First described in 2009, histopathologically anastomosing hemangioma is similar to aggressive angiosarcoma. No long-term follow-up data of anastomosing hemangioma have been described yet. Here, we present the case of a healthy 56-year-old man diagnosed in 2002 with a 7 × 5-cm anastomosing hemangioma mimicking an aggressive renal angiosarcoma. The patient underwent nephrectomy and has been followed up disease free for 13 years.

  5. Managment of superficial infantile capillary hemangiomas with topical timolol maleate solution.

    PubMed

    Rizvi, Syed Ali Raza; Yusuf, Faraz; Sharma, Rajeev; Rizvi, Syed Wajahat Ali

    2015-01-01

    Capillary hemangioma is the most common benign tumor of eyelids and orbit in children. Recently, a topical beta blocker has been reported as an effective treatment for superficial capillary hemangiomas. We present a case report of two children having large capillary hemangiomas who responded well to topical treatment by 0.5% timolol maleate solution. After 12 months of treatment, the lesion has significantly reduced in size, thickness, and color in both cases. Thus, we conclude that long-term use of topical 0.5% timolol maleate solution is safe and effective in treating superficial capillary hemangiomas.

  6. Massive Hemoptysis due to Endotracheal Hemangioma: A Case Report and Literature Review

    PubMed Central

    Yu, Yeonsil; Lee, Suhyeon; An, Jinyoung; Lee, Jeongmin; Kim, Jihoon; Lee, Youngkyung; Jung, Eunah; Song, Sookhee; Kim, Hyeok

    2015-01-01

    Tracheal hemangioma is a rare benign vascular tumor in adults. We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man. This is the first report, to our knowledge, of a tracheal cavernous hemangioma that presented with massive hemoptysis. The lesion was removed with a CO2 laser under rigid laryngoscopy. Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion. PMID:25861344

  7. Transcatheter Arterial Embolization of Two Symptomatic Giant Cavernous Hemangiomas of the Liver

    SciTech Connect

    Althaus, Sandra; Ashdown, Boyd; Coldwell, Douglas; Helton, W. Scott; Freeny, Patrick C.

    1996-09-15

    Cavernous hemangiomas are usually asymptomatic; however, a small percentage may cause symptoms. This case report discusses palliation by transcatheter arterial embolization with polyvinyl alcohol particles.

  8. Retroperitoneal tumor: giant cavernous hemangioma – case presentation and literature review

    PubMed Central

    Haponiuk, Ireneusz; Jaworski, Radoslaw; Peksa, Rafal; Irga-Jaworska, Ninela; Jaskiewicz, Janusz

    2016-01-01

    Retroperitoneal hemangiomas are very rare. This paper presents the case of a 71-year-old female patient with giant cavernous hemangioma of the retroperitoneum who underwent surgical treatment for abdominal pain and left lower limb edema. Interventional staged treatment with percutaneous transcatheter arterial embolization prior to surgery was considered. Radical resection of the tumor was performed, which caused the symptoms to abate. Additionally a literature review of cases involving cavernous hemangioma in the retroperitoneal space is presented. No description of retroperitoneal cavernous hemangioma originating from the bowel was found in the analyzed reports. PMID:28096841

  9. Computed tomography and magnetic resonance imaging findings of nasal cavity hemangiomas according to histological type.

    PubMed

    Kim, Jun Ho; Park, Sun-Won; Kim, Soo Chin; Lim, Myung Kwan; Jang, Tae Young; Kim, Yeo Ju; Kang, Young Hye; Lee, Ha Young

    2015-01-01

    To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma). CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes. The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases. CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision.

  10. Computed Tomography and Magnetic Resonance Imaging Findings of Nasal Cavity Hemangiomas According to Histological Type

    PubMed Central

    Kim, Jun Ho; Kim, Soo Chin; Lim, Myung Kwan; Jang, Tae Young; Kim, Yeo Ju; Kang, Young Hye; Lee, Ha Young

    2015-01-01

    Objective To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma). Materials and Methods CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes. Results The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases. Conclusion CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision. PMID:25995686

  11. Massive hemoptysis caused by tracheal hemangioma treated with interventional radiology.

    PubMed

    Zambudio, Antonio Ríos; Calvo, Maria Jose Roca; Lanzas, Juan Torres; Medina, J García; Paricio, Pascual Parrilla

    2003-04-01

    Capillary hemangiomas of the tracheobronchial tree are extremely rare in adults, with hemoptysis being one of the most serious forms of presentation. An operation has been the treatment of choice, although it does involve high rates of morbidity and mortality, especially in emergency situations such as massive hemoptysis, which has led to the search for other therapeutic alternatives. There is no experience with embolization by interventional radiology when the hemoptysis is tracheal in origin, caused partly because the infrequency of this pathology; however, the foundations for it have been laid with the development of embolization for bronchopulmonary pathology. We report a case of a tracheal capillary hemangioma in a 66-year-old woman diagnosed with idiopathic thrombopenic purpura, which began as a massive hemoptysis and was treated successfully with embolization by interventional radiology. There has been no recurrence of the bleeding after 1 year's follow-up, and the patient's control fibrobronchoscopy is normal.

  12. Lymph node hemangioma in one-humped camel

    PubMed Central

    Aljameel, M.A.; Halima, M.O.

    2015-01-01

    Hemangioma is a benign tumor of blood and lymphatic vessels. It is common in skin, mucosa and soft tissues, and its occurrence in lymph nodes is extremely rare. A 10 year-old she-camel was slaughtered at Nyala slaughterhouse, South Darfur State, Sudan. Grossly, the carcass was emaciated. The left ventral superficial cervical lymph node was enlarged, hard on palpation and protruded outside the body. Its cut surface was dark red in color and measured (18 cm) in diameter. Histopathologically, the sections revealed vascular masses were composed of non-encapsulated clusters of small and medium sized with thick and thin-walled, filled with blood, separated by courageous stroma and surrounded by closely packed proliferating capillaries. To the best of our knowledge, this is the first record of the left ventral superficial cervical lymph node hemangioma in a camel in the Sudan. PMID:26753134

  13. Spinal lobular capillary hemangioma with an intramedullary component.

    PubMed

    Gonzalez, Ricardo; Spears, Julian; Bharatha, Aditya; Munoz, David G

    2014-01-01

    Capillary hemangiomas are benign vascular neoplasms rarely involving the spinal cord, where their usual location is extramedullary. A 59-year-old man presented with a 7-month history of progressive numbness which began in the left lower extremity and progressed across the lower back, right flank, trunk and into the right lower extremity with associated pressure and pain in his lower back. On magnetic resonance imaging, there was an avidly-enhancing thoracic intradural lesion that contained an extramedullary intradural component posteriorly, with an apparent intramedullary component anteriorly. Laminectomy of T7 - 8 was performed, and intradural exploration revealed a highly vascular-appearing tumor below the arachnoid, which was not completely dissected because it was densely adherent to the spinal cord. The pathological diagnosis was lobular capillary hemangioma with extra- and intramedullary components. We suggest this lesion should be considered in the differential diagnosis of spinal cord tumors with an intramedullary component.

  14. Spontaneous regression of congenital cutaneous hemangiomas in a calf.

    PubMed

    Priestnall, S L; De Bellis, F; Bond, R; Alony-Gilboa, Y; Summers, B A

    2010-03-01

    Congenital vascular tumors of the skin have been described in people and a few animals, but unlike infantile hemangiomas in children, spontaneous regression has not been described in animals. A 2-day-old male Belgian Blue cross calf was presented for multiple congenital cutaneous masses that were soft, alopecic, and hyperemic; the calf had no other apparent abnormalities. Two weeks later, one mass had regressed. Surgical excision of one of the remaining masses was performed; histopathologic and immunohistochemical findings were considered diagnostic for epithelioid hemangioma. Eight months following initial presentation, all the masses had regressed spontaneously. This constitutes the first account in the veterinary literature of spontaneous regression in a congenital vascular tumor.

  15. Red blood cell scan in cavernous hemangioma of the larynx

    SciTech Connect

    Finkelstein, D.M.; Noyek, A.M.; Kirsh, J.C. )

    1989-09-01

    Cavernous hemangioma of the larynx is an uncommon, difficult-to-diagnose vascular tumor for which there is no significant imaging literature to date. The possibility of improved diagnosis through RBC scanning might obviate injudicious biopsy and potential hemorrhage within the airway. Utilizing the radionuclide RBC scan, which labels the patient's own RBCs initially with cold pyrophosphate, and subsequently with technetium 99m as pertechnetate, we have identified successfully four patients with cavernous hemangioma of the larynx. All presented with a supraglottic mass involving at least the aryepiglottic fold and arytenoid region unilaterally. This report describes our satisfactory diagnostic imaging experience with the radionuclide RBC scan and suggests both its imaging specificity and its role in the management of this lesion.

  16. Percutaneous Technique for Sclerotherapy of Vertebral Hemangioma Compressing Spinal Cord

    SciTech Connect

    Gabal, Abdelwahab M.

    2002-12-15

    Purpose: In this study we report a percutaneous technique to achieve sclerosis of vertebral hemangioma and decompression of the spinal cord and nerve roots. Methods: Under CT guidance the affected vertebral body is punctured by a biopsy needle and sclerosant is injected directly into the tumor. In the case of large paravertebral extension, additional injection is given in the paravertebral soft tissue component to induce shrinkage of the whole tumor mass and release of the compressed spinal cord. Results: Using this technique we treated five patients in whom vertebral hemangioma gave rise to neurologic symptoms.In three patients, sclerotherapy was the only treatment given. In the other two patients, sclerotherapy was preceded by transcatheter embolization. Neither decompressive surgery, radiation therapy nor stabilization was required with this technique. Conclusion: Our experience with CT-guided intraosseous sclerotherapy has proved highly satisfactory.

  17. Segmental ulcerated perineal hemangioma of infancy: a complex case of PELVIS syndrome successfully treated using a multidisciplinary approach.

    PubMed

    Kaushik, Shivani B; Kwatra, Shawn G; McLean, Thomas W; Powers, Alexander; Atala, Anthony J; Yosipovitch, Gil

    2013-01-01

    We report a case of PELVIS (perineal hemangioma, external genital malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus and skin tag) syndrome in which hemangioma in the perineal area was misdiagnosed at birth as diaper rash. Investigations revealed associated vesicorenal and spinal abnormalities. We emphasize careful diagnosis of suspicious lesions at birth and confirm the successful use of propranolol in treating ulcerated segmental hemangiomas.

  18. Hemangiomas and Vascular Malformations: Current Theory and Management

    PubMed Central

    Richter, Gresham T.; Friedman, Adva B.

    2012-01-01

    Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumor. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. This paper reviews current theory and practice in the etiology, diagnosis, and treatment of these more common vascular anomalies. PMID:22611412

  19. Intralesional injection of diprospan is effective for infantile hemangioma.

    PubMed

    Yuan, Si-Ming; Zhang, Min; Guo, Yao; Cui, Lei; Hong, Zhi-Jian; Jiang, Hui-Qing

    2015-03-01

    The use of glucocorticoid in infantile hemangioma has remained the main stream for over 30 years. Intralesional corticosteroids got good effects in small-size hemangioma. Here, we introduce a new compound glucocorticoids preparation, Diprospan. Diprospan 1 mL/ampoule contains betamethasone disodium phosphate 2 mg and betamethasone dipropionate 5 mg. It is the combination of short-acting and long-acting components. From January 2005 to December 2013, 57 children with hemangioma were enrolled into this study. The area of tumor ranged from 1 cm to 60 cm. The average age of them receiving the first treatment was 3.9 months. The compound betamethasone preparation was given directly into the lesion at multiple sites along the edge and in the center of tumor. The dosage ranged from 3.5 mg to 14 mg glucocorticoids. In the follow-up, the treatment could be repeated if the tumor tended to grow again. Nineteen patients received the treatment once, 35 patients twice, and 3 patients thrice. At the end of follow-up, 80.7% (46/57) of the patients' tumors involuted completely. Moreover, 15.8% (9/57) of the patients' tumors shrank but did not involute completely. Also, 3.5% (2/57) of the patients' tumors showed no obvious change and so switched to systemic propranolol treatment. The adverse effects included local atrophy in 3 patients, local ulcer in 2 patients, and Cushing-like manifestations in 2 patients, all of which recovered in a short period. Intralesional compound betamethasone preparation is a feasible choice for the small-size hemangioma. For a few of the patients who had no response to it, other treatments including oral propranolol should be adopted in time.

  20. Propranolol reduces infantile hemangioma volume and vessel density.

    PubMed

    Bingham, Matthew M; Saltzman, Babette; Vo, Nghia-Jack; Perkins, Jonathan A

    2012-08-01

    To evaluate changes in infantile hemangioma tissue before and after propranolol therapy, using gray-scale and color Doppler ultrasound imaging. Case series with chart review. Tertiary pediatric hospital. Medical records and image studies of head and neck infantile hemangioma patients treated with propranolol, identified in a quality improvement database, were reviewed. Patients with imaging before and at least 4 weeks following the initiation of treatment were included. Data collected included sex, age, location, and concurrent treatment. Student t tests were used to evaluate change in cutaneous lesion area, volume, and vessel density. Logistic regression was used to compare lesion area, volume, and vessel density. Of the 177 patients identified, 19 met inclusion criteria. Fourteen of 19 were female, and 5 of 19 were older than 1 year. Mean lesion area change with treatment was 13.0 cm(2) (range, -2.8 to 28.9 cm(2), P = .05). Measured volume change was a mean of 10.3 cm(3) (range, 1.5-19.2 cm(3), P = .01). Mean vessel density change was 4.4 vessels per cm(2) (range, 2.5-6.3 vessels per cm(2), P < .01). Treatment decreased clinically determined hemangioma area proportionately less than gray-scale and color Doppler ultrasound measured lesion volume. Gray-scale and color Doppler ultrasound measured treatment response did not differ with sex, lesion location, or age at propranolol initiation. Gray-scale and color Doppler ultrasound imaging of propranolol-treated infantile hemangiomas detected a significant reduction in lesion volume and vessel density. Patient age at propranolol treatment and concomitant corticosteroid use did not affect lesion volume change.

  1. Signaling pathways in the development of infantile hemangioma

    PubMed Central

    2014-01-01

    Infantile hemangioma (IH), which is the most common tumor in infants, is a benign vascular neoplasm resulting from the abnormal proliferation of endothelial cells and pericytes. For nearly a century, researchers have noted that IH exhibits diverse and often dramatic clinical behaviors. On the one hand, most lesions pose no threat or potential for complication and resolve spontaneously without concern in most children with IH. On the other hand, approximately 10% of IHs are destructive, disfiguring and even vision- or life-threatening. Recent studies have provided some insight into the pathogenesis of these vascular tumors, leading to a better understanding of the biological features of IH and, in particular, indicating that during hemangioma neovascularization, two main pathogenic mechanisms prevail, angiogenesis and vasculogenesis. Both mechanisms have been linked to alterations in several important cellular signaling pathways. These pathways are of interest from a therapeutic perspective because targeting them may help to reverse, delay or prevent hemangioma neovascularization. In this review, we explore some of the major pathways implicated in IH, including the VEGF/VEGFR, Notch, β-adrenergic, Tie2/angiopoietins, PI3K/AKT/mTOR, HIF-α-mediated and PDGF/PDGF-R-β pathways. We focus on the role of these pathways in the pathogenesis of IH, how they are altered and the consequences of these abnormalities. In addition, we review the latest preclinical and clinical data on the rationally designed targeted agents that are now being directed against some of these pathways. PMID:24479731

  2. Cavernous hemangioma of the dura mater mimicking meningioma

    PubMed Central

    Di Vitantonio, Hambra; De Paulis, Danilo; Ricci, Alessandro; Marzi, Sara; Dehcordi, Soheila Raysi; Galzio, Renato Juan

    2015-01-01

    Background: Cavernomas are benign lesions that most commonly occur intra-parenchymally, but occasionally they have been described as arising from the dura mater. Extra-axial cavernous angiomas (or hemangiomas) account for 0.4–2% of all intracranial vascular malformations, and they usually occur in the middle cranial fossa, associated with the cavernous sinus. Other possible localizations (e.g. tentorium, convexity, anterior cranial fossa, cerebellopontine angle, Meckel's cave, sella turcica and internal auditory meatus) are rare, and they account only for 0.2–0.5%. Case Description: We report a case of a 30-year-old female presenting with a 2 years history of headache unresponsive to drug therapy. The magnetic resonance imaging showed a dural-based lesion in the left frontal region; the lesion size was: 1.5 cm × 3.5 cm. The appearance suggested a convexity meningioma. A left frontal craniotomy was performed, and the histopathological diagnosis deposed for a cavernous hemangioma of the dura mater. The follow-up at 1-year was good without any neurologic deficit. Conclusions: Dural-based cavernous hemangiomas of the convexity are uncommon lesions. Up to now, only 13 cases have been described in the literature. The authors have discussed clinical aspects, radiological features, surgical treatment, and operative findings. PMID:26421218

  3. Intramedullary capillary hemangioma of the thoracic spine: case report and review of the literature

    PubMed Central

    Kasukurthi, Rahul; Ray, Wilson Z; Blackburn, Spiros L; Lusis, Eriks A; Santiago, Paul

    2009-01-01

    Capillary hemangiomas are benign vascular neoplasms. When associated with the spine, these growths frequently involve the vertebral body, but rarely have they been reported to occur as intradural lesions, while even more rarely occurring in a true intramedullary location. We report a rare case of an intramedullary capillary hemangioma of the thoracic spinal cord and a review of the literature. PMID:21139881

  4. Large cavernous hemangioma in the cecum treated by laparoscopic ileocecal resection

    PubMed Central

    Huh, Jung Wook; Cho, Sang Hyuk; Lee, Jae Hyuk; Kim, Hyeong Rok

    2009-01-01

    A cavernous hemangioma of the cecum is a rare vascular malformation but is clinically important because of the possibility of massive bleeding. We report a case of a large cavernous hemangioma with pericolic infiltration in the cecum which was removed successfully using minimally invasive surgery. PMID:19598312

  5. A New Perspective for Infantile Hepatic Hemangioma in the Age of Propranolol: Experience at Baskent University.

    PubMed

    Sarıalioğlu, Faik; Yazıcı, Nalan; Erbay, Ayşe; Boyvat, Fatih; Demir, Şenay; Özçay, Figen; Uslu, Nihal

    2017-03-01

    Propranolol was first used in 2008 to treat hemangioma; its efficacy and safety have since changed the classical treatment indications. Infantile hepatic hemangioma presents as a spectrum of clinical conditions varying from simple asymptomatic lesions to lethal complications. Tufted hemangioma and Kaposiform hemangioendothelioma are congenital vascular tumors that lead to Kasabach-Merritt syndrome. Hemangiomas, like pure arteriovenous malformations, can cause hyperdynamic heart failure, and diffuse nodular-type hemangiomas can present with hypothyroidism. Respiratory problems and hepatic failure can be associated with diffuse nodular-type liver hemangiomas. There is a spectrum of approaches to management, varying from "watchful waiting" to liver transplant. In the age of propranolol, there has been a prominent change in the infantile hepatic hemangioma treatment algorithm. Our suggestion is early treatment with 3 mg/kg/day propranolol plus 1.0 to1.5 mg/kg/day prednisolone in all patients. This protocol is the most effective strategy for type 3 infantile hepatic hemangioma. Approximately one-third of patients with abdominal compartment syndrome in the era before propranolol treatment required liver transplant; this new treatment obviates transplant for many of these patients.

  6. Surgically intractable epilepsy associated with focal cortical dysplasia and congenital cutaneous hemangiomas.

    PubMed

    Brzezinski, Anna; Cruz, Vincent B; Prayson, Richard A

    2014-11-01

    We describe a 6-month-old girl with medically intractable seizures, multiple congenital hemangiomas, and developmental delay. The patient underwent two surgical resections. Pathological findings at both the first and second resections were consistent with focal cortical dysplasia. The literature was reviewed on focal cortical dysplasia associated with cutaneous hemangiomas. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Laparoscopic Radiofrequency Ablation for Large Subcapsular Hepatic Hemangiomas: Technical and Clinical Outcomes

    PubMed Central

    Ding, Xue-Mei; Ke, Shan; Xin, Zong-Hai; Ning, Chun-Min; Guo, Shi-Gang; Li, Xiao-Long; Dong, Yong-Hong; Sun, Wen-Bing

    2016-01-01

    Objectives The aim of this study was to evaluate the technical and clinical outcomes of using laparoscopic radiofrequency (RF) ablation for treating large subcapsular hepatic hemangiomas. Methods We retrospectively reviewed our sequential experience of treating 124 large subcapsular hepatic hemangiomas in 121 patients with laparoscopic RF ablation. Results The mean diameter of the 124 hemangiomas was 9.1 ± 3.2 cm (5.0–16.0 cm). RF ablation was performed successfully in all patients. There were 55 complications related to the ablation in 26 patients, including 5 of 69 (7.3%) patients with hemangioma <10 cm and 21 of 52 (40.4%) patients with hemangiomas ≥10 cm (P < 0.001). No injuries to abdominal viscera occurred in all the 121 patients. According to the Dindo–Clavien classification, all the complications were minor in 26 patients (Grade I). Out of 124 hepatic hemangiomas, 118 (95.2%) were completely ablated, including 70 of 72 (97.2%) lesions < 10 cm and 48 of 52 (92.3%) lesions ≥ 10 cm (P = 0.236). Conclusion Laparoscopic RF ablation therapy is a safe, feasible and effective procedure for large subcapsular hepatic hemangiomas, even in the hepatic hemangiomas ≥ 10 cm. Its use avoids thermal injury to the abdominal viscera. PMID:26901132

  8. Growth Hormone Induces Recurrence of Infantile Hemangiomas After Apparent Involution: Evidence of Growth Hormone Receptors in Infantile Hemangioma.

    PubMed

    Munabi, Naikhoba C O; Tan, Qian Kun; Garzon, Maria C; Behr, Gerald G; Shawber, Carrie J; Wu, June K

    2015-01-01

    Infantile hemangiomas (IHs) are the most common benign tumor of infancy, characterized by a natural history of early proliferation in the first months of life to eventual involution during childhood, often with residual fibrofatty tissue. Once involution has been achieved, IHs do not typically recur. We present two cases of exogenous growth hormone therapy resulting in the recurrence of IHs in late childhood, supported by radiological, immunohistochemical, in vitro, and in vivo evidence.

  9. Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation.

    PubMed

    Yu, Bin; Wu, Desheng; Shen, Bin; Zhao, Weidong; Huang, Yufeng; Zhu, Jianguang; Qi, Dongduo

    2014-01-01

    Vertebral hemangiomas are benign lesions and are often asymptomatic. Most vertebral hemangiomas that cause cord compression and neurological symptoms are located in the thoracic spine and involve a single vertebra. The authors report the rare case of lumbar hemangiomas in a 60-year-old woman presenting with severe back pain and rapidly progressive neurological signs attributable to 2 noncontiguous lesions. After embolization of the feeding arteries, no improvement was noted. Thus, the authors performed open surgery using a combination of posterior decompression, intraoperative kyphoplasty, and segmental fixation. The patient experienced relief from back and leg pain immediately after surgery. At 3 months postoperatively, her symptoms and neurological deficits had improved completely. To the authors' knowledge, this is the first description of 2 noncontiguous extensive lumbar hemangiomas presenting with neurological symptoms managed by such combined treatment. The combined management seems to be an effective method for treating symptomatic vertebral hemangiomas.

  10. A practical guide to treatment of infantile hemangiomas of the head and neck

    PubMed Central

    Zheng, Jia Wei; Zhang, Ling; Zhou, Qin; Mai, Hua Ming; Wang, Yan An; Fan, Xin Dong; Qin, Zhong Ping; Wang, Xv Kai; Zhao, Yi Fang

    2013-01-01

    Infantile hemangiomas are the most common benign vascular tumors in infancy and childhood. As hemangioma could regress spontaneously, it generally does not require treatment unless proliferation interferes with normal function or gives rise to risk of serious disfigurement and complications unlikely to resolve without treatment. Various methods for treating infant hemangiomas have been documented, including wait and see policy, laser therapy, drug therapy, sclerotherapy, radiotherapy, surgery and so on, but none of these therapies can be used for all hemangiomas. To obtain the best treatment outcomes, the treatment protocol should be individualized and comprehensive as well as sequential. Based on published literature and clinical experiences, we established a treatment guideline in order to provide criteria for the management of head and neck hemangiomas. This protocol will be renewed and updated to include and reflect any cutting-edge medical knowledge, and provide the newest treatment modalities which will benefit our patients. PMID:24260591

  11. Atypical appearance of an hepatic hemangioma with technetium-99m red blood cell scintigraphy

    SciTech Connect

    Larcos, G.; Farlow, D.C.; Gruenewald, S.M.; Antico, V.F. )

    1989-11-01

    Three-phase 99mTc red blood cell scintigraphy is an established technique for distinguishing hemangiomas from other focal liver lesions. The most widely recognized feature is the perfusion to blood-pool mismatch characterized by decreased or normal arterial perfusion, with lesion activity which progressively increases over 1-2 hr. Although increased arterial vascularity of hemangiomas has been described, such cases either involved small portions of the lesion only or occurred in lesions not conclusively proven to be hemangiomas. We report a case of an angiography proven hemangioma with increased arterial vascularity involving a significant portion of the lesion as well as intense early blood-pool activity similar to that seen on delayed imaging. This case emphasizes the diverse appearance of hepatic hemangiomas using 99mTc blood cell scintigraphy.

  12. Sacroplasty for symptomatic sacral hemangioma: a novel treatment approach. A case report.

    PubMed

    Agarwal, V; Sreedher, G; Weiss, K R; Hughes, M A

    2013-06-01

    Painful vertebral body hemangiomas have been successfully treated with vertebroplasty and kyphoplasty. Sacral hemangiomas are uncommon and as such painful sacral hemangiomas are rare entities. We report what we believe is only the second successful treatment of a painful sacral hemangioma with CT-guided sacroplasty. A 56-year-old woman with a history of right-sided total hip arthroplasty and lipoma excision presented to her orthopedic surgeon with persistent right-sided low back pain which radiated into her buttock and right groin and hindered her ability to walk and perform her activities of daily living. MRIs of the thoracic spine, lumbar spine and pelvis showed numerous lesions with imaging characteristics consistent with multiple hemangiomas including a 2.2×2.1 cm lesion involving the right sacrum adjacent to the right S1 neural foramen. Conservative measures including rest, physical therapy, oral analgesics and right-sided sacroiliac joint steroid injection did not provide significant relief. Given her lack of improvement and the fact that her pain localized to the right sacrum, the patient underwent CT-guided sacroplasty for treatment of a painful right sacral hemangioma. Under CT fluoroscopic guidance, a 10 gauge introducer needle was advanced through the soft tissues of the back to the margin of the lesion. Biopsy was then performed and after appropriate preparation, cement was then introduced through the needle using a separate cement filler cannula. Appropriate filling of the right sacral hemangioma was visualized using intermittent CT fluoroscopy. After injection of approximately 2.5 cc of cement, it was felt that there was near complete filling of the right sacral hemangioma. With satisfactory achievement of cement filling, the procedure was terminated. Pathology from biopsy taken at the time of the procedure was consistent with hemangioma. Image-guided sacroplasty with well-defined endpoints is an effective, minimally invasive and safe procedure

  13. Detection of p53 and Bcl-2 expression in cutaneous hemangioma through the quantum dot technique.

    PubMed

    Tang, Tian; Zhang, Duan-Lian

    2017-05-01

    Hemangioma is one of the most common types of infantile vascular benign tumor. The aim of the present study was to investigate the role of B-cell lymphoma 2 (Bcl-2) and tumor protein p53 (p53) in the proliferation and apoptosis of hemangioma cells. A total of 38 paraffin-embedded hemangioma specimens (16 males and 22 females) and another 5 paraffin-embedded healthy surrounding tissue samples, collected between January 2007 and December 2010, were obtained from the Department of Pathology at Renmin Hospital of Wuhan University (Wuhan, China). Immunohistochemistry, hematoxylin and eosin staining, and quantum dot double staining were used to detect the expression of proliferating cell nuclear antigen (PCNA), Bcl-2 and p53 in hemangioma and healthy surrounding skin tissue samples. All hemangioma specimens were classified into proliferative or the involuting stage hemangioma according to Mulliken's criteria and their expression of PCNA. The results of the quantum dot double staining were analyzed using a multi-spectral imaging system. One-way analysis of the variance and the Student-Newman-Keuls q test were performed to statistically analyze the data. There were 24 cases of proliferative stage and 14 cases of involuting stage hemangioma among the specimens. Immunohistochemical analysis results indicated a high expression of Bcl-2 and p53 in proliferative stage hemangioma tissue samples, and low expression in involuting stage hemangioma and healthy tissue samples. Statistical analysis of the results from quantum dot double staining demonstrated that the expression of Bcl-2 and p53 in proliferative hemangioma was significantly increased compared with that in involuting stage specimens (P<0.05) and healthy tissue samples (P<0.05). No significant difference in Bcl-2 and p53 expression was identified between the involuting hemangioma and healthy surrounding tissue samples. The higher expression of Bcl-2 and p53 in proliferative hemangioma suggests that Bcl-2 may cause an

  14. Successful liver resection in a giant hemangioma with intestinal obstruction after embolization

    PubMed Central

    Zhou, Ji-Xiang; Huang, Ji-Wei; Wu, Hong; Zeng, Yong

    2013-01-01

    Hepatic hemangiomas are the most common benign tumor of the liver. Most hepatic hemangiomas remain asymptomatic and require no treatment. Giant hepatic hemangiomas with established complications, diagnostic uncertainty and incapacitating symptoms, however, are generally considered an absolute indication for surgical resection. We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization, by which the volume of the hemangioma was significantly reduced, and it was completely resected by a left hepatectomy. A 21-year-old Asian man visited our hospital for left upper quadrant pain. Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity, with a maximum diameter of 31.5 cm. Embolization of the left hepatic artery was performed and confirmed a decrease in its size. However, the patient was readmitted to our hospital one month after embolization for intestinal obstruction. A left hepatectomy was completed through a herringbone incision, and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight. Pre-operative arterial embolization is effective for reducing tumor size, but a close follow-up to decide the time for hepatectomy is important. PMID:23704832

  15. The pigment epithelium-derived factor (PEDF): an important potential therapeutic agent for infantile hemangioma.

    PubMed

    Li, Ming; Chen, Yanru; Guo, Zhihui; Xie, Yide; Zhou, Yakuan; Jiang, Chenghong; Chen, Xiaosong

    2017-04-01

    In previous studies, the expression and the role of proangiogenic factors in infantile hemangiomas have been well studied. However, the role of angiogenic inhibitors has been revealed rarely. The expression of PEDF, as the strongest and safe endogenous inhibitor, is still unrecognized until the current study. In order to investigate the expression and significance of the pigment epithelium-derived factor (PEDF) in the proliferating and regressing phases of infantile hemangiomas, the expression of PEDF, VEGF, Ki-67, and CD34 protein in hemangioma tissues was examined with immunohistochemical polymer HRP method in 42 cases during the proliferative phase, 40 cases during the regressing phase, and 11 cases of non-involuting congenital hemangiomas (NICHs). Meanwhile, the mRNA expression of these factors was detected with quantitative realtime RT-PCR. We found the protein and mRNA expression of PEDF in regressing phase was significantly higher than those in proliferative phase and NICHs (P < 0.001), while the protein and mRNA expression of VEGF were much lower (P < 0.001). The microvessel density (MVD), Ki-67 changes, and the expression of PEDF and VEGF were found significantly correlated. These results indicated that the reduction of VEGF and increase in PEDF are causative to the evolution of infantile hemangioma. PEDF may play a key role in the spontaneous regression of infantile hemangioma and may become an important potential therapeutic agent for infantile hemangioma.

  16. Kupffer-phase findings of hepatic hemangiomas in contrast-enhanced ultrasound with sonazoid.

    PubMed

    Sugimoto, Katsutoshi; Moriyasu, Fuminori; Saito, Kazuhiro; Yoshiara, Hiroki; Imai, Yasuharu

    2014-06-01

    The aim of this study was to assess quantitatively the Kupffer-phase enhancement patterns of hepatic hemangiomas in contrast-enhanced ultrasound (CEUS) with Sonazoid. A total of 46 patients with 46 hepatic hemangiomas (17.1 ± 6.2 mm in diameter, 34 typical type and 12 high-flow type) underwent CEUS in the Kupffer phase. The lesion-to-liver contrast ratio in the Kupffer phase was quantitatively assessed for both types of hemangioma. Most of the hepatic hemangiomas, whether or not they were the high-flow type, were iso- to hypo-echoic relative to the surrounding liver parenchyma. The contrast ratio was -5.33 ± 6.70 dB for the high-flow hemangiomas and -4.54 ± 6.28 dB for the typical hemangiomas. There was no significant difference in contrast ratio between the two types of lesions (p = 0.73). All of the hemangiomas, whether of typical or high-flow type, are iso- to hypo-echoic relative to the surrounding liver parenchyma on Kupffer-phase imaging.

  17. Pure spinal epidural cavernous hemangioma with intralesional hemorrhage: a rare cause of thoracic myelopathy.

    PubMed

    Jang, Donghwan; Kim, Choonghyo; Lee, Seung Jin; Ryu, Young-Joon; Kim, Jiha

    2014-06-01

    Although cavernous hemangiomas occur frequently in the intracranial structures, they are rare in the spine. Most of spinal hemangiomas are vertebral origin and "pure" epidural hemangiomas not originating from the vertebral bone are very rare. Our spinal hemangioma case is extremely rare because of its "pure" epidural involvement and intralesional hemorrhage. A 64-year-old man presented with progressive paraparesis from two months ago. His motor weakness was rated as grade 4/5 in bilateral lower extremities. He also complained of decreased sensation below the T4 sensory dermatome, which continuously progressed to the higher dermatome level. Magnetic resonance imaging demonstrated thoracic spinal tumor at T3-T4 level. The tumor was located epidural space compressing thoracic spinal cord ventrally. The tumor was not involved with the thoracic vertebral bone. We performed T3-5 laminectomy and removed the tumor completely. The tumor was not infiltrating into intradural space or vertebral bone. The histopathologic study confirmed the epidural tumor as cavernous hemangioma. Postoperatively, his weakness improved gradually. Four months later, his paraparesis recovered completely. Here, we present a case of pure spinal epidural cavernous hemangioma, which has intralesional hemorrhage. We believe cavernous hemangioma should be included in the differential diagnosis of the spinal epidural tumors.

  18. Hypoxia-induced mediators of stem/progenitor cell trafficking are increased in children with hemangioma.

    PubMed

    Kleinman, Mark E; Greives, Matthew R; Churgin, Samara S; Blechman, Keith M; Chang, Eric I; Ceradini, Daniel J; Tepper, Oren M; Gurtner, Geoffrey C

    2007-12-01

    The mechanism of neovascularization during the proliferative phase of infantile hemangioma is poorly understood. It is known that circulating bone marrow-derived endothelial progenitor cells (EPCs) form new blood vessels in ischemic tissues using mediators regulated by the transcription factor, HIF-1alpha. Mobilization of EPCs is enhanced by VEGF-A, matrix metalloproteinase (MMP)-9, and estrogen, whereas homing is secondary to localized expression of stromal cell-derived factor-1alpha (SDF-1alpha). We examined whether these mediators of EPC trafficking are upregulated during the proliferation of infantile hemangioma. Surgical specimens and blood samples were obtained from children with proliferating hemangioma and age-matched controls (n=10, each group). VEGF-A and MMP-9 levels were measured in blood, and tissue sections were analyzed for SDF-1alpha, MMP-9, VEGF-A, and HIF-1alpha. The role of estrogen as a modulator of hemangioma endothelial cell growth was also investigated. We found that all these mediators of EPC trafficking are elevated in blood and specimens from children with proliferating infantile hemangioma. In vitro, the combination of hypoxia and estrogen demonstrated a synergistic effect on hemangioma endothelial cell proliferation. These findings demonstrate that proliferating hemangiomas express known mediators of vasculogenesis and suggest that this process may play a role in the initiation or progression of this disease.

  19. An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity.

    PubMed

    da Silva Filho, Tiago João; de Oliveira, Denise Hélen Imaculada Pereira; Brasil, Veruska Lima Moura; Nonaka, Cassiano Francisco Weege; da Silveira, Éricka Janine Dantas; Queiroz, Lélia Maria Guedes

    2017-08-01

    To evaluate cases diagnosed as "oral hemangiomas" based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. All cases stored in the archives of an Oral Pathology Service and diagnosed as "oral hemangiomas" were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(-) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. Only 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(-) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as "hemangiomas" were IHs. In the group of "capillary hemangiomas", most cases (56.2%) were PGs. Among the three "cellular hemangiomas", two were PGs and one was IH. Most (88.8%) "cavernous hemangiomas" were vascular malformations. Careful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. Accurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis. Copyright © 2017. Published by Elsevier Inc.

  20. Distinction between hemangioma of the liver and hepatocellular carcinoma: value of labeled RBC-SPECT scanning

    SciTech Connect

    Kudo, M.; Ikekubo, K.; Yamamoto, K.; Ibuki, Y.; Hino, M.; Tomita, S.; Komori, H.; Orino, A.; Todo, A.

    1989-05-01

    The role of adding single-photon emission CT (SPECT) to /sup 99m/Tc-labeled RBC imaging of the liver was evaluated by specifically focusing on the differentiation between hepatic hemangioma and hepatocellular carcinoma. Planar RBC imaging followed by blood-pool SPECT scanning was performed in 77 patients with a total of 108 hemangiomas and in 29 patients with a total of 46 hepatocellular carcinomas. All lesions were smaller than 5 cm in diameter. Thirty-six (33%) of 108 hemangiomas were detected by planar delayed RBC imaging, whereas 63 (58%) were detected by the delayed RBC-SPECT scan. The smallest hemangioma shown by delayed RBC-SPECT scanning was 1.4 cm in diameter, compared with 1.7 cm by planar RBC scanning. When confined to nodules larger than 1.4 cm in diameter, 42% of hemangiomas (36/85) were detected by planar delayed RBC imaging, whereas 74% (63/85) were detected by delayed RBC-SPECT. Increase in sensitivity was noted in nodules 2.1-4.0 cm in diameter. No hepatocellular carcinomas were shown by delayed RBC planar or SPECT scans. We concluded that with the addition of SPECT, the sensitivity of delayed RBC scans in the detection of small hemangiomas is considerably improved. Delayed RBC-SPECT scanning can be used to distinguish hemangioma from hepatocellular carcinoma.

  1. External and intralesional photocoagulation of hemangioma in children with infrared diode laser

    NASA Astrophysics Data System (ADS)

    Abushkin, Ivan A.; Privalov, Valery A.; Lappa, Alexander V.; Besshtanko, Evgeny L.

    2005-08-01

    Infra-red diode laser with wavelength 1060 nm was used for combined treatment of 163 children aged from 21 days to 13 years with 221 hemangiomas. For interstitial coagulation a power of 1.8-2 W and a power density of 5-90 J/cm3 were used in continuous mode. For distant coagulation pulse mode was applied with pulse/pause duration 30-50/200-250 ms, average power 1.3-2 W, and power density 65-450 J/cm2. 197 (89.1 %) hemangiomas were capillary, 7 (3.2 %) cavernous, and 17 (7.7 %) combined (combination of capillary and cavernous hemangiomas). The area of hemangiomas ranged from 6 mm2 to 48 cm2. For the majority (193, 87.3 %) of hemangiomas one session of photocoagulation was enough to achieve a good cosmetic effect. However, 28 (12.7 %) hemangiomas were treated repeatedly, 11 (5%) of them needed 4-7 sessions. In 8 children with cavernous and combined hemangiomas both distant and interstitial laser coagulation were used. In all, good or excellent results were obtained in 96,3 % of the patients. In 6 (3.7%) patients with extensive combined hematomas the considerable improvement was achieved.

  2. An interesting case of angiogenesis in cavernous hemangioma

    PubMed Central

    Das, Dipankar; Bhattacharjee, Kasturi; Deka, Panna; Bhattacharjee, Harsha; Misra, Diva Kant; Koul, Akanksha; Kapoor, Deepika; Deka, Apurba

    2016-01-01

    Cavernous hemangioma is the most common orbital tumor in adult. There is lot of literatures for clinicopathological features of this tumor. These tumors had been studied for the model of angiogenesis in many of the experimental setups. We present a case of 34-year-old male with this tumor in the left eye with computerized tomography evidence. Postsurgical laboratory findings gave interesting evidence of tumor angiogenesis with tumor endothelial cells and sprouting of the small vessels endothelial cells. Podosome rosette could be conceptualized from the characteristic patterns seen in the tumor. PMID:27905347

  3. A Giant Cavernous Hemangioma of the Left Atrioventricular Groove

    PubMed Central

    Fan, Chengming; Tan, Changming; Kong, Demiao; Yuan, Shuwen; Wu, Sijie

    2017-01-01

    A 10-year-old Chinese female diagnosed with an asymptomatic giant cardiac cavernous hemangioma was reported. The patient originally tended to observation because this unusual cardiac tumoral mass was discovered incidentally during routine health examination of transthoracic echocardiography. Over 5 years of follow-up, the mass had enlarged obviously, and the patient visited our outpatient clinic and was prone to excision. Subsequently, a total resection surgery of the tumor was performed, and the tumor was found to be located on the left atrioventricular groove with complete packing membrane. The patient was discharged on postoperative day 4 and remains asymptomatic on last follow-up. PMID:28409047

  4. [Treatment with photodynamic therapy of circumscribed choroidal hemangioma].

    PubMed

    Andonegui, J; Pérez de Arcelus, M; Jiménez-Lasanta, L

    2010-10-01

    The clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy. Photodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation. Some questions such as whether attempts should be made to obtain a complete tumour regression, laser settings or the way the spots must be applied remain unresolved. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  5. Aggressive vertebral hemangioma as a rare cause of myelopathy.

    PubMed

    Sari, Hidayet; Uludag, Murat; Akarirmak, Ulku; Ornek, Nurettin Irem; Gun, Kerem; Gulsen, Fatih

    2014-01-01

    Vertebral hemangiomas (VHs) are common lesions in the adult population. They are usually asymptomatic and found incidentally on radiological imaging. New-onset back pain followed by subacute progression of thoracal myelopathy is the most common presentation in patients with neurological deficit. Differential diagnoses would include metastasis, multiple myeloma, lymphoma, Paget disease, osseous tumors such as Ewing sarcoma or hemangioblastoma and blood dyscrasia. We present a 41 year-old-male patient with thoracal VH causing myelopathy that completely improved after rehabilitation program with embolization and vertebroplasty procedures.

  6. Brimonidine Toxicity Secondary to Topical Use for an Ulcerated Hemangioma.

    PubMed

    Gill, Kamalvir; Bayart, Cheryl; Desai, Ritu; Golden, Alex; Raimer, Patricia; Tamburro, Joan

    2016-07-01

    Combigan (Allergan, Irvine, CA) is an ophthalmic solution that combines 0.2% brimonidine, a selective α-2 adrenergic agonist, with 0.5% timolol, a nonselective β-adrenergic antagonist. It is approved for the reduction of intraocular pressure in patients with glaucoma or ocular hypertension. There have been recent reports of successful treatment of superficial infantile hemangiomas (IHs) using Combigan topically. We report the case of a 2-month-old girl who developed life-threatening brimonidine toxicity requiring intubation and mechanical ventilation secondary to central nervous system depression and apnea after topical application to an ulcerated IH.

  7. Transoral Fully Robotic Dissection of a Parapharyngeal Hemangioma.

    PubMed

    Granell, Jose; Alonso, Ana; Garrido, Laura; Gutierrez-Fonseca, Raimundo

    2016-10-01

    Soft tissue robotics found its trigger for success in minimally invasive surgery. The minimization of the surgical damage is more obvious as the surgical alternative is more aggressive. In head and neck surgery, potential sequelae are both functional and cosmetic. Robotic instrumentation might allow for further development of the transoral approach to the deep regions of the face.The authors present an uneventful, fully robotic, transoral surgical excision of a parapharyngeal hemangioma. The authors discuss management alternatives, surgical risks, and safety measures. The medial approach is the natural choice, provided it is safe and technically feasible. Transoral robotic surgery could be a reasonable minimally invasive approach for selected parapharyngeal tumors.

  8. Propranolol Accelerates Adipogenesis in Hemangioma Stem Cells and Causes Apoptosis of Hemangioma Endothelial Cells

    PubMed Central

    Wong, Alvin; Hardy, Krista L.; Kitajewski, Alex M.; Shawber, Carrie J.; Kitajewski, Jan K.; Wu, June K.

    2013-01-01

    Background Infantile hemangiomas (IHs) can cause significant morbidity during proliferation, yet there is no FDA-approved treatment. IHs are believed to form from stem cells (HemSCs), which differentiate towards an endothelial cell (HemECs) phenotype. Recently, propranolol has demonstrated effectiveness in the treatment of complicated IHs. We hypothesize that propranolol facilitates IH involution by altering cellular behavior in both HemECs and HemSCs. Methods HemECs and HemSCs were isolated from resected IH specimens. Cells were treated with 100μM propranolol for 48 hours, and apoptosis determined by presence of Annexin V antibody. Proliferation of HemSCs and HemECs were assessed after treatment with 50μM or 100μM propranolol, or vehicle for 72 and 96 hours respectively. Adipogenesis was induced in HemSCs with and without propranolol. Pro-adipogenic genes PPARδ, PPARγ, C/EBPα, C/EBPβ, C/EBPδ, RXRα and RXRγ were analyzed by quantitative PCR (qPCR). Results Annexin V levels were increased in propranolol-treated HemECs, but not in HemSCs. Proliferation of HemSCs and HemECs was inhibited by propranolol in a dose-dependent manner. Propranolol-treated HemSCs demonstrated accelerated adipogenesis when compared to untreated controls. Transcript levels of adipogenesis-associated genes C/EBPβ (p<0.05), RXRγ (p<0.05), and PPARγ (p<0.02) were significantly increased when treated with 50μM or 100μM propranolol, and C/EBPδ (p<0.05), RXRα (p<0.05), PPARδ (p<0.01) transcripts were increased when treated with 100μM propranolol. C/EBPα transcript levels remained unchanged at either dose. Conclusions These results show that propranolol increased apoptosis of HemECs but not HemSCs, and accelerated adipogenesis of HemSC. Thus, propranolol likely accelerates involution to fibrofatty residuum. PMID:23096601

  9. A cavernous hemangioma of the thyroid gland: First documentation by ultrasound of a rare pathology.

    PubMed

    Gutzeit, Andreas; Stuckmann, Gerd; Tosoni, Ivo; Erdin, Dieter; Binkert, Christoph A

    2011-01-01

    Hemangioma of the thyroid gland is an extremely rare condition. We report a case of a primary cavernous hemangioma in the left lobe of the thyroid gland in an 84-year-old woman. Ultrasound examination of the lesion showed an inhomogeneous and hypoechoic nodule that was well demarcated from the rest of the left lobe and hypovascular on color Doppler ultrasound. Ultrasound-guided fine-needle aspiration was performed. The cytologic differential diagnosis included an anaplastic carcinoma of the thyroid gland. After hemithyroidectomy, the final diagnosis was a benign hemangioma of the thyroid gland.

  10. Massive splenomegaly caused by cavernous hemangiomas associated with Klippel-Trenaunay syndrome: report of a case.

    PubMed

    Misawa, Takeyuki; Shiba, Hiroaki; Fujiwara, Yuki; Futagawa, Yasuro; Harada, Toru; Ikegami, Masahiro; Yanaga, Katsuhiko

    2014-01-01

    The etiology of Klippel-Trenaunay syndrome (KTS) is not well understood. Although splenic involvement is very rare in KTS, life-threatening events such as spontaneous rupture of a splenic hemangioma may occur. We recently performed elective splenectomy for massive splenomegaly causing uncontrollable abdominal pain in a woman with KTS. The extracted spleen weighed 4260 g, and cavernous hemangiomas in the spleen were found to be the cause of the splenomegaly. The patient's abdominal pain resolved after surgery and her postoperative course was uneventful, except for persistent bleeding from the bladder. This is a rare case of KTS with associated severe splenomegaly caused by hemangiomas.

  11. Complementary role of SPECT in the diagnosis of cavernous hemangioma of the liver

    SciTech Connect

    Tumeh, S.S.; English, R.J.; Holman, B.L.

    1985-12-01

    Cavernous hemangiomas are the most common benign tumors of the liver. Although their clinical course is usually uncomplicated, an accurate diagnosis may be important to exclude conditions that need treatment, (or to avoid an unnecessarily risky percutaneous biopsy). Although blood pool scintigraphy using planar gamma camera imaging is a reliable examination for the diagnosis of liver hemangiomas, it may fail to depict small, deeply seated lesions, and hence miss the diagnosis. Two cases are reported in which SPECT demonstrated delayed pooling in small, deep, space-occupying lesions, which were poorly seen on planar images, and therefore made a cavernous hemangioma the most likely diagnosis.

  12. Cardiovascular Profile of Propranolol after Multiple Dosing in Infantile Hemangioma.

    PubMed

    Salice, Patrizia; Giovanni Bianchetti, Mario; Giavarini, Alessandra; Gondoni, Erica; Cavalli, Riccardo; Maria Colli, Anna; Lombardi, Federico

    2017-01-01

    Propranolol is becoming the treatment of choice for complicated infantile hemangioma. We report here data on peripheral blood flow, O2-saturation, electrocardiographic PR-interval, left ventricular function, blood pressure and heart rate that were assessed before and during treatment for ≥4 weeks with propranolol 2 mg/kg of body weight daily in 67 infants <12 months of age in normal sinus rhythm and with structurally normal hearts. Management with propranolol was well tolerated in all and did not modify peripheral blood flow, O2-saturation, electrocardiographic PR-interval and left ventricular fractional shortening or ejection fraction. Absolute blood pressure levels were similar without and with propranolol. However, age-adjusted centile levels for both systolic and diastolic levels were significantly lower while on propranolol. The heart rate was significantly lower both when expressed as absolute value and when expressed as age-adjusted centile on treatment with propranolol. In conclusion, propranolol 2 mg/kg of body weight daily causes a statistically though not clinically relevant decrease in blood pressure and heart rate in cardially healthy infants affected by infantile hemangioma. Temporary discontinuation during acute febrile illnesses and during diarrheal diseases should be considered to prevent excessive hypotension.

  13. Cavernous hemangioma of rhinopharynx: our experience and review of literature

    PubMed Central

    Testa, Domenico; Motta, Sergio; Massimilla, Eva Aurora; Tafuri, Domenico; Russo, Daniela; Russo, Anna; Landolfo, Pasquale Gianluca; Mesolella, Massimo; Motta, Gaetano

    2015-01-01

    Hemangiomas are benign tumors originating in the vascular tissues of skin, mucosa, muscles, glands, and bones. Although these tumors are common lesions of the head and neck, they rarely occur in the nasal cavity and paranasal sinuses. Cavernous haemangioma of the lateral wall of the nasopharynx has not previously been reported. We examined the clinical, radiological and therapeutic management of cavernous haemangioma of nasopharynx starting from a clinical case of a 26-year-old woman with a history of recurrent and conspicuous epistaxis and left-sided nasal associated severe obstruction. Nasopharynx examination, by flexible endoscopy, showed a cystic mass borne by the left side wall of the nasopharynx, in contact with the soft palate, covered by intact and regular mucosa. Contrast-enhanced computed tomography (CT) scan, confirmed these findings and showed contextual lamellar calcifications and inhomogeneous enhancement. The nasal endoscopic approach (FESS), under general anesthesia, allowed removal of the mass, without complications, after careful hemostasis of arterial branches. It was possible to establish the precise site of origin of the tumor only during the surgical procedure. Histopathological study showed mucosa with extensive vascular proliferation, with framework of lacunar/cavernous haemangioma, also present at lamellar bone tissue level. An unusual site and an unspecific clinical appearance can make diagnosis and treatment of a cavernous hemangioma of the nasopharynx difficult. The nasal endoscopic technique proved to be reliable in terms of adequate exposure and visualization of the lesion, control of bleeding, and complete removal of the mass. PMID:28352748

  14. Diode laser photocoagulation in PHACES syndrome hemangiomas: a case series

    NASA Astrophysics Data System (ADS)

    Romeo, U.; Russo, N.; Polimeni, A.; Favia, G.; Lacaita, M. G.; Limongelli, L.; Franco, S.

    2014-01-01

    PHACES syndrome is a pediatric syndrome with cutaneous and extra-cutaneous manifestations, such as Posterior fossa defects, Hemangiomas, Arterial lesions, Cardiac abnormalities/aortic coarctation, Eye abnormalities and Sternal cleft. Facial hemangiomas affect the 75% of patients and may arise on the oral mucosa or perioral cutaneous regions. In this study we treated 26 Intraoral Haemangiomas (IH) and 15 Perioral Haemangiomas (PH) with diode laser photocoagulation using a laser of 800+/-10nm of wavelength. For IH treatment an optical fiber of 320 μm was used, and the laser power was set ted at 4 W (t-on 200 ms / t-off 400ms; fluence: 995 J/cm2). For PH treatment an optical fiber of 400 μm at the power of 5 W was used (t-on 100 ms / t-off 300 ms; fluence: 398 J/cm2). IH healed after one session (31%), the other (69%) after two sessions of Laser therapy. In each session, only a limited area of the PH was treated, obtaining a progressive improvement of the lesion. Diode laser photocoagulation is an effective option of treatment for IH and PH in patients affected by PHACE because of its minimal invasiveness. Moreover laser photocoagulation doesn't have side effects and can be performed repeatedly without cumulative toxicity. Nevertheless, more studies are required to evaluate the effectiveness of the therapy in mid and long time period.

  15. Verrucous hemangioma with pseudoepitheliomatous epidermal hyperplasia in an adult horse.

    PubMed

    Pérez-Écija, A; Estepa, J C; Barranco, I; Rodríguez-Gómez, I M; Mendoza, F J; Gómez-Laguna, J

    2014-09-01

    Verrucous hemangiomas are a rare specific variant of equine skin tumors not well described in the literature. An 8-year-old gelding presented a unilateral lesion on the pastern. Macroscopically, the mass showed a warty and verrucous surface with focal ulcerations. The histology showed a dermal proliferation of endothelial-layered capillaries and venules separated by a delicate stroma of scant fibroblasts and collagen deposition, with pseudoepitheliomatous hyperplasia (exuberant reactive irregular epithelial hyperplasia with tongue-like projections extending into the dermis, mimicking downgrowth of squamous cell carcinoma) and orthokeratotic hyperkeratosis of the overlying epidermis. The immunohistochemical study confirmed the endothelial origin of the tumor, and a final diagnosis of verrucous hemangioma with pseudoepitheliomatous hyperplasia was confirmed. To the knowledge of the authors, this is the first detailed description of this entity in adult horses. Moreover, the clinical progression and epidermal changes have not been previously reported, emphasizing the importance of a pathological study of any epithelial preneoplastic lesion to rule out an underlying dermal neoplasia. © The Author(s) 2013.

  16. A Case of Eccrine Angiomatous Hamartoma Associated with Verrucous Hemangioma

    PubMed Central

    Cheong, Seung Hyun; Lim, Ji Yeon; Kim, So Young; Choi, You Won; Choi, Hae Young

    2009-01-01

    Eccrine angiomatous hamartomas are benign vascular and eccrine malformations often accompanied by hyperhidrosis or pain, increased eccrine glands, and aggregates of vessels. Verrucous hemangiomas are congenital vascular malformations presenting as unilateral grouped papules. Histologically, they show verrucous epidermal change and proliferation of capillaries in the dermis. We report a case of a 47-year-old woman with a red keratotic patch overlying a bluish plaque on the right sole, which had been present since birth. It was accompanied by pain and hyperhidrosis. Histologically, there were verrucous changes in the epidermis, numerous dilated capillaries in the papillary dermis, and increased eccrine glands with angiomatous foci in the deep dermis. The epithelial cells of the eccrine glands were positive for CEA, and the endothelial cells were positive for CD31 and GLUT-1. Eccrine angiomatous hamartomas have been reported in conjunction with other vascular tumors in only a few instances. We report an interesting case of an eccrine angiomatous hamartoma associated with a verrucous hemangioma. PMID:20523811

  17. Hemangioma of the nasal vault: MR and CT features.

    PubMed

    Dillon, W P; Som, P M; Rosenau, W

    1991-09-01

    Six patients with a history of epistaxis (five patients) or nasal obstruction (one patient) were found to have a capillary hemangioma of the nasal vault that involved one or more nasal turbinates. Four patients underwent computed tomographic (CT) examination; two of these also underwent magnetic resonance (MR) imaging. Four others underwent only MR imaging. At CT and MR, all of the lesions were well circumscribed and intensely enhancing, with contralateral deviation of the nasal septum. Remodeling of the surrounding bone was present in three patients. On T1-weighted MR images, the masses were intermediate in signal intensity. Varying degrees of T2 shortening were shown on T2-weighted MR images, with an appearance that suggested the presence of blood products surrounding an inner matrix of higher-signal-intensity tumor. Intense enhancement at CT and MR assisted differentiation of tumor from retained sinonasal secretions. In two patients, external carotid arteriography revealed small foci of pooling contrast material; in one of these patients, arteriovenous shunting was also present. Pathologic examination in all patients demonstrated capillary hemangiomas with varying degrees of fibrosis and hemosiderin deposition.

  18. Thoracic vertebral hemangioma causing paraplegia in Klippel-Trenaunay-Weber syndrome: case report.

    PubMed

    Okutan, Ozerk; Yildirim, Timur; Isik, Serdar; Gokce, Berna; Saygili, Barıs; Konakli, Ethem Bes

    2013-01-01

    Vertebral hemangiomas are the most common tumours of the vertebral column. Generally, these tumours are asymptomatic but some patients complain of back pain and develop neurologic symptoms due to extraosseous extension. Vertebral hemangiomas can extend extradurally causing neurological impairment as a result of compression of the spinal cord and nerve roots. Vertebral hemangiomas may be multiple and detectable as a component of the Klippel-Trenaunay-Weber syndrome. Although this syndrome consists of deep venous thrombosis, lymphatic anomalies, cutaneous capillary malformations, and hypertrophy of soft tissue and bone on extremities, its clinical presentation may be very variable. We present a unique case of vertebral hemangioma causing spinal cord compression due to the extradural extension that also had deep venous thrombosis, hematuria, hypophyseal cyst and ventricle asymmetry, diagnosed as the Klippel-Trenaunay-Weber syndrome.

  19. Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: case report and review of literature.

    PubMed

    Syrimpeis, Vasileios; Vitsas, Vasileios; Korovessis, Panagiotis

    2014-03-01

    Context Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture. Findings We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful. Conclusion In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended.

  20. Ventral midline blanching in the setting of segmental infantile hemangiomas: clinical observations and pathogenetic implications.

    PubMed

    Feigenbaum, Dana F; Sybert, Virginia P; Vanderhooft, Sheryll L; Siegel, Dawn; Drolet, Beth A; Frieden, Ilona J; Mathes, Erin F D

    2015-01-01

    Areas of blanched skin in children may be seen as an independent finding or in association with vascular birthmarks. We performed a retrospective chart review to identify and describe infants with areas of ventral midline blanching in the presence of segmental infantile hemangiomas. We identified nine full-term infants with partial or full segmental hemangiomas and areas of midline ventral blanching. Additional ventral wall defects were seen in five patients. Six had cardiac anomalies and six had intracranial anomalies. Five were diagnosed with definite PHACE (posterior fossa, hemangioma, arterial, cardiac, and eye abnormalities) syndrome and three had possible PHACE syndrome. Eight were complicated by ulceration. Treatment varied according to the case. Ventral blanching, even in the absence of overt midline defects, can be seen in infants with segmental hemangiomas at risk for PHACE syndrome. We hypothesize that midline blanching may represent a minor manifestation of a developmental ventral defect. © 2014 Wiley Periodicals, Inc.

  1. Visualization of cutaneous hemangioma with Tc-99m tagged red blood cells

    SciTech Connect

    Gordon, L.; Vujic, I.; Spicer, K.M.

    1981-10-01

    Scintigraphy with Tc-99m labeled red blood cells (RBCs) was used to evaluate a patient with a large cutaneous hemangioma. The usefulness of this procedure when combined with arteriography is discussed.

  2. Risk Factors for Degree and Type of Sequelae After Involution of Untreated Hemangiomas of Infancy.

    PubMed

    Baselga, Eulalia; Roe, Esther; Coulie, Julien; Muñoz, Fania Z; Boon, Laurence M; McCuaig, Catherine; Hernandez-Martín, Angela; Gich, Ignasi; Puig, Luis

    2016-11-01

    Infantile hemangiomas involute to some extent, but they often leave sequelae that may cause disfigurement. Factors determining the risk of permanent sequelae after regression are of crucial importance in treatment decision making. To describe the sequelae left by infantile hemangiomas after natural involution and to identify clinical characteristics that could predict the most severe or a particular type of sequelae. Multicentric retrospective cohort study of images from 187 infantile hemangiomas that had not received systemic treatment and had follow-up pictures until regression that were selected from photographic files taken between 2003 and 2013 at 4 university hospitals with large vascular clinics in 3 different countries. Outcome measures were the type of sequelae classified as residual telangiectasia, anetodermal skin, redundant skin, persistent superficial component, and the degree of sequelae ranging from 1 to 4. A total of 184 hemangiomas were included. The overall incidence of significant sequelae was 101 of 184 (54.9%). The most common sequelae after involution were telangiectasias (145, 84.3%), fibrofatty tissue (81, 47.1%), and anetodermic skin (56, 32.6%). The average age at which hemangioma completed involution was 3.5 years. Superficial and deep hemangiomas left significantly fewer sequelae than combined hemangiomas (Mann-Whitney; superficial vs deep, OR, 1.6; 95% CI, 0.6-3.8; P = .81; superficial vs combined, OR, 3.3; 95% CI, 1.7-6.3; P < .001; deep vs combined, OR, 2.1; 95% CI, 0.9-5.1; P < .001). Hemangiomas with a step or abrupt border of the superficial component left more severe sequelae than those with a smooth border (χ2,OR, 3.4; 95% CI, 1.8-6.6; P < .001). Superficial hemangiomas with a cobblestone appearance or rough surface left more severe sequelae than those with a smooth surface (Kruskal-Wallis; α, 0.05; P < .001). Using multivariate analysis, combined hemangiomas with a superficial component and a step border

  3. Use of intravenous propranolol for control of a large cervicofacial hemangioma in a critically ill neonate.

    PubMed

    Fernando, Shanik J; Leitenberger, Sabra; Majerus, Matt; Krol, Alfons; MacArthur, Carol J

    2016-05-01

    Cervicofacial segmental infantile hemangiomas (IH) may result in airway obstruction requiring use of propranolol to induce hemangioma regression and reestablish the airway. We present the first case using intravenous (IV) propranolol for control of airway obstruction and rapid expansion of cervicofacial IH in the setting of necrotizing enterocolitis (NEC) impaired gastrointestinal function. Intravenous dosing of propranolol was tolerated well in a critically ill neonate with multisystem complications of prematurity.

  4. Preoperative diagnosis of cavernous hemangioma presenting with melena using wireless capsule endoscopy of the small intestine

    PubMed Central

    Akazawa, Yu; Hiramatsu, Katsushi; Nosaka, Takuto; Saito, Yasushi; Ozaki, Yoshihiko; Takahashi, Kazuto; Naito, Tatsushi; Ofuji, Kazuya; Matsuda, Hidetaka; Ohtani, Masahiro; Nemoto, Tomoyuki; Suto, Hiroyuki; Yamaguchi, Akio; Imamura, Yoshiaki; Nakamoto, Yasunari

    2016-01-01

    Background and study aims: Primary neoplasms of the small intestine are relatively rare in all age groups, accounting for about 5 % of all gastrointestinal tumors 1. Cavernous hemangiomas of the small intestine are also rare, can cause gastrointestinal bleeding, and are extremely difficult to diagnose preoperatively 2. We present a patient who presented with melena and iron deficiency anemia, for whom wireless capsule endoscopy and single-balloon enteroscopy facilitated the diagnosis of cavernous hemangioma. PMID:27004239

  5. Aggressive vertebral hemangioma in the postpartum period: an eye-opener

    PubMed Central

    Jain, Rajendra Singh; Agrawal, Rakesh; Srivastava, Trilochan; Kumar, Sunil; Gupta, Pankaj Kumar; Kookna, Jagdeesh Chandra

    2014-01-01

    Pregnancy is a well-known risk factor for incidental or asymptomatic vertebral hemangiomas becoming aggressive or symptomatic, most often during the third trimester of pregnancy, related to hemodynamic and endocrinal changes occurring during pregnancy. Many patients show spontaneous incomplete remission after delivery. We report a rare case of aggressive vertebral hemangioma in the postpartum period in a 26-year-old woman, who presented with upper backache with progressive spastic paraparesis. PMID:25988053

  6. Liver hemangioma and vascular liver diseases in patients with systemic lupus erythematosus

    PubMed Central

    Berzigotti, Annalisa; Frigato, Marilena; Manfredini, Elena; Pierpaoli, Lucia; Mulè, Rita; Tiani, Carolina; Zappoli, Paola; Magalotti, Donatella; Malavolta, Nazzarena; Zoli, Marco

    2011-01-01

    AIM: To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS: Thirty-five consecutive adult patients with SLE and 35 age- and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed. RESULTS: Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P < 0.0001), with hemangioma being the most commonly observed lesion in the two groups. SLE was associated with the presence of single hemangioma [odds ratios (OR) 5.05; 95% confidence interval (CI) 1.91-13.38] and multiple hemangiomas (OR 4.13; 95% CI 1.03-16.55). Multiple hemangiomas were associated with a longer duration of SLE (9.9 ± 6.5 vs 5.5 ± 6.4 years; P = 0.04). Imaging prior to SLE onset was available in 9 patients with SLE and hemangioma, showing absence of lesions in 7/9. The clinical data of our patients suggest that SLE possibly plays a role in the development of hemangioma. In addition, a Budd-Chiari syndrome associated with nodular regenerative hyperplasia (NRH), and a NRH associated with hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population. CONCLUSION: SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE. PMID:22110281

  7. Intraosseous Hemangioma of the Middle Turbinate: A Case Report of a Rare Entity and Literature Review

    PubMed Central

    Weindling, Steven; Gupta, Vivek; Nassar, Aziza

    2015-01-01

    Intraosseous hemangiomas arising from the nasal turbinate are exceedingly rare, with few reported cases in the literature. We describe a 61-year-old man found to have a nasal cavity mass on sinus computed tomograph (CT) and magnetic resonance imaging (MRI). Although an atypical site of occurrence, distinctive internal honeycomb bony trabeculations demonstrated on CT allowed the correct diagnosis of an intraosseous hemangioma to be prospectively proposed by the interpreting radiologist which had direct clinical and surgical impacts. PMID:25923679

  8. Laparoscopic treatment of a large pedunculated hemangioma of the liver: a case report

    PubMed Central

    MELFA, G.; COCORULLO, G.; RASPANTI, C.; FALCO, N.; PORRELLO, C.; GULLO, R.; ROTOLO, G.; GENOVA, C.; GULOTTA, G.; SCERRINO, G.

    2016-01-01

    Hepatic hemangiomas are the most common benign tumors of the liver, often asymptomatic and discovered incidentally. A 62-year-old woman was referred to our Institution under the suspicion of having an 8 cm-sized GIST. Due to the atypical features of the lesion on TC scan, a biopsy was performed. We report the case of pedunculated hepatic hemangioma with the aim to discuss the diagnostic approach, the possible causes of misdiagnosis and the opportunity of the laparoscopic approach. PMID:27938533

  9. Cardiac hemangioma of the right atrium in a neonate: fetal management and expedited surgical resection

    PubMed Central

    Sebastian, VA; Einzig, S; D’Cruz, CA; Costello, C; Kula, M; Campbell, A

    2005-01-01

    Cardiac hemangioma is a rare tumor with a reported incidence of 1-2%. We describe the case of a neonate with a right atrial mass that was diagnosed prenatally. The fetus developed a supraventricular tachycardia and was delivered by cesarean section in the 35th week of gestation. The infant underwent surgery after 24 hours to remove the mass which was diagnosed as a cardiac capillary-cavernous hemangioma. PMID:22368656

  10. [Pyogenic granuloma vs. lobular capillary hemangioma. Histopathological analysis and epidemiology (Venezuela)].

    PubMed

    Tinoco, P J; Sanalzar, N

    1989-01-01

    A review of the literature is done concerning Pyogenic Granuloma. From two hundred and thirty eight cases of our files. Twenty four cases are separated which are considered histopathologically different and to which the term Lobular Capillary Hemangioma is more applicable. Epidemiologic studies are analyzed and conclusions are established. Pyogenic Granuloma is more a reactive type of lesion of inflammatory nature, while Lobular Capillary Hemangioma separated as an entity is considered a lesion of benign neoplastic nature and vascular origin.

  11. Laparoscopic vs computerized tomography-guided radiofrequency ablation for large hepatic hemangiomas abutting the diaphragm

    PubMed Central

    Gao, Jun; Kong, Jian; Ding, Xue-Mei; Ke, Shan; Niu, Hai-Gang; Xin, Zong-Hai; Ning, Chun-Min; Guo, Shi-Gang; Li, Xiao-Long; Zhang, Long; Dong, Yong-Hong; Sun, Wen-Bing

    2015-01-01

    AIM: To compare safety and therapeutic efficacy of laparoscopic radiofrequency (RF) ablation vs computed tomography (CT)-guided RF ablation for large hepatic hemangiomas abutting the diaphragm. METHODS: We retrospectively reviewed our sequential experience of treating 51 large hepatic hemangiomas abutting the diaphragm in 51 patients by CT-guided or laparoscopic RF ablation due to either the presence of symptoms and/or the enlargement of hemangioma. Altogether, 24 hemangiomas were ablated via a CT-guided percutaneous approach (CT-guided ablation group), and 27 hemangiomas were treated via a laparoscopic approach (laparoscopic ablation group). RESULTS: The mean diameter of the 51 hemangiomas was 9.6 ± 1.8 cm (range, 6.0-12.0 cm). There was no difference in the diameter of hemangiomas between the two groups (P > 0.05). RF ablation was performed successfully in all patients. There was no difference in ablation times between groups (P > 0.05). There were 23 thoracic complications in 17 patients: 15 (62.5%, 15/24) in the CT-guided ablation group and 2 (7.4%, 2/27) in the laparoscopic ablation group (P < 0.05). According to the Dindo-Clavien classification, two complications (pleural effusion and diaphragmatic rupture grade III) were major in two patients. All others were minor (grade I). Both major complications occurred in the CT-guided ablation group. The minor complications were treated successfully with conservative measures, and the two major complications underwent treatment by chest tube drainage and thoracoscopic surgery, respectively. Complete ablation was achieved in 91.7% (22/24) and 96.3% (26/27) in the CT-guided and the laparoscopic ablation groups, respectively (P > 0.05). CONCLUSION: Laparoscopic RF ablation therapy should be used as the first-line treatment option for large hepatic hemangiomas abutting the diaphragm. It avoids thermal injury to the diaphragm and reduces thoracic complications. PMID:26019459

  12. Symptomatic Congenital Hemangioma and Congenital Hemangiomatosis Associated With a Somatic Activating Mutation in GNA11.

    PubMed

    Funk, Tracy; Lim, Young; Kulungowski, Ann M; Prok, Lori; Crombleholme, Timothy M; Choate, Keith; Bruckner, Anna L

    2016-09-01

    Congenital hemangiomas are uncommon benign vascular tumors that present fully formed at birth. They are rarely associated with transient hematologic abnormalities, which are typically less severe than the Kasabach-Merritt phenomenon associated with kaposiform hemangioendotheliomas. Congenital hemangiomas are typically solitary and have not been reported to occur in a multifocal, generalized pattern. To describe a male infant born with an unusual, large vascular mass complicated by anemia, thrombocytopenia, and disseminated intravascular coagulopathy, as well as innumerable small vascular papules in a generalized cutaneous distribution. This case report is a descriptive observation of the results of clinical, pathologic, and genetic studies performed in a single male infant observed for 2 years (May 2013 to June 2015) for vascular anomalies at a tertiary care referral center. Histopathologic, immunohistochemical, and genetic study results of tumor specimens and saliva. Careful pathologic study of 3 tumor specimens revealed similar lobular proliferations of bland endothelial cells. Lesional vessels did not express GLUT1 or the lymphatic marker D2-40, whereas WT1 was expressed. A somatic c.A626C, p.Q209P mutation in the GNA11 gene was identified in tumoral tissue. These findings support a unifying diagnosis of congenital hemangioma for these vascular tumors. To date, this is the first-reported case of a hemangiomatosis presentation of congenital hemangioma. In addition to highlighting this novel phenotype, this case indicates the rare association of congenital hemangioma with hematologic abnormalities and verifies somatic activating mutations as the underlying cause of congenital hemangioma.

  13. Preliminary Report On Combined Surgical- And Laser-Treatment Of Large Hemangiomas And Tattoos

    NASA Astrophysics Data System (ADS)

    Ginsbach, G.

    1981-05-01

    As most hemangiomas and tattoos require many sessions to be cured completely by argon-laser or conventional therapy I developed a new combined surgical and laser-therapy method for large hemangiomas and tattoos. This is a three step method. First: The skin lesion is treated by argon-laser with the point by point method, developed by ourself. Second: Under local or general anaesthesia a) the hemangioma is partially excised and undermined letting only the skin which is already treated by argon-laser-beams. Than the hemangioma is exstirpated in toto, the wound closed by running intradermal sutures and a pressure bandage applied, b) the tattoo is abraded as deep as possible, draped by lyofoam. Then a pressure bandage is applied. Third: The hemangioma as well as the tattoo are treated by argon-laser-beams after the operation. This method is safe and effective, gives good results, minimal scars in the case of hemangiomas and tattoos. In this paper the method is described and some cases are illustrated by pre- and postoperational photographs.

  14. Glomeruloid hemangioma in POEMS syndrome shows two different immunophenotypic endothelial cells.

    PubMed

    Kishimoto, S; Takenaka, H; Shibagaki, R; Noda, Y; Yamamoto, M; Yasuno, H

    2000-02-01

    The case of a Japanese woman with glomeruloid hemangioma, an initial marker for POEMS syndrome, is reported. Her cutaneous lesions were multiple and consisted of glomeruloid hemangiomas, cherry-type capillary hemangiomas, and a mixture of both. The specimens of glomeruloid hemangiomas were studied by paraffin section immunohistochemistry with a large panel of antibodies and electron microscopy, respectively. The lesions, whose size ranged from minute foci to large nodules, were composed of anastomosing vascular channels resembling renal glomeruli and had irregular lumina, often featuring capillaries and sinusoid-like spaces. The vascular channels were lined by a single layer of endothelial cells, which showed two types of cells. The capillary-type endothelium possessed large vesicular nuclei with open chromatin and large amount of cytoplasm. The sinusoidal endothelium possessed small basal nuclei with dense chromatin as well as scant amount of cytoplasm. The former cells had a characteristic CD31+/CD34+/UEA I+/CD68- phenotype. Some of these cells ultrastructurally showed intracytoplasmic lumen formation. The latter cells had a characteristic CD31+/CD34-/UEA I-/CD68+ phenotype. The present study shows that glomeruloid hemangioma has unique morphologic and immunologic features that differ from the traditional hemangiomas as well as littoral cell angioma of the spleen.

  15. Hemangioma of the prostate - an unusual cause of lower urinary tract symptoms: Case report

    PubMed Central

    2011-01-01

    Background Hemangioma of the prostate gland is extremely rare and only a few cases have been reported. There have been several cases of hemangioma of posterior urethra, urinary bladder and periprostatic plexus in the literature, all presenting with hematuria or hematospermia. Diagnosis of prostatic hemangioma is difficult due to its rarity and unspecific symptoms such as hematuria, hematospermia or lower urinary tract symptoms. It cannot be detected by conventional examinations such as cystoscopy or standard rectal ultrasonography. Case presentation We present a case of prostatic hemangioma in an 84-year old male presenting with lower urinary tract symptoms. Bleeding has not been a feature in our case and diagnosis was not made until after operation. The patient was treated as a case of bladder neck outflow obstruction with transurethral resection of prostate gland and simultaneous bladder neck incisions. A period of self-catheterization was instituted due to postoperative urinary retention as the result of detrusor insufficiency. Conclusion Hemangioma of prostate gland is extremely rare and symptomatic prostatic hemangioma should be treated either by transurethral resection of prostate or laser evaporation. PMID:21486499

  16. Intrinsic regulation of hemangioma involution by platelet-derived growth factor

    PubMed Central

    Roach, E E; Chakrabarti, R; Park, N I; Keats, E C; Yip, J; Chan, N G; Khan, Z A

    2012-01-01

    Infantile hemangioma is a vascular tumor that exhibits a unique natural cycle of rapid growth followed by involution. Previously, we have shown that hemangiomas arise from CD133+ stem cells that differentiate into endothelial cells when implanted in immunodeficient mice. The same clonally expanded stem cells also produced adipocytes, thus recapitulating the involuting phase of hemangioma. In the present study, we have elucidated the intrinsic mechanisms of adipocyte differentiation using hemangioma-derived stem cells (hemSCs). We found that platelet-derived growth factor (PDGF) is elevated during the proliferating phase and may inhibit adipocyte differentiation. hemSCs expressed high levels of PDGF-B and showed sustained tyrosine phosphorylation of PDGF receptors under basal (unstimulated) conditions. Inhibition of PDGF receptor signaling caused enhanced adipogenesis in hemSCs. Furthermore, exposure of hemSCs to exogenous PDGF-BB reduced the fat content and the expression of adipocyte-specific transcription factors. We also show that these autogenous inhibitory effects are mediated by PDGF receptor-β signaling. In summary, this study identifies PDGF signaling as an intrinsic negative regulator of hemangioma involution and highlights the therapeutic potential of disrupting PDGF signaling for the treatment of hemangiomas. PMID:22717583

  17. Rapamycin Inhibits Proliferation of Hemangioma Endothelial Cells by Reducing HIF-1-Dependent Expression of VEGF

    PubMed Central

    Medici, Damian; Olsen, Bjorn R.

    2012-01-01

    Hemangiomas are tumors formed by hyper-proliferation of vascular endothelial cells. This is caused by elevated vascular endothelial growth factor (VEGF) signaling through VEGF receptor 2 (VEGFR2). Here we show that elevated VEGF levels produced by hemangioma endothelial cells are reduced by the mTOR inhibitor rapamycin. mTOR activates p70S6K, which controls translation of mRNA to generate proteins such as hypoxia inducible factor-1 (HIF-1). VEGF is a known HIF-1 target gene, and our data show that VEGF levels in hemangioma endothelial cells are reduced by HIF-1α siRNA. Over-expression of HIF-1α increases VEGF levels and endothelial cell proliferation. Furthermore, both rapamycin and HIF-1α siRNA reduce proliferation of hemangioma endothelial cells. These data suggest that mTOR and HIF-1 contribute to hemangioma endothelial cell proliferation by stimulating an autocrine loop of VEGF signaling. Furthermore, mTOR and HIF-1 may be therapeutic targets for the treatment of hemangiomas. PMID:22900063

  18. Differentiation between multiple liver hemangiomas and liver metastases of gastrinomas: Value of enhanced MRI

    SciTech Connect

    Berger, J.F.; Laissy, J.P.; Limot, O.; Cadiot, G.

    1996-05-01

    Hepatic metastases of neuroendocrine tumors are known to mimic hemangiomas on nonenhanced SE MR sequences. The usefulness of MR examination with gadolinium injection to identify lesions was prospectively evaluated. Nine patients with multiple liver metastases of gastrinomas were compared with six patients showing multiple liver hemangiomas. Patients underwent unenhanced T2-weighted SE, T1-weighted SE, and FLASH sequences, followed by enhanced sequential FLASH sequences and a 5 min delayed T1-weighted SE sequence. On T2-weighted SE sequence, all hemangiomas displayed the same typical morphology as a sharply defined, homogeneous, high signal intensity lesion, but this pattern was also observed for some or all of the lesions in seven of nine patients with gastrinoma metastases. Dynamic FLASH sequences were accurate for lesions larger than 2 cm, hemangiomas displaying a nodular peripheral enhancement with centripetal filling in, and metastases displaying either an initial homogeneous or a regular peripheral enhancement. Precise assessment of lesions smaller than 2 cm remained equivocal. Delayed T1-weighted SE sequence (performed at least 5 min after Gd-chelate injection) was the most accurate technique to identify metastases by showing hypo-or isointensity signal, whereas all hemangiomas were hyperintense. Postcontrast delayed T1-weighted sequence is the primary technique to differentiate equivocal cases of hemangiomas from metastases of gastrinoma. 25 refs., 3 figs., 2 tabs.

  19. Use of intraoperative sodium tetradecyl sulfate for the treatment of a spinal epidural hemangioma. Technical note.

    PubMed

    Baig, Mirza N; Saquib, Syed; Christoforidis, Greg; Caragine, Louis P

    2007-08-01

    Spinal hemangiomas can be categorized into three different groups based on location. Vertebral body (VB) hemangiomas are frequent incidental findings on magnetic resonance (MR) imaging. There is a subdivision of these with spinal epidural extension that have been reported in the literature. Spinal hemangiomas can also be epidural without VB involvement; these are extremely rare with few reported cases in the thoracic epidural spinal column. The diagnosis and imaging characteristics as well as the surgical tools used in gross-total resection of spinal epidural hemangioma are not well understood. The authors present a detailed characterization of a spinal epidural hemangioma in a 30-year-old woman who presented with complaints of gradual onset of low-back pain that worsened over 1 year. The MR imaging findings indicated a large L2-S1 epidural spinal mass causing thecal sac compression. The patient underwent an L2-S1 laminectomy, and a vascular extradural mass was noted on the posterior aspect of the dura mater. Preoperative spinal angiography as well as intraoperative angiography was performed. Total resection of the tumor was achieved using intraoperative embolization with sodium tetradecyl sulfate and microscopic dissection. The postoperative MR imaging findings and clinical outcome were excellent. The findings and use of sodium tetradecyl sulfate in gross-total resection are discussed. The authors also review treatment modalities and demonstrate the utility and effectiveness of intraoperative sodium tetradecyl sulfate in grosstotal resection of large difficult spinal epidural hemangiomas.

  20. A pure epidural spinal cavernous hemangioma - with an innocuous face but a perilous behaviour!!

    PubMed

    A L, Hemalatha; T, Ravikumar; Chamarthy, Neelima P; Puri, Kunal

    2013-07-01

    Cavernous hemangiomas occur frequently in the intracranial structures but they are rare in the spine, with an incidence of 0.22 cases/million/year, which account for 5 - 12% of the spinal vascular lesions, 51% of which are extradural. Most of the epidural hemangiomas are secondary extensions from the vertebral lesions. The spinal cavernous hemangiomas which do not involve the vertebrae are referred to as "pure" types. The pure epidural hemangiomas are rare, which account for only 4% of all the epidural lesions. A case of a Pure spinal epidural cavernous hemangioma in a 50 year old male, with the clinical picture of a slowly progressive compressive myelopathy, has been presented here. The imaging studies showed a well-defined, enhancing epidural lesion at the T7 - T8 level, with dorsal cordedema and myelomalacic changes. A radiological diagnosis of a meningioma was considered. Histopathologically, the lesion was diagnosed as a hemangioma. The patient improved dramatically after the excision of the lesion.

  1. Successful en bloc resection of an esophageal hemangioma by combined EBL & EMR: a case report and technical review.

    PubMed

    Baek, Il Hyun; Jeon, Jung Won; Shin, Hyun Phil; Cha, Jae Myung; Joo, Kwang Ro; Lee, Joung Il; Won, Kyu Yeoun; Min, Kyeong Won

    2016-01-01

    A 58-year-old male was diagnosed esophageal hemangioma during a endoscopy in regular examination. The patient was referred to the department of gastroenterology in our hospital to treatment. Combined endoscopic band ligation (EBL) and endoscopic mucosal resection (EMR) was performed for diagnostic treatment. Histopathological results revealed hemangioma. Even though several approaches such as esophagectomy, endoscopic removal, sclerotherapy, and laser therapy have been used to remove the esophageal hemangiomas, recently less invasive methods were preferred. Here we describe a case of esophageal hemangioma removed by EBL & EMR.

  2. The natural history of an umbilical cord hemangioma.

    PubMed

    Smulian, John C; Sarno, Albert P; Rochon, Meredith L; Loven, Victoria A

    2016-09-01

    Umbilical cord hemangiomas are rare, and the natural history is poorly understood. We present a case where the clinical course was complicated by distal umbilical cord edema, episodes of proximal obstruction of umbilical artery blood flow, transient fetal pleural and pericardial effusions, and position-dependent abnormal fetal heart rate monitoring with periods of sustained fetal tachycardia. Delivery was performed for fetal growth restriction with abnormal fetal surveillance. This case highlights possible mechanisms for fetal decompensation as well as the importance of a multifaceted approach to the management of an umbilical cord mass using multiple tools for fetal assessment. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:455-458, 2016. © 2016 Wiley Periodicals, Inc.

  3. An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma

    PubMed Central

    Ribeiro, Sara Filipa Teixeira; Queirós, Tatiana; Amorim, José M.; Ferreira, Ana M.; Sales-Sanz, Marco

    2017-01-01

    Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications. PMID:28626414

  4. Computed tomography and sonography of cavernous hemangioma of the liver

    SciTech Connect

    Itai, Y.; Ohtomo, K.; Araki, T.; Furui, S.; Iio, M.; Atomi, Y.

    1983-08-01

    Accuracy and limitations of computed tomography (CT) and sonography in the detection and diagnosis of cavernous hemangioma of the liver were analyzed in 39 cases. In 35 of 38 lesions examined by CT before and after bolus contrast enhancement, findings were dense contrast enhancement spreading in all directions on subsequent scans and/or density (other than capsule or septa) higher than normal hepatic parenchyma after 2 min. Lesions smaller than 1 cm were not detected. Misregistration in sequential scane prevented diagnosis of three of nine lesions smaller than 2 cm. Sonography revealed various patterns of mass, but in the smaller lesions, an extremely hyperechoic pattern was dominant. The contributions of CT and sonography depend on the size of the lesions.

  5. Scalloping Characteristics in a Patient with Extra-Cranial Hemangioma

    PubMed Central

    Agrawal, Amit; Jena, Ranjan K.; Reddy, Umamaheswara

    2017-01-01

    Summary Infantile hemangiomas are the most common benign tumors of infancy and childhood with a reported incidence of 4% to 10% in infants. We report of a 9 year-old male child with a history of progressively increasing swelling over the right eyebrow region. The lesion was present since childhood; however, it increased in in size over the previous 3–4 months. The CT scan showed scalloping over the right supra-orbital ridge with an intact bone. The child underwent total excision of the lesion. A characteristic scalloping seen on imaging (depression in the outer or inner table of the skull) can help differentiate lesions of extracranial and intracranial origins. PMID:28144385

  6. Lack of anti-tumor activity by anti-VEGF treatments in hepatic hemangiomas.

    PubMed

    Lee, Minsu; Choi, Jin-Young; Lim, Joon Seok; Park, Mi-Suk; Kim, Myeong-Jin; Kim, Honsoul

    2016-04-01

    Recently, anti-vascular endothelial growth factor (anti-VEGF) agents have been described in the literature as a valid treatment option for symptomatic liver hemangiomas, but only limited evidence supports this notion. The purpose of this study was to elucidate whether or not the administration of anti-VEGF agents can reliably achieve a size reduction in liver hemangiomas. We examined patients with incidental hemangiomas who received anti-angiogenic agents for the treatment of other malignancies. Our study population consisted of 17 colorectal cancer patients and one lung cancer patient carrying 21 hemangiomas who received bevacizumab, and seven renal cell carcinoma patients carrying nine hepatic hemangiomas who received sunitinib. We have measured the liver hemangioma volume on both the pre-treatment and post-treatment computed tomography images and then calculated the volume alteration rates. No statistically significant difference (P = 0.365) in the volume of the liver hemangiomas was observed before (1.1-168.8 cm(3); mean ± SD 19.8 ± 39.7 cm(3)) or after (1.2-163.6 cm(3); 19.3 ± 38.0 cm(3)) bevacizumab treatment. The volume reduction rate ranged from -35.0 to 11.2 % (mean ± SD -1.3 ± 10.8 %). The sunitinib treatment group also showed no statistically significant difference (P = 0.889) in hemangioma volume before (1.2-6.5 cm(3); 3.0 ± 1.8 cm(3)) or after (1.2-6.0 cm(3); 3.0-1.7 cm(3)) treatment. The volume reduction rate ranged from -13.3 to 7.7 % (median: mean ± SD -2.5 ± 6.6 %). We did not observe liver hemangioma shrinkage after bevacizumab or sunitinib treatment. Our data do not support the application of anti-VEGF agents for the treatment of hepatic hemangiomas.

  7. Expression of β-Adrenergic Receptor Subtypes in Proliferative, Involuted, and Propranolol-Responsive Infantile Hemangiomas.

    PubMed

    Phillips, James D; Zhang, Haihong; Wei, Ting; Richter, Gresham T

    2017-03-01

    Propranolol hydrochloride has become the primary medical treatment for problematic infantile hemangioma; however, the expression of propranolol's target receptors during growth, involution, and treatment of hemangioma remains unclear. To measure and compare the expression of β1-, β2-, and β3-adrenergic receptors (ADBR1, ADBR2, and ADBR3, respectively) in proliferative (n = 10), involuted (n = 11), and propranolol-responsive (n = 12) hemangioma tissue. Infantile hemangioma specimens were harvested for molecular investigation. Messenger RNA (mRNA) expression of the ADBR1, ADBR2, and ADBR3 genes was detected by real-time polymerase chain reaction. Protein level expression was measured by Western blot and standardized with densitometry. A total of 33 specimens were collected from patients in a tertiary pediatric hospital who underwent excision of problematic hemangiomas. This study was conducted from January 18, 2011, to September 24, 2013, and data analysis was performed from February 25, 2015, to June 25, 2016. Of the 33 patients included, 21 were female (64%). The mean (SD) patient age at the time of excision was 7 (2.5) months for the proliferative group lesions, 23.5 (10) months for the involuted group, and 16 (10) months for the propranolol group. The mean level of ADBR1 mRNA expression was significantly higher in proliferative hemangioma than in propranolol-responsive hemangioma (1.05 [0.56] vs 0.52 [0.36]; P = .01; 95% CI, 0.12-0.94). There was no difference in ADBR2 expression among the groups. Protein expression of ADBR3 was significantly higher in involuted (0.64 [0.12] vs 0.26 [0.04]; P < .01; 95% CI, 0.26-0.49) and propranolol-responsive hemangioma (0.66 [0.31] vs 0.26 [0.04]; P = .01; 95% CI, 0.16-0.68) compared with proliferative hemangioma. These data demonstrate the variable expression of ADBR subtypes among infantile hemangiomas during growth, involution, and response to treatment. These findings may have clinical

  8. Propranolol Targets Contractility of Infantile Hemangioma-derived Pericytes

    PubMed Central

    Lee, D.; Boscolo, E.; Durham, J.T.; Mulliken, J.B.; Herman, I.M.; Bischoff, J.

    2014-01-01

    Propranolol, a β-adrenergic receptor (AR) antagonist, was discovered serendipitously to be an effective treatment for endangering infantile hemangioma (IH). Dramatic fading of cutaneous color is often seen a short time after initiating propranolol therapy, with accelerated regression of IH blood vessels discerned after weeks to months. Here we focus on hemangioma-derived pericytes (HemPericytes) isolated from proliferating and involuting phase tumors to assess a possible role for these cells in the apparent propranolol-induced vasoconstriction. HemPericytes express high levels of β2 AR mRNA, compared to positive control bladder smooth muscle cells. In addition, β2 AR mRNA levels were relatively high in IH specimens (n=15) compared to β1 AR, β3 AR and α1bAR. HemPericytes were assayed for contractility on a deformable silicone substrate: propranolol (10μM) restored basal contractile levels in HemPericytes that were relaxed with the AR agonist epinephrine. siRNA knockdown β2 AR blunted this response. Normal human retinal and placental pericytes were not affected by epinephrine or propranolol in this assay. Propranolol (10μM) inhibited proliferation of HemPericytes in vitro, as well as normal pericytes, indicating a non-selective effect in this assay. HemPericytes and HemEC were co-implanted subcutaneously in nude mice to form blood vessels, and at day 7 after injection, mice were randomized into vehicle and propranolol treated groups. Contrast-enhanced micro-ultrasonography of the implants after 7 days of treatment showed significantly decreased vascular volume in propranolol-treated animals, but no reduction in vehicle-treated animals. These findings suggest that the mechanism of propranolol's effect on proliferating IH involves increased pericytic contractility. PMID:24720697

  9. Cavernous hemangioma-like kaposi sarcoma: histomorphologic features and differential diagnosis.

    PubMed

    Onak Kandemir, Nilüfer; Barut, Figen; Doğan Gün, Banu; Solak Tekin, Nilgün; Hallaç Keser, Sevinç; Oğuz Özdamar, Sükrü

    2013-01-01

    Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant.

  10. [Intralesional Pingyangmycin therapy for 51 infantile patients with parotid gland hemangiomas].

    PubMed

    Wang, Li-Li; Gao, Qing-Hong; Liu, Kun; Wang, Xiao-Yi; Wang, Chang-Mei; Wen, Yu-Ming

    2009-04-01

    To investigate the indication and outcome of intralesional Pingyangmycin (PYM) therapy for parotid gland hemangiomas in early childhood. 51 infantile patients with hemangiomas in the parotid gland were studied retrospectively, which had been treated in the clinic of West China Hospital of Stomatology, Sichuan University during the 15-year period from May 1990 to May 2005. In this study, 21 were male, 30 were female, and the ratio of male to female was 1:1.43. The age of the children ranged from 6 months to 4 years, with an average age of 10 months. 38 were deep-seated hemangiomas, and 13 were mixed hemangiomas. 27 were in the right parotid gland and 24 in the left, no bilateral case. All the patients underwent intralesional injection of a solution of 8 mg PYM in 8 mL normal saline mixed with 5 mg dexamethasone. The total dose of PYM ranged from 20mg to 35 mg, which was administered 0.5 or 1 mg per injection. SPSS10.0 software package was used to compare the treatment efficacy between the patients with hemangioma <4 cm in diameter and >or=4 cm in diameter. Hemangiomas of 42 cases (82.35%) showed complete resolution with good appearance, 8 cases (15.69%) were partly regressed, and 1 case (1.96%) had no obvious size change. No serious side effects were seen, such as pulmonary fibrosis and growth inhibition. No significant correlation was found between treatment efficacy and tumor size. Intralesional PYM therapy maybe is a selective primary therapy option for parotid gland hemangioma, and ultrasonography should be useful for diagnosis and treatment of this lesion.

  11. Cavernous Hemangioma-Like Kaposi Sarcoma: Histomorphologic Features and Differential Diagnosis

    PubMed Central

    Onak Kandemir, Nilüfer; Barut, Figen; Doğan Gün, Banu; Solak Tekin, Nilgün; Hallaç Keser, Sevinç; Oğuz Özdamar, Şükrü

    2013-01-01

    Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant. PMID:24187557

  12. Anastomosing hemangioma of the kidney: a case report of a rare subtype of hemangioma mimicking angiosarcoma and review of the literature

    PubMed Central

    Zhao, Ming; Li, Changshui; Zheng, Jiangjiang; Sun, Ke

    2013-01-01

    Anastomosing hemangioma is a recently described, unusual variant of capillary hemangioma which seems to be unique for the genitourinary system, with a particular proclivity for the kidney. Histologically, it is characterized by a unique sinusoidal architecture reminiscent of splenic parenchyma that can lead to concern for angiosarcoma. We herein report a further case of anastomosing hemangioma originating in the right kidney of a 48-year-old Chinese man. The patient had a past medical history significant for hepatocellular carcinoma; this tumor was incidentally identified as an asymptomatic right renal mass during the periodical surveillance of the hepatic cancer. The resected tumor measured 2.5cm in maximum diameter and microscopically demonstrated an overall lobulated growth pattern with alternating cellular areas composed of anastomosing sinusoidal capillary-sized vessels lined by hobnail endothelial cells, and edematous, hyaline paucicellular areas. Cytologically the tumor cells were generally bland and exhibited positivity for CD31, CD34 immunohistochemically. The patient had been in a good status without evidence of tumor recurrence 12 months after the surgery. This rare variant renal hemangioma is in need of more recognition and should not be over-diagnosed as a malignance, particularly angiosarcoma. PMID:23573324

  13. Abnormal blood vessels formed by human liver cavernous hemangioma endothelial cells in nude mice are suitable for drug evaluation.

    PubMed

    Zhang, Wen-jian; Wu, Lian-qiu; Liu, Hong-lin; Ye, Li-ya; Xin, Yu-ling; Grau, Georges E; Lou, Jin-ning

    2009-12-01

    Cavernous hemangioma is vascular malformation with developmental aberrations. It was assumed that the abnormality of endothelial cells contributed greatly to the occurrence of cavernous hemangioma. In our previous study, we have found distinct characteristics of endothelial cells derived from human liver cavernous hemangioma (HCHEC). Here, we reported the abnormal vascular vessels formed by primary HCHEC in nude mice and that the drug podophyllotoxin can destroy HCHEC in vitro and in vivo. HCHEC was isolated from a human liver cavernous hemangioma specimen, and the HCHEC generated a red hemangioma-like mass 7 days after subcutaneously co-inoculating HCHEC and human liver cancer cells (Bel-7402) in nude mice. Lentiviral expression of GFP and immunohistochemistry for human CD31 was used to confirm that the HCHEC formed the blood vessels in nude mice. And the pathological features of vascular vessels formed by HCHEC were very similar to clinical cavernous hemangioma. In addition, by MTT assay, the drug podophyllotoxin was found inhibiting HCHEC viability, and by TUNEL and DNA ladder assays, podophyllotoxin was found inducing apoptosis of HCHEC. Moreover, podophyllotoxin was also effective for destroying the abnormal vascular vessels in the hemangioma-like mass in nude mice. In summary, the HCHEC can form abnormal blood vessels in nude mice, and we can evaluate drugs for cavernous hemangioma by using HCHEC in vitro and in vivo.

  14. Soft tissue hemangioma with osseous extension: a case report and review of the literature.

    PubMed

    Daoud, Alexander; Olivieri, Brandon; Feinberg, Daniel; Betancourt, Michel; Bockelman, Brian

    2015-04-01

    Soft tissue hemangiomas are commonly encountered lesions, accounting for 7-10 % of all benign soft tissue masses (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010). While the literature describes the great majority of hemangiomas as asymptomatic and discovered only as incidental findings, they do have the potential to induce reactive changes in neighboring structures (Pastushyn et al. Surg Neurol 50(6):535-47, 1998). When these variants occur in close proximity to bone, they may elicit a number of well-documented reactive changes in osseous tissue (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010; DeFilippo et al. Skelet Radiol 25(2):174-7, 1996; Ly et al. AJR Am J Roentgenol 180(6):1695-700, 2003; Sung et al. Skelet Radiol 27(4):205-10, 1998). However, instances of direct extension into bone by soft tissue hemangiomas--that is, infiltration of the mass's vascular components into nearby osseous tissue--are currently undocumented in the literature. In these cases, imaging plays an important role in differentiating hemangiomas from malignant lesions (Mitsionis et al. J Foot Ankle Surg 16(2):27-9, 2010; Sung et al. Skelet Radiol 27(4):205-10, 1998; Pourbagher, Br J Radiol 84(1008):1100-8, 2011). In this article, we present such a case that involved the sacral spine. Imaging revealed a soft tissue mass with direct extension of vascular components into osseous tissue of the adjacent sacral vertebrae. Biopsy and subsequent histopathologic examination led to definitive diagnosis of soft tissue hemangioma. While MRI is widely regarded as the gold standard imaging modality for evaluating hemangiomas, in this report we describe how CT can aid in narrowing the differential diagnosis when one encounters a vascular lesion with adjacent osseous changes. Furthermore, we review the literature as it pertains to the imaging of soft tissue hemangiomas that occur in proximity to osseous tissue, as well as correlate this case to current theories on the pathogenesis of hemangiomas

  15. Somatic Activating Mutations in GNAQ and GNA11 Are Associated with Congenital Hemangioma

    PubMed Central

    Ayturk, Ugur M.; Couto, Javier A.; Hann, Steven; Mulliken, John B.; Williams, Kaitlin L.; Huang, August Yue; Fishman, Steven J.; Boyd, Theonia K.; Kozakewich, Harry P.W.; Bischoff, Joyce; Greene, Arin K.; Warman, Matthew L.

    2016-01-01

    Congenital hemangioma is a rare vascular tumor that forms in utero. Postnatally, the tumor either involutes quickly (i.e., rapidly involuting congenital hemangioma [RICH]) or partially regresses and stabilizes (i.e., non-involuting congenital hemangioma [NICH]). We hypothesized that congenital hemangiomas arise due to somatic mutation and performed massively parallel mRNA sequencing on affected tissue from eight participants. We identified mutually exclusive, mosaic missense mutations that alter glutamine at amino acid 209 (Glu209) in GNAQ or GNA11 in all tested samples, at variant allele frequencies (VAF) ranging from 3% to 33%. We verified the presence of the mutations in genomic DNA using a combination of molecular inversion probe sequencing (MIP-seq) and digital droplet PCR (ddPCR). The Glu209 GNAQ and GNA11 missense variants we identified are common in uveal melanoma and have been shown to constitutively activate MAPK and/or YAP signaling. When we screened additional archival formalin-fixed paraffin-embedded (FFPE) congenital cutaneous and hepatic hemangiomas, 4/8 had GNAQ or GNA11 Glu209 variants. The same GNAQ or GNA11 mutation is found in both NICH and RICH, so other factors must account for these tumors’ different postnatal behaviors. PMID:27058448

  16. Somatic Activating Mutations in GNAQ and GNA11 Are Associated with Congenital Hemangioma.

    PubMed

    Ayturk, Ugur M; Couto, Javier A; Hann, Steven; Mulliken, John B; Williams, Kaitlin L; Huang, August Yue; Fishman, Steven J; Boyd, Theonia K; Kozakewich, Harry P W; Bischoff, Joyce; Greene, Arin K; Warman, Matthew L

    2016-04-07

    Congenital hemangioma is a rare vascular tumor that forms in utero. Postnatally, the tumor either involutes quickly (i.e., rapidly involuting congenital hemangioma [RICH]) or partially regresses and stabilizes (i.e., non-involuting congenital hemangioma [NICH]). We hypothesized that congenital hemangiomas arise due to somatic mutation and performed massively parallel mRNA sequencing on affected tissue from eight participants. We identified mutually exclusive, mosaic missense mutations that alter glutamine at amino acid 209 (Glu209) in GNAQ or GNA11 in all tested samples, at variant allele frequencies (VAF) ranging from 3% to 33%. We verified the presence of the mutations in genomic DNA using a combination of molecular inversion probe sequencing (MIP-seq) and digital droplet PCR (ddPCR). The Glu209 GNAQ and GNA11 missense variants we identified are common in uveal melanoma and have been shown to constitutively activate MAPK and/or YAP signaling. When we screened additional archival formalin-fixed paraffin-embedded (FFPE) congenital cutaneous and hepatic hemangiomas, 4/8 had GNAQ or GNA11 Glu209 variants. The same GNAQ or GNA11 mutation is found in both NICH and RICH, so other factors must account for these tumors' different postnatal behaviors. Copyright © 2016 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  17. Photodynamic therapy suppresses tumor growth in an in vivo model of human hemangioma.

    PubMed

    Choi, Jaehoon; Kim, Woo Jung; Park, Sang Woo; Xu, Lianji; Kim, Sang-Hyon; Min, Hye Sook; Kwon, Geun-Yong; Cho, Chung-Hyun; Kim, Sukwha; Choi, Tae Hyun

    2014-01-01

    The authors investigated the efficacy of photodynamic therapy against infantile hemangioma using a hemangioma animal model. Eighty-three hemangioma specimens from five children were implanted into nude mice. The gross and volume changes of the implants were evaluated for up to 13 weeks. The histological change of the implant was evaluated at 5 weeks after transplantation. Photodynamic therapy was performed between 6 and 10 weeks after transplantation. The photosensitizer uptake of the implant was evaluated at 24 h after photosensitizer administration. The implant response was evaluated at 0, 12, and 24 h after light delivery. The change in ATF3 levels, a transcription factor induced under severe hypoxic conditions, was investigated immediately after treatment. The implant volume increased slowly during the first 4 weeks and then involuted. At 5 weeks after transplantation, plump endothelial cells formed tightly packed sinusoidal channels, and the endothelial cells were positive for CD31 and GLUT1 expression. At 24 h after photosensitizer administration, confocal analysis showed that the photosensitizer was present within CD31-positive cells. The implant volume was significantly decreased in the treated implants compared with the untreated implants (p < 0.0001). At 24 h after light delivery, most cells had collapsed. ATF3 expression increased gradually and then reached a maximum level at 4 h after treatment. Photodynamic therapy was effective in the treatment of infantile hemangioma. Apoptosis, a major mechanism of hemangioma destruction in the early phase, might be caused by ischemic injury as well as direct effects of photodynamic therapy.

  18. Oral Propranolol for the Treatment of Periorbital Infantile Hemangioma: A Preliminary Report from Oman

    PubMed Central

    Harikrishna, Beena; Ganesh, Anuradha; Al-Zuahibi, Sana; Al-Jabri, Samia; Al-Waily, Ahmed; Al-Riyami, Adil; Al-Azri, Faisal; Masoud, Feraz; Al-Mujaini, Abdullah

    2011-01-01

    Purpose: To investigate the efficacy and safety of oral propranolol in the management of periorbital infantile hemangioma in four subjects. Materials and Methods: Consecutive patients who presented with periorbital capillary hemangioma with vision-threatening lesions were prospectively enrolled in this study between January 2009 and October 2010. All subjects underwent treatment with 2 mg/kg/day oral propranolol. All subjects underwent ocular, systemic, and radiologic evaluations before treatment and at periodic intervals after starting therapy. Side effects from therapy were also evaluated. Results: Four subjects, between 3 months and 19 months of age, with periorbital hemangioma were enrolled in this study. Two subjects had been previously treated with oral corticosteroids with unsatisfactory response. All subjects had severe ptosis, with the potential for deprivation amblyopia. Three subjects had orbital involvement. After hospital admission, oral propranolol was initiated in all subjects under monitoring by a pediatric cardiologist. Subsequent therapy was performed with periodic out-patient monitoring. All subjects had excellent response to treatment, with regression of periorbital and orbital hemangioma. There were no side effects from therapy. Conclusions: Oral propranolol for periorbital hemangioma was effective in all the four subjects. Oral propranolol may be appropriate for patients who are nonresponsive to intralesional or systemic steroids. In patients with significant orbital involvement and lesions causing vision-threatening complications, oral propranolol can be the primary therapy. PMID:22224018

  19. Therapeutic superiority of combined propranolol with short steroids course over propranolol monotherapy in infantile hemangioma.

    PubMed

    Aly, Mohamed M D; Hamza, Alaa F; Abdel Kader, Hesham M; Saafan, Hatem A; Ghazy, Mohamed S; Ragab, Iman A

    2015-11-01

    Infantile hemangiomas are the most common benign childhood tumor that may have functional and/or cosmetic complications. We aimed to compare the clinical efficacy of propranolol alone and propranolol primed with systemic corticosteroids on the outcome of infantile hemangioma. A prospective randomized study included 40 infants aged less than 9 months with cutaneous hemangiomas. Patients were randomly assigned into two groups: group A were given oral prednisolone for the initial 2 weeks combined with oral propranolol, while group B were given oral propranolol alone for 6 months. The median age of the studied patients was 4.5 months (ranged 4 weeks-8 months). Sequential determination of the dimensions of the hemangiomas based on direct measurement and photographic analysis were performed. A significant reduction in the size of the lesions was found in group A in the 2-, 4-, and 8-week evaluation compared to group B (p < 0.001) with no statistical difference in the ultimate 6 month response (p = 0.134). Multiple logistic regression showed that early treatment before 6 months of age (OR 9.82, p = 0.007) and combined treatment with propranolol and prednisolone (OR 10.71, p = 0.006) were the predictors of best response. Combining propranolol with corticosteroids gives a faster response and should be considered in treating life- or function-threatening hemangiomas.

  20. Cellular markers that distinguish the phases of hemangioma during infancy and childhood.

    PubMed Central

    Takahashi, K; Mulliken, J B; Kozakewich, H P; Rogers, R A; Folkman, J; Ezekowitz, R A

    1994-01-01

    Hemangiomas, localized tumors of blood vessels, appear in approximately 10-12% of Caucasian infants. These lesions are characterized by a rapid proliferation of capillaries for the first year (proliferating phase), followed by slow, inevitable, regression of the tumor over the ensuing 1-5 yr (involuting phase), and continual improvement until 6-12 yr of age (involuted phase). To delineate the clinically observed growth phases of hemangiomas at a cellular level, we undertook an immunohistochemical analysis using nine independent markers. The proliferating phase was defined by high expression of proliferating cell nuclear antigen, type IV collagenase, and vascular endothelial growth factor. Elevated expression of the tissue inhibitor of metalloproteinase, TIMP 1, an inhibitor of new blood vessel formation, was observed exclusively in the involuting phase. High expression of basic fibroblast growth factor (bFGF) and urokinase was present in the proliferating and involuting phases. There was coexpression of bFGF and endothelial phenotypic markers CD31 and von Willebrand factor in the proliferating phase. These results provide an objective basis for staging hemangiomas and may be used to evaluate pharmacological agents, such as corticosteroids and interferon alfa-2a, which accelerate regression of hemangiomas. By contrast, vascular malformations do not express proliferating cell nuclear antigen, vascular endothelial growth factor, bFGF, type IV collagenase, and urokinase. These data demonstrate immunohistochemical differences between proliferating hemangiomas and vascular malformations which reflect the biological distinctions between these vascular lesions. Images PMID:7911127

  1. Assessment of soft tissue hemangiomas in children utilizing Tc-99m labelled red blood cells

    SciTech Connect

    Miller, J.H.

    1984-01-01

    Hemangiomas may present in infancy as soft tissue masses. Occasionally these lesions may be extensive or may not be clinically recognized as a hemangioma, often causing concern for the presence of a malignant lesion. In later childhood these lesions, which may be occult, may cause overgrowth of an extremity. Evaluation of soft tissue masses suspected of being a hemangioma utilizing Technetium 99m labelled red blood cells has been very valuable. This method allows a dynamic evaluation of first pass blood flow. Subsequent static scintiphotos allow an assessment of the lesion itself. These scintiphotos may be obtained sequentially to evaluate therapy. Twenty patients were evaluated by this method ranging in age from two months to eleven years. There were 13 females and seven males. Lesions evaluated by this method include six hemangiomas of the head and neck: parotic region (2), facial (3), and tongue (1). Extremity lesions were evaluated in six children including both upper extremity (1) and lower extremity (5). Torso lesions evaluated include chest wall (2), abdominal wall (2), and one hemangioma of the gut. This procedure is quickly performed on an outpatient basis, has high anatomic resolution, provides and assessment of these lesions in a manner not available by any other imaging procedure and usually requires no sedation. The radiation exposure for this procedure is low (approximately, a 400mR total body dose) and has been well tolerated by both patients and their parents. Scintigraphic evaluation should be the first diagnostic method utilized in the evaluation of these lesions.

  2. Infantile hepatic hemangiomas. Clinical features, radiologic investigations, and treatment of 20 patients

    SciTech Connect

    Stanley, P.; Geer, G.D.; Miller, J.H.; Gilsanz, V.; Landing, B.H.; Boechat, I.M. )

    1989-08-15

    The clinical features, radiologic investigation, and treatment of 20 infants with hepatic hemangiomas are presented. Palpable abdominal mass (n = 18) and cardiac failure (n = 11) were the common presenting features. Nine patients had hyperconsumptive coagulopathy. Seven patients had other hemangiomas. Ultrasound (n = 15) showed the number and distribution of the hemangiomas within the liver. Hypoechoic and hyperechoic elements were present in addition to prominent vascular channels and diminished caliber of the distal aorta. Radionuclide sulfur colloid (n = 12) and labeled red blood cell (n = 7) studies showed the distribution and vascularity of the hemangiomas. Computed tomography (n = 8) revealed central hypointensity with marked peripheral enhancement after contrast. Arteriography now performed only as a prelude to therapeutic embolization demonstrated hypervascularity in each patient, contrast pooling in six and early draining veins in five. Magnetic resonance scanning (n = 3) showed decreased signal intensity on T1 images and high intensity signal on T2. In two patients, there was resolution or improvement of the hemangiomas without therapy. Four patients had surgery (lobectomy (2), trisegmentectomy (1), and surgical evacuation of a central hematoma (1)). Steroids and radiation were given to seven patients, and one patient also required therapeutic embolization. Steroids were the initial therapy in five patients, one of whom later required therapeutic embolization and another cyclophosphamide. Two patients were treated initially with radiation therapy, one of whom also needed emergency hepatic artery ligation. Seventeen of the 20 patients are alive and well from 6 months to 14 years after diagnosis.

  3. Genomic Imprinting of IGF2 Is Maintained in Infantile Hemangioma despite its High Level of Expression

    PubMed Central

    Yu, Ying; Wylie-Sears, Jill; Boscolo, Elisa; Mulliken, John B; Bischoff, Joyce

    2004-01-01

    Hemangioma, the most common tumor of infancy, is characterized by rapid growth and slow regression. Increased mRNA expression of insulin-like growth factor 2 (IGF2) has been detected in the proliferating phase by cDNA microarray analysis, but the underlying mechanism causing the increase remains unknown. Here, using quantitative real-time polymerase chain reaction (PCR) and immunohistochemistry, we show that IGF2 is highly expressed in both proliferating and involuting phase hemangioma, but is not detectable in other vascular lesions such as pyogenic granuloma, venous malformation, lymphatic malformation, or in normal infant skin. Loss of imprinting of the Igf2 gene has been associated with IGF2 overexpression in a variety of childhood tumors. To determine if loss of imprinting and consequent bi-allelic expression might contribute to the increased expression of IGF2, we examined the genomic imprinting status of Igf2 in 48 individual hemangiomas. We determined allele-specific Igf2 expression using reverse transcriptase–PCR combined with analysis of an Apa I–sensitive restriction fragment length polymorphism. Similar to heterozygous normal skin controls, all 15 informative hemangiomas showed uniform mono-allelic expression of Igf2. Therefore, loss of imprinting is not involved in the increased expression of IGF2 in infantile hemangioma. PMID:15706404

  4. Capillary hemangioma as a rare benign tumor of the oral cavity: a case report

    PubMed Central

    2009-01-01

    Introduction Hemangioma is a relatively common benign proliferation of blood vessels that primarily develops during childhood. Two main forms of hemangioma recognized: capillary and cavernous. The capillary form presents as a flat area consisting of numerous small capillaries. Cavernous hemangioma appears as an elevated lesion of a deep red color, and consists of large dilated sinuses filled with blood. The purpose of the study was to report the case of a capillary hemangioma in a patient and to describe the successful treatment of this case. Case presentation The patient was a 19-year-old female who presented herself to the Atatürk University, Faculty of Dentistry, Department of Periodontology, with the complaint of bleeding and slowly enlarging mass on the upper right molar region. The lesion was diagnosed as capillary hemangioma after clinical examination and biopsy. Treatment consisted of scaling, root planning and surgical excision. Four months after surgery healing was occurred and two years later area of the lesion appeared completely normal as clinically. Conclusions The surface is highly keratinized and no further growth was evidenced during the two year of follow-up. Early detection and biopsy is necessary to determine the clinical behavior of the tumor and potential dentoalveolar complications. PMID:20181211

  5. Subcutaneous Cavernous Hemangioma in the Nasal Dorsum: Report of Case Treated with Endoscopic Rhinoplasty

    PubMed Central

    Socher, Jan Alessandro; Marchi, Maurício F. de Sá; Rickli, Jeniffer C. Kozechen

    2013-01-01

    Introduction Hemangiomas are vascular malformations, with slow blood flow, that can occur in any part on the body. They are more common in women and, predominantly, are isolated lesions. The malformation does not spontaneously regress. Subcutaneous hemangioma is a rare variant with an aggressive growth pattern that sometimes recurs after excision. Objective Case report of a subcutaneous cavernous hemangioma in the nasal dorsum treated with endoscopic rhinoplasty. Case Report A 27-year-old woman had a fibroelastic tumor mass in the midline of the nasal dorsum, which was pulsatile; she had obstruction and nasal congestion with associated rhinorrhea, with evolution and worsening over the previous 2 years. Computed tomography showed a tumor demarcated in the nasal dorsum without evidence of intracranial communication. Endoscopic rhinoplasty with septoplasty and associated paranasal sinus sinusectomy was performed without arteriography embolization, sclerotherapy, or laser. Pathologic diagnosis showed cavernous hemangioma. Postoperative follow-up shows no recurrence at 3 years. Discussion This case presented with atypical features, thus making the diagnosis a challenge. Imaging studies were required to confirm the vascular nature of the tumor. Excisional biopsy is the procedure of choice for pathologic examination. Subcutaneous hemangiomas never involute and always need treatment. The surgical approach is exceptional because there was no preoperative diagnosis. In addition, the closed technique provided best aesthetic results in this case. Conclusion Endoscopic rhinoplasty is suitable for nasal dorsum tumor resection and has superior aesthetic result to open techniques. PMID:25992093

  6. Laser therapy and sclerotherapy in the treatment of oral and maxillofacial hemangioma and vascular malformations

    NASA Astrophysics Data System (ADS)

    Crişan, Bogdan; BǎciuÅ£, Mihaela; BǎciuÅ£, Grigore; Crişan, Liana; Bran, Simion; Rotar, Horatiu; Moldovan, Iuliu; Vǎcǎraş, Sergiu; Mitre, Ileana; Barbur, Ioan; Magdaş, Andreea; Dinu, Cristian

    2016-03-01

    Hemangioma and vascular malformations in the field of oral and maxillofacial surgery is a pathology more often found in recent years in patients. The aim of this study was to evaluate the efficacy of the laser photocoagulation performed with a diode laser (Ga-Al-As) 980 nm wavelength in the treatment of vascular lesions which are located on the oral and maxillofacial areas, using color Doppler ultrasonography for evaluation of the results. We also made a comparison between laser therapy and sclerotherapy in order to establish treatment protocols and recommendations associated with this pathology. We conducted a controlled study on a group of 92 patients (38 male and 54 female patients, with an average age of 36 years) having low flow hemangioma and vascular malformations. Patients in this trial received one of the methods of treatment for vascular lesions such as hemangioma and vascular malformations: laser therapy or sclerotherapy. After laser therapy we have achieved a reduction in size of hemangioma and vascular malformations treated with such a procedure, and the aesthetic results were favorable. No reperfusion or recanalization of laser treated vascular lesions was observed after an average follow-up of 6 to 12 months. In case of sclerotherapy a reduction in the size of vascular lesions was also obtained. The 980 nm diode laser has been proved to be an effective tool in the treatment of hemangioma and vascular malformations in oral and maxillofacial area. Laser therapy in the treatment of vascular lesions was more effective than the sclerotherapy procedure.

  7. A Symptomatic Case of Thoracic Vertebral Hemangioma Causing Lower Limb Spastic Paresis.

    PubMed

    Alfawareh, Mohammad; Alotaibi, Tariq; Labeeb, Abdallah; Audat, Ziad

    2016-10-31

    BACKGROUND Despite being the most common tumor of the spine, vertebral hemangioma is rarely symptomatic in adults. In fact, only 0.9-1.2% of all vertebral hemangiomas may be symptomatic. When hemangiomas occur in the thoracic vertebrae, they are more likely to be symptomatic due to the narrow vertebral canal dimensions that mandate more aggressive management prior to the onset of severe neurological sequelae. CASE REPORT An 18-year-old male presented to the emergency room with a one-month history of mild to moderate mid-thoracic back pain, radiating to both lower limbs. It was associated with both lower limb weakness and decreased sensation. There was no history of bowel or bladder incontinence. Neurological examination revealed lower limb weakness with power 3/5, exaggerated deep tendon reflexes, bilateral sustained clonus, impaired sensation below the umbilicus, spasticity, and a positive Babinski sign. A CT scan showed a diffuse body lesion at the 8th thoracic vertebra with coarse trabeculations, corduroy appearance, or jail-bar sign. The patient underwent decompression and fixation. Biopsy of permanent samples showed proliferation of blood vessels with dilated spaces and no malignant cells, consistent with hemangioma. Postoperatively, spasticity improved, and the patient regained normal power. CONCLUSIONS Symptomatic vertebral hemangiomas are rare but should be considered as a differential diagnosis. They can present with severe neurological symptoms. When managed appropriately, patients regain full motor and sensory function. Decompression resulted in quick relief of symptoms, which was followed by an extensive rehabilitation program.

  8. Surgical management of symptomatic T8 vertebral hemangioma: case report and review of the literature.

    PubMed

    Tucer, Bulent; Ekici, Mehmet Ali; Menku, Ahmet; Koc, Rahmi Kemal; Guclu, Bulent

    2013-01-01

    Vertebral hemangiomas are benign vascular lesions of the vertebral column; only 0.9-1.2% of all vertebral hemangiomas cause spinal cord compression. We report a 34-year-old female who was admitted to the neurosurgery clinic with a history of back pain, poor quality of life and easy fatigability for 1.5 years. Her medical history revealed a fall from a height of 2 meters 1.5 years ago. Neurology examination revealed bilateral hypoesthesia below the T8 level and hyperactive deep tendon reflexes in her left leg. Computed tomography scan of the thoracic spine showed T8 vertebral hemangioma, and magnetic resonance imaging showed a T8 hemangioma compressing the spinal cord. Surgical intervention was planned and T8 total laminectomy was performed. The tumor extending into the anterior spinal cord was resected, and T8 vertebroplasty with short segment posterior stabilization and fusion was performed. We aimed to present a new treatment approach for symptomatic vertebral hemangiomas and reviewed the relevant literature.

  9. Spinal capillary hemangioma in infants: report of two cases and review of the literature.

    PubMed

    Karikari, Isaac O; Selznick, Lee A; Cummings, Thomas J; George, Timothy M

    2007-01-01

    We report the case of 2 infants born with a lumbar dermal sinus tract and an overlying angiomatous skin lesion referred to our pediatric neurosurgery service for evaluation of a tethered cord. Both infants were born with a lumbar dimple and were found to have a large cutaneous hemangioma without neurologic symptoms. An MRI of the lumbar spine revealed an isointense mass in the dorsal epidural at L(4) with an adjacent mass effect and extension into the overlying soft tissues. The spinal cord also appeared to be tethered with a fatty filum terminale. We performed a lumbar laminectomy and laminoplasty to remove the mass and to release the tethered cord. Pathologic examination confirmed the diagnosis of capillary hemangioma. Several case reports describe spinal capillary hemangiomas in adults, but only one found in the literature describes a case in an infant. We provide a review of the literature of spinal capillary hemangiomas and support the practice of evaluating infants with cutaneous lumbosacral hemangiomas for underlying spinal cord abnormalities.

  10. Anesthesia in an adult patient with tracheal hemangiomas: one-lung ventilation for lung lobectomy.

    PubMed

    Tsujikawa, Shogo; Okutani, Ryu; Oda, Yutaka

    2012-04-01

    Primary tracheal tumors are rare in adults, and careful airway management is required during anesthesia for affected patients. We report the case of a patient with tracheal hemangiomas undergoing nontracheal operation. A 61-year-old woman was scheduled for a lung operation. During preoperative examination, hemangiomas were detected on the tracheal mucosa. As she was asymptomatic and the degree of airway stenosis was small, treatment was not required for the hemangiomas, and left upper lobectomy for lung cancer was scheduled. After induction of general anesthesia, a regular tracheal tube was inserted under fiberoptic bronchoscopy, with care taken to prevent damage to the hemangiomas. An endobronchial blocker was inserted for one-lung ventilation. The operation was performed uneventfully, and the tracheal tube was replaced postoperatively with a laryngeal mask airway while the patient was under deep anesthesia and neuromuscular blockade. The mask was removed after confirming lack of bleeding from the hemangiomas. No hypoxia or other complications occurred during or after the operation.

  11. Ultrasound (US) and computed tomographic (CT) appearances of large (giant) hepatic cavernous hemangiomas.

    PubMed

    Samad, S A; Maimunah, A; Zulfiqar, A; Zaharah, M

    1995-03-01

    The sonographic and CT appearances of 9 large cavernous hemangiomas of the liver were studied. On sonography, 6 masses (67%) exhibit heterogenous echo pattern; where in 2 patients the echotexture was a mixture of hypoechoic and isoechoic areas and in 4 patients there are varying amounts of bright hyperreflective areas similar to the texture typical of small hemangiomas. The masses were predominantly hypoechoic in the remaining 3 patients (33%). Incremental bolus or bolus-infusion dynamic CT showed peripheral contrast enhancement of varying intensities and thickness in all patients. The lesions were incorrectly diagnosed as hepatomas in 4 patients, suspected as hemangiomas with a differential diagnosis of hepatomas in 4 patients and an early liver abscess in 1 patient. It is concluded that large cavernous hemangiomas of the liver do not exhibit the typical homogenous hyperreflective echotexture as exhibited by small lesions and they mimic primary and secondary hepatic neoplasms. However, the diagnosis of hemangioma should be entertained when such a mass contains bright hyperechoic areas within its heterogenous echo pattern and exhibit peripheral enhancement on contrast enhanced CT. In addition to correlation with appropriate clinical information, confirmation of diagnosis include delayed scanning during a routine incremental bolus dynamic CT, single-slice dynamic contrast enhanced CT, angiography or isotope scintigraphy and magnetic resonance imaging depending on the availability of facility.

  12. Extensively Myxoid and Hyalinized Sinonasal Capillary Hemangiomas: A Clinicopathologic Study of 16 Cases of a Distinctive and Potentially Confusing Hemangioma Variant.

    PubMed

    Guo, Ruifeng; Folpe, Andrew L

    2015-11-01

    Capillary hemangiomas, the most common vascular tumors of the sinonasal region, are benign endothelial neoplasms, typically growing in an easily recognized lobular pattern. Some sinonasal capillary hemangiomas may show atypical features, such as high cellularity or mitotic activity, and represent more challenging diagnoses. Over the past several years we have seen in consultation a number of examples of sinonasal capillary hemangiomas displaying very striking stromal myxoid change and hyalinization, features that have received scant attention in the past. Available slides from 16 sinonasal capillary hemangiomas previously coded as showing such changes were retrieved from our archives. Submitting diagnoses included "query angiofibroma, rule out malignancy" (N=4), "vascular polyp, rule out malignancy" (N=3), "query malignant vascular tumor" (N=4), "sinonasal hemangiopericytoma" (N=1), and "benign vascular tumor" (N=1). Available radiographic studies often showed worrisome features. Grossly, the tumors ranged from 1.1 to 6.0 cm and appeared as ulcerated, vascular-appearing polyps. Microscopically, the tumors showed striking stromal myxoid change and/or hyalinization, which largely obscured the underlying lobular capillary arrangement. Within this myxohyaline matrix, a florid capillary proliferation was present, frequently with nonatypical mitotic activity. In some instances a branching, "hemangiopericytoma-like" vascular pattern was present in areas. The overall cellularity was low to moderate, and endothelial atypia or hyperchromatism was absent. Ulceration and thrombosis were frequently present. Immunostains to CD31, CD34, and SMA highlighted areas of lobular growth pattern inapparent on the routinely stained slides. Four tested cases were negative for androgen receptors and β-catenin. Follow-up from 12 patients revealed no local recurrences or metastases. Awareness of that sinonasal capillary hemangioma may show these unusual stromal changes, and the use of

  13. Juxtaphyseal Intraosseous Hemangioma of Proximal Femur causing Coxa vara and Coxa breva deformity in a growing child

    PubMed Central

    Song, Hae Ryong; Shyam, Ashok K.

    2011-01-01

    Introduction: Bony hemangiomas are rare lesions in growing skeleton. Affection of the epiphyseal plate by a bony hemangioma leading to growth retardation is rare. Case report: We report the radiological picture of a juxtaphyseal osseous hemangioma affecting the capital femoral physis leading to coxa vara and coxa breva deformity. This hemangioma is also a rarity as it has both intracortical and intra medullary components. A diagnostic and therapeutic CT guided core needle biopsy/decompression was performed to confirm the histopathological diagnosis and to decompress the lesion. Patient was treated conservatively with shoe raise and regular checkups and at two year follow-up there were no interval changes noted on the radiographs with patient completely asymptomatic. Conclusion: Juxtaphyseal hemangiomas may be amenable to needle decompression, however longer follow will be required to assess the further response.

  14. Propranolol represses infantile hemangioma cell growth through the β2-adrenergic receptor in a HIF-1α-dependent manner.

    PubMed

    Li, Peng; Guo, Zhengtuan; Gao, Ya; Pan, Weikang

    2015-06-01

    Propranolol, as a non-selective blocker of the β-adrenergic receptor (AR), is utilised as the first-line treatment for infantile hemangiomas. However, the underlying mechanism remains poorly understood. The present study was designed to investigate the molecular basis of propranolol on the regression of infantile hemangiomas using a proliferating infantile hemangioma-derived endothelial cell line. In infantile hemangioma patients, we found that propranolol significantly decreased the expression levels of the hypoxia inducible factor (HIF)-1α in serum and urine, as well as in hemangioma tissues. In vitro analysis revealed that propranolol reduces the expression of HIF-1α in hemangioma cells in a dose- and time-dependent manner, mainly by acting on β2-AR. Interestingly, it was observed that overexpression of HIF-1α apparently abrogated the inhibitory effects of propranolol on vascular endothelial growth factor (VEGF) expression and cell growth. Our data further demonstrated that propranolol inhibited the signal transducer and activator of transcription 3 (STAT3), a critical oncogenic signaling molecule, and the anti-apoptotic protein Bcl-2. Additionally, overexpression of HIF-1α significantly reversed the inhibitory effects of propranolol on STAT3 signaling. In a mouse xenograft hemangioma model, overexpression of HIF-1α significantly attenuated the therapeutic effects of propranolol and inhibited propranolol-induced hemangioma cell apoptosis. Moreover, the protein levels of VEGF, phosphorylated STAT3, total STAT3 and Bcl-2 were significantly upregulated by HIF-1α overexpression in propranolol-treated nude mice bearing hemangiomas. Collectively, our data provide evidence that propranolol may regress infantile hemangiomas by suppressing VEGF and STAT3 signaling pathways in an HIF-1α-dependent manner.

  15. Infantile Hemangioma Originates From A Dysregulated But Not Fully Transformed Multipotent Stem Cell

    PubMed Central

    Harbi, Shaghayegh; Wang, Rong; Gregory, Michael; Hanson, Nicole; Kobylarz, Keith; Ryan, Kamilah; Deng, Yan; Lopez, Peter; Chiriboga, Luis; Mignatti, Paolo

    2016-01-01

    Infantile hemangioma (IH) is the most common tumor of infancy. Its cellular origin and biological signals for uncontrolled growth are poorly understood, and specific pharmacological treatment is unavailable. To understand the process of hemangioma-genesis we characterized the progenitor hemangioma-derived stem cell (HemSC) and its lineage and non-lineage derivatives. For this purpose we performed a high-throughput (HT) phenotypic and gene expression analysis of HemSCs, and analyzed HemSC-derived tumorspheres. We found that IH is characterized by high expression of genes involved in vasculogenesis, angiogenesis, tumorigenesis and associated signaling pathways. These results show that IH derives from a dysregulated stem cell that remains in an immature, arrested stage of development. The potential biomarkers we identified can afford the development of diagnostic tools and precision-medicine therapies to “rewire” or redirect cellular transitions at an early stage, such as signaling pathways or immune response modifiers. PMID:27786256

  16. Spontaneous rupture of the kidney in the patients with synchronous renal hemangioma and nephrogenic hypertension

    PubMed Central

    Memmedoğlu, Akif; Musayev, Jamal

    2015-01-01

    Most renal neoplasms in adults are epithelial in origin and mesenchymal tumors are rarely encountered. Vascular tumors and tumor-like lesions account for a very small subset. Hemangioma of the kidney is a rarely seen benign vascular neoplasm that probably arises from angioblastic cells. Its general sign is macroscopic hematuria with or without pain. Preoperative diagnosis is difficult or impossible. Previously, spontaneous rupture of the kidney caused by renal hemangioma was not reported in the English literature. In this study, two cases with a history of nephrogenic hypertension who presented with spontaneous renal rupture are presented. There wasn’t any trauma history in the background of our patients. A long-standing nephrogenic hypertension was present in both patients. Patients underwent radical nephrectomy due to rupture of the renal tumor. In histopathological examination, capillary hemangioma was detected in the renal medulla in both cases. Patients didn’t need antihypertensive therapy during the postoperative period. PMID:26623154

  17. Cavernous hemangioma of adult pancreas: A case report and literature review

    PubMed Central

    Mondal, Utpal; Henkes, Nichole; Henkes, David; Rosenkranz, Laura

    2015-01-01

    Pancreatic hemangioma is a rare type of benign vascular tumor. Low clinical suspicion and inability of current cross sectional imaging techniques to differentiate it from other pancreatic lesions, contribute to the difficulty in making the correct diagnosis. Without a definitive diagnosis, and due to concern for malignancy, in many instances, surgery is performed. We report a case of pancreas cavernous hemangioma in an 18-year-old female. The patient presented with three-month history of epigastric pain. Physical examination and routine blood tests were normal. Abdominal Computed Tomography scan revealed a 5 cm × 6 cm complex non-enhancing cystic mass in the head of pancreas. Magnetic resonance imaging, endoscopic ultrasonography (EUS) and EUS guided fine needle aspiration cytology were non-diagnostic. Because of uncontrolled symptoms, the patient underwent surgical resection. Histopathology and Immunohistochemical staining confirmed the diagnosis of cavernous hemangioma of pancreas. PMID:26361427

  18. Expanded flap to repair facial scar left by radiotherapy of hemangioma.

    PubMed

    Zhao, Donghong; Ma, Xinrong; Li, Jiang; Zhang, Lingfeng; Zhu, Baozhen

    2014-09-01

    This study explored the feasibility and clinical efficacy of expanded flap to repair facial scar left by radiotherapy of hemangioma. From March 2000 to April 2011, 13 cases of facial cicatrices left by radiotherapy of hemangioma have been treated with implantation surgery of facial skin dilator under local anesthesia. After water flood expansion for 1-2 months, resection of facial scar was performed, and wound repairing with expansion flap transfer was done. Thirteen patients were followed up from 5 months to 3 years. All patients tolerated flap transfer well; no contracture occurred during the facial expansion flap transfer. The incision scar was not obvious, and its color and texture were identical to surrounding skin. In conclusion, the use of expanded flap transfer to repair the facial scar left by radiotherapy of hemangioma is advantageous due to its simplicity, flexibility, and large area of repairing. This method does not affect the subsequent facial appearance.

  19. Intracranial extra-axial hemangioma in a newborn: A case report and literature review

    PubMed Central

    Dalsin, Marcos; Silva, Rafael Sodré; Galdino Chaves, Jennyfer Paula; Oliveira, Francine Hehn; Martins Antunes, Ápio Cláudio; Vedolin, Leonardo Modesti

    2016-01-01

    Background: Congenital hemangiomas are benign vascular tumors, and the intracranial counterpart was described in very few cases. Case Description: A newborn presented with an intracranial tumor associated with an arachnoid cyst, diagnosed by antenatal ultrasound at 37 weeks of gestation. Surgery was indicated due to increased head circumference and bulging fontanelle, and a complete resection of an extra-axial red–brown tumor was performed at the 3rd week of life. Microscopy revealed a hemangioma. Conclusion: Hemangioma is a rare differential diagnosis that must be considered in extra-axial intracranial tumors affecting infants and neonates. The radiological features are not helpful in differentiating from other tumors, and surgery is indicated when the diagnosis is uncertain or whenever there are signs of increased intracranial pressure. PMID:27274403

  20. Central cavernous hemangioma of mandible: Case report and review of literature

    PubMed Central

    Dhiman, Neeraj Kumar; Jaiswara, Chandresh; Kumar, Naresh; Patne, Shashikant C. U.; Pandey, Arun; Verma, Vishal

    2015-01-01

    Intraosseous hemangiomas are one of the rarest lesion of jaw bones (0.5–1%) occurring most commonly in vertebral column, skull bone, and rarely in mandible. Mainly occurs in the second decade of life with female: male predilection (2:1). Origin of hemangiomas is still debatable. World Health Organization considers it as a true benign neoplasm of vascular origin, and many authors believe it to be a hamartoma. It is very difficult to diagnose due to variable clinical and radiological features. A biopsy is not done on a routine basis due to a higher risk of hemorrhage. Management is very difficult because of massive vascular network in that region. Here, we are presenting a case report of a 14-year-old boy with intraosseous hemangioma of right body of mandible, which was treated with en bloc surgical resection of mandible and followed by reconstruction. PMID:27390499

  1. Hepatic hemangiomas: evaluation by magnetic resonance imaging and technetium-99m red blood cell scintigraphy

    SciTech Connect

    Brown, R.K.; Gomes, A.; King, W.; Pusey, E.; Lois, J.; Goldstein, L.; Busuttil, R.W.; Hawkins, R.A.

    1987-11-01

    A study was performed to evaluate and compare the sensitivity of magnetic resonance imaging (MRI) and radionuclide blood-pool scanning in the detection of hepatic hemangiomas. All patients had known hemangiomas which were first detected on either ultrasound or computed tomography. Sixteen patients with a total of 23 lesions were investigated. Eleven patients had both MRI and blood-pool scans performed. In the group studied by both modalities, 18 lesions were detected ranging in size from 1 to 11 cm. All lesions were detected by both techniques. However, two of the 18 lesions had an atypical appearance on MRI. Our experience to date indicates that the anatomic location and specific diagnosis of hemangiomas can be made with a high degree of certainty when both MRI and blood-pool scanning techniques are utilized.

  2. Bilateral epidural extension of thoracic capillary vertebral (intraosseous) hemangioma mimicking spinal meningioma.

    PubMed

    Kan, C H; Saw, C B; Rozaini, R; Fauziah, K; Ng, C M; Saffari, M H

    2008-06-01

    We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead the neurosurgeon to the more common diagnosis of spinal meningioma. Epidural extension of vertebral hemangiomas causing cord compression is rarely reported. Review of literatures reveal that cases that have been reported are of unilateral extension into epidural space and of cavernous type. This is the first case report of capillary vertebral (intraossous) hemangioma with bilateral extension through both intervetebral foramen into the epidural space causing myelopathy.

  3. Social isolation in parents of children with hemangiomas: effects of coping styles and emotional distress.

    PubMed

    Quintard, Bruno; Gana, Kamel; Constant, Aymery; Quintric, Chantal; Taïeb, Alain; Léauté-Labrèze, Christine

    2013-01-01

    This study investigated factors associated with social isolation in parents of children with hemangiomas. Eighty-one parents completed questionnaires assessing their emotional distress, social isolation, and coping styles. To explore the relationships between these variables, a path analysis was used to test a model in which clinical characteristics of hemangiomas and parents' coping strategies do not have direct effects on their social isolation but indirect effects via their emotional distress. Bootstrapping was used to assess indirect effects. Time since onset and lesional complications had positive direct effects on parents' social isolation. Lesional visibility and emotion-focused coping had negative indirect effects on parents' social isolation via their emotional distress, while problem-focused coping showed a positive indirect effect. These findings may have implications for clinicians managing parents of children with hemangiomas.

  4. [Serous macular detachment associated with circumscribed choroidal hemangioma: a case report].

    PubMed

    Munteanu, M; Giuri, Stela; Rosca, C; Boruga, O; Chercota, V; Stanca, H T

    2013-01-01

    Choroidal hemangiomas are benign vascular hamartomas that typically present from second to fourth decade of life, when they can cause visual disturbance due to exudative retinal detachment. They represent uncommon benign choroidal vascular tumors, usually occuring sporadically in the absence of systemic disease. We report the case of a young female patient, presenting a juxtapapillary circumscribed choroidal haemangioma complicated with serous macular detachment. The patient underwent photodynamic therapy with verteporfin (PDT). Systematic follow-up using ophthalmoscopy, ultrasonography, Fluorescein angiography and Indocyanine green angiography was performed. The patient presented regression with flattening of tumour, resolution of the subretinal fluid, and significant improvement of vision. Mostly asymptomatic, the choroidal hemangiomas can be associated with serous retinal detachment, leading to reduced vision and metamorphopsia; in those cases, the long term visual prognosis is poor, even in adequately treated patients. PDT is effective in eliminating the subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.

  5. Scintigraphic diagnosis of hepatic hemangioma: its role in the management of hepatic mass lesions

    SciTech Connect

    Moinuddin, M.; Allison, J.R.; Montgomery, J.H.; Rockett, J.F.; McMurray, J.M.

    1985-08-01

    Hepatic cavernous hemangiomas are benign tumors of the liver that are often an incidental finding. They are usually asymptomatic but may cause symptoms when traumatized, may bleed spontaneously, or may produce pain by virtue of their large size and mass effect. A retrospective analysis of the clinical presentation, liver function tests, and diagnostic imaging procedures in 20 patients with hepatic hemangiomas is presented and the literature is reviewed. The 20 patients had 27 mass lesions as seen on liver scintigraphy, computed tomography, or sonography. Technetium-99m-labeled red blood cell flow studies and blood pool scintigrams showed delayed filling of the mass lesions, diagnostic of hemangiomas. This finding was not encountered in any other type of lesion. A new diagnostic algorithm is proposed in which flood-flow and blood-pool scintigraphy play a more prominent role in the diagnostic workup.

  6. Sinusoidal hemangioma of the breast: diagnostic evaluation management and literature review

    PubMed Central

    2017-01-01

    Vascular tumors of the breast are rare and may pose a diagnostic challenge. Breast hemangioma is a very rare benign vascular neoplasm accounting for 0.4% of all breast tumors. It is most commonly detected as an incidental microscopic finding in biopsy specimens obtained for unrelated reasons. We describe here a very rare case of a sinusoidal breast hemangioma in a postmenopausal patient who presented with a palpable breast mass. A complete surgical resection was performed because the tumor exhibited atypical imaging features. We conclude that although in carefully selected cases of breast hemangioma a conservative management with follow up imaging is a reasonable option, in cases with atypical imaging or pathological characteristics a complete surgical resection of the vascular tumor is mandatory in order to exclude the possibility of an underlying angiosarcoma. PMID:28210560

  7. Computed Tomography-Guided Radiofrequency Ablation Following Transcatheter Arterial Embolization in Treatment of Large Hepatic Hemangiomas.

    PubMed

    Ji, Jiansong; Gao, Jun; Zhao, Lizhen; Tu, Jianfei; Song, Jingjing; Sun, Wenbing

    2016-04-01

    The aim of the study was to evaluate the feasibility, safety, and efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation combined with transcatheter arterial embolization (TAE) to treat large (≥10 cm) hepatic hemangiomas. We retrospectively reviewed our sequential experience with 15 large hepatic hemangiomas in 15 patients. The mean diameter of the 15 hemangiomas was 13.0 ± 2.2 cm (10.0-16.0 cm). RF ablation combined with TAE treatment was performed successfully in all patients. The mean diameter of the hemangiomas decreased from 13.0 ± 2.2 to 7.1 ± 2.0 cm (P < 0.001) after TAE treatment. Out of 15 hepatic hemangiomas, 14 (93.3%) showed no enhancement on CT or MRI indicating complete ablation after RF treatment. The mean diameter of the ablation zone decreased to 6.1 ± 2.0 cm 1 month after ablation and further decreased to 4.9 ± 1.6 cm 6 months after ablation. There were 6 complications related to the ablation in 4 patients. According to the Dindo-Clavien classification, all the complications were minor (Grade I). RF ablation combined with TAE is a safe and effective treatment for large hepatic hemangiomas. TAE can improve the disruption of lesion blood supply and reduce lesion size to facilitate subsequent RF ablation and reduce the risk of ablation-related complications.

  8. Computed Tomography-Guided Radiofrequency Ablation Following Transcatheter Arterial Embolization in Treatment of Large Hepatic Hemangiomas

    PubMed Central

    Ji, Jiansong; Gao, Jun; Zhao, Lizhen; Tu, Jianfei; Song, Jingjing; Sun, Wenbing

    2016-01-01

    Abstract The aim of the study was to evaluate the feasibility, safety, and efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation combined with transcatheter arterial embolization (TAE) to treat large (≥10 cm) hepatic hemangiomas. We retrospectively reviewed our sequential experience with 15 large hepatic hemangiomas in 15 patients. The mean diameter of the 15 hemangiomas was 13.0 ± 2.2 cm (10.0–16.0 cm). RF ablation combined with TAE treatment was performed successfully in all patients. The mean diameter of the hemangiomas decreased from 13.0 ± 2.2 to 7.1 ± 2.0 cm (P < 0.001) after TAE treatment. Out of 15 hepatic hemangiomas, 14 (93.3%) showed no enhancement on CT or MRI indicating complete ablation after RF treatment. The mean diameter of the ablation zone decreased to 6.1 ± 2.0 cm 1 month after ablation and further decreased to 4.9 ± 1.6 cm 6 months after ablation. There were 6 complications related to the ablation in 4 patients. According to the Dindo–Clavien classification, all the complications were minor (Grade I). RF ablation combined with TAE is a safe and effective treatment for large hepatic hemangiomas. TAE can improve the disruption of lesion blood supply and reduce lesion size to facilitate subsequent RF ablation and reduce the risk of ablation-related complications. PMID:27082617

  9. A Symptomatic Case of Thoracic Vertebral Hemangioma Causing Lower Limb Spastic Paresis

    PubMed Central

    Alfawareh, Mohammad; Alotaibi, Tariq; Labeeb, Abdallah; Audat, Ziad

    2016-01-01

    Patient: Male, 18 Final Diagnosis: Hemangioma Symptoms: Pain • weaknes of lower limbs Medication: — Clinical Procedure: Decompression and fixation Specialty: Neurosurgery Objective: Unusual clinical course Background: Despite being the most common tumor of the spine, vertebral hemangioma is rarely symptomatic in adults. In fact, only 0.9–1.2% of all vertebral hemangiomas may be symptomatic. When hemangiomas occur in the thoracic vertebrae, they are more likely to be symptomatic due to the narrow vertebral canal dimensions that mandate more aggressive management prior to the onset of severe neurological sequelae. Case Report: An 18-year-old male presented to the emergency room with a one-month history of mild to moderate midthoracic back pain, radiating to both lower limbs. It was associated with both lower limb weakness and decreased sensation. There was no history of bowel or bladder incontinence. Neurological examination revealed lower limb weakness with power 3/5, exaggerated deep tendon reflexes, bilateral sustained clonus, impaired sensation below the umbilicus, spasticity, and a positive Babinski sign. A CT scan showed a diffuse body lesion at the 8th thoracic vertebra with coarse trabeculations, corduroy appearance, or jail-bar sign. The patient underwent decompression and fixation. Biopsy of permanent samples showed proliferation of blood vessels with dilated spaces and no malignant cells, consistent with hemangioma. Postoperatively, spasticity improved, and the patient regained normal power. Conclusions: Symptomatic vertebral hemangiomas are rare but should be considered as a differential diagnosis. They can present with severe neurological symptoms. When managed appropriately, patients regain full motor and sensory function. Decompression resulted in quick relief of symptoms, which was followed by an extensive rehabilitation program. PMID:27795545

  10. Primary spinal epidural cavernous hemangioma: clinical features and surgical outcome in 14 cases.

    PubMed

    Li, Teng-Yu; Xu, Yu-Lun; Yang, Jun; Wang, James; Wang, Gui-Huai

    2015-01-01

    The aim of this study was to investigate the clinical characteristics, imaging features, differential diagnosis, treatment options, and prognosis for primary spinal epidural cavernous hemangiomas. Fourteen patients with pathologically diagnosed non-vertebral origin cavernous hemangiomas who had undergone surgery at Beijing Tiantan Hospital between 2003 and 2012 were identified in the hospital's database. The patients' clinical data, imaging characteristics, surgical treatment, and postoperative follow-up were analyzed retrospectively. There were 9 males and 5 females with an average age of 51.64 years. The primary epidural cavernous hemangiomas were located in the cervical spine (2 cases), cervicothoracic junction (2 cases), thoracic spine (8 cases), thoracolumbar junction (1 case), and lumbar spine (1 case). Hemorrhage was confirmed in 4 cases during surgery. Preoperatively 5 lesions were misdiagnosed as schwannoma, 1 was misdiagnosed as a meningioma, and 1 was misdiagnosed as an arachnoid cyst. Preoperative hemorrhages were identified in 2 cases. Three patients had recurrent cavernous hemangiomas. The initial presenting symptoms were local pain in 5 cases, radiculopathy in 6 cases, and myelopathy in 3 cases. Upon admission, 1 patient had radicular symptoms and 13 had myelopathic symptoms. The average symptom duration was 18 months. All patients underwent surgery; complete resection was achieved in 8 cases, subtotal resection in 4 cases, and partial resection in 2 cases. Postoperative follow-up was completed in 10 cases (average follow-up 34 months); 1 patient died, 5 patients showed clinical improvement, and 4 patients remained neurologically unchanged. Total surgical removal of spine epidural cavernous hemangiomas with a chronic course is the optimum treatment and carries a good prognosis. Secondary surgery for recurrent epidural cavernous hemangioma is technically more challenging. In patients with profound myelopathy from acute hemorrhage, even prompt surgical

  11. Treatment with propranolol for infantile hemangiomas: single-center experience.

    PubMed

    Turhan, Ayşe Bozkurt; Bör, Özcan; Özdemir, Zeynep Canan

    2016-09-01

    Infantile hemangiomas (IHs) are the most common soft tissue tumors of infancy. Although spontaneous regression is expected, medical treatment is needed in approximately 10-20% of cases. We aimed to assess the safety and efficacy of systemic propranolol for the treatment of IH. Medical records of 34 eligible patients were analyzed retrospectively. Treatment indications were local complications (hemorrhage, ulceration) in 38.2% of patients, cosmetic risk and face deformity in 35.3%, life-threatening organ dysfunction in 17.6%, and impending visual impairment in 8.8%. The median age at start of treatment with propranolol was 3.5 months (range, 2-65 months). The median duration of propranolol treatment was 8 months (3-12). Response was graded as excellent (>75% improvement) in 30 patients (88.2%) and good (50-75% improvement) in 3 (8.9%). Recurrence was not observed after termination of treatment. None of our patients showed severe side effects at the beginning of or during the treatment. Propranolol is a well-tolerated, efficacious, and safe drug for treatment of IH. It can be initiated and administered in the outpatient setting. Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for IH. © 2016 Wiley Periodicals, Inc.

  12. Efficacy of propranolol for cutaneous hemangiomas in premature children.

    PubMed

    Brazzelli, Valeria; Giorgini, Chiara; Barruscotti, Stefania; Codazzi, Claudia A; Mannarino, Savina; Tzialla, Chryssoula; Stronati, Mauro; Marseglia, Gian L; Borroni, Giovanni

    2016-10-01

    The purpose of the present study is to evaluate the efficacy and safety of propranolol for problematic infantile hemangiomas (IH), showing our experience on 24 children, with special focus on premature infants. A retrospective observational study considered 24 patients who were given oral propranolol for the treatment of "problematic" IH. A multidisciplinary team, composed of a dermatologist, a pediatrician, a pediatric cardiologist, and a neonatologist, took part in the indication for propranolol and follow-up on all the patients. Propranolol was administered orally at the starting dose of 0.5-1 mg/kg/die and was gradually increased to the target dose of 2 mg/kg/die. A clinical gravity score, based on color, major diameter, thickness and texture was calculated for each IH, giving a numeric score before (t0) and after (tf) propranolol therapy. Improvement rate was evaluated in terms of score percentage difference between t0 and tf. All of the IH except one (96%), showed a variable grade of improvement, with a median score improvement of 69.1%. Median initial score in premature and term infants did not show any significant difference (P=0.38). Otherwise the two subgroups showed a significant difference in final scores: medium percentage improvement in premature and term infants, was respectively 80.9% and 49.6% (P<0.01). No significant side effects were reported during the treatment period. As pointed out in our study, IH in premature children showed a significantly better response to propranolol treatment.

  13. Breast cancer after radiotherapy for skin hemangioma in infancy

    SciTech Connect

    Lundell, M.; Mattsson, A.; Hakulinen, T.; Holm, L.E.

    1996-02-01

    Between 1920 and 1959, 9675 women were irradiated in infancy for skin hemangioma at Radiumhemmet, Stockholm. They were exposed to low to moderate doses of ionizing radiation. The mean age at first exposure was 6 months and the mean absorbed dose to the breast anlage was 0.39 Gy (range < 0.01-35.8 Gy). The breast cancer incidence was analyzed by record linkage with the Swedish Cancer Register for the period 1958-1986. Seventy-five breast cancers were found after a mean absorbed dose of 1.5 Gy in the breasts with cancer. The analyses showed a significant dose-response relationship with a linear model estimate for the excess relative risk (ERR) of 0.38 at 1 Gy (95% CI 0.09-0.85). This relationship was not modified significantly by age at exposure or by dose to the ovaries. The ERR increased significantly with time after exposure and for > 50 years after exposure the ERR at 1 Gy was 2.25 (95% CI 0.59-5.62). The fitted excess absolute risk (EAR) was 22.9 per 10{sup 4} breast-year gray. The breast absorbed dose and time after exposure were important risk determinants for breast cancer excess risk. Forty to 50 years of follow-up was necessary for the excess risk to be expressed. The study confirms previous findings that the breast anlage of female infants is sensitive to ionizing radiation. 17 refs., 6 figs.

  14. Cavernous sinus hemangioma: a fourteen year single institution experience.

    PubMed

    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable.

  15. Mast cells in canine cutaneous hemangioma, hemangiosarcoma and mammary tumors.

    PubMed

    Woldemeskel, Moges; Rajeev, Sreekumari

    2010-02-01

    Mast cell count (MCC) in 45 dogs with cutaneous hemangioma (HA, n = 12), hemangiosarcoma (HSA, n = 12), mammary adenoma (AD, n = 9) and mammary adenocarcinoma (AC, n = 12) was made using Toluidine blue stained sections. Antibodies against endothelial cell markers, Factor VIII and VEGF were used to visualize and determine the hot spot micro-vessel density (MVD). Total MCC and MCC along the invasive edges were significantly higher (p < 0.001) in canine mammary AC than in AD. The total MCC did not significantly differ (p > 0.05), in HSAs (8.6 +/- 3.3) than in HAs (5.5 +/- 2.8). There is a positive correlation (r = 0.14) between the hot spot MCC and MVD in mammary AC, although not significant (p = 0.3172), indicating that mast cells are associated with angiogenesis in canine mammary AC. This study suggests that mast cells may play an important role in neovascularization of canine cutaneous vascular and mammary neoplasms. Detailed studies encompassing correlation of MCC and MVD with clinical outcomes and prognosis in these neoplasms are recommended.

  16. A Hydrogel-Endothelial Cell implant Mimics Infantile Hemangioma: Modulation by Survivin and the Hippo pathway*

    PubMed Central

    Tsuneki, Masayuki; Hardee, Steven; Michaud, Michael; Morotti, Raffaella; Lavik, Erin; Madri, Joseph A.

    2015-01-01

    Microvascular endothelial cells cultured in three-dimensional hydrogel scaffolds form a network of microvessel structures when implanted subcutaneously in mice, inosculate with host vessels and over time remodel into large ectatic vascular structures resembling hemangiomas. When compared to infantile hemaniomas similarities were noted including a temporal progression from a morphological appearance of a proliferative phase to the appearance of an involuted phase mimicking the proliferative and involutional phases of infantile hemangioma. Consistent with the progression of a proliferative phase to an involuted phase, both the murine implants and human biopsy tissue exhibit reduced expression of Ajuba, YAP and Survivin labeling as they progressed over time. Significant numbers of CD45+, CD11b+, Mac3+ mononuclear cells were found at the 2 week time point in our implant model which correlated with the presence of CD45+, CD68+ mononuclear cells observed in biopsies of human proliferative phase hemangiomas. At the 4 week time point in our implant model only small numbers of CD45+ cells were detected, which again correlated with our findings of significantly diminished CD45+, CD68+ mononuclear cells in human involutional phase hemangiomas. The demonstration of mononuclear cell infiltration transiently in the proliferative phase of these lesions suggests that the vascular proliferation and/or regression may be driven in part by an immune response. Gross and microscopic morphological appearances of human proliferative and involutional hemangiomas and our implant model correlate well with each other as do the expression levels of Hippo pathway components (Ajuba and YAP) and Survivin and correlate with proliferation in these entities. Inhibitors of Survivin and Ajuba (which we have demonstrated to inhibit proliferation and increase apoptosis in murine hemangioma cell tissue culture) may have potential as other beneficial treatments for proliferating infantile hemangiomas

  17. A hemangioma on the floor of the mouth presenting as a ranula.

    PubMed

    Skoulakis, Charalampos E; Khaldi, Lubna; Serletis, Demetre; Semertzidis, Themistoklis

    2008-11-01

    A painless, bluish, submucosal swelling on one side of the floor of the mouth usually indicates the presence of a ranula. Rarely, such a swelling may be caused by an inflammatory disease process in a salivary gland, a neoplasm in the sublingual salivary gland, a lymphatic nodular swelling, or embryologic cysts. We report a patient with swelling in the floor of her mouth that was clinically diagnosed as a ranula. Suspicion arose during surgery that it was a vascular tumor and, on histologic testing, the swelling was confirmed to be a hemangioma. To our knowledge, this is the first report in the literature of a hemangioma presenting as a ranula.

  18. A case of giant hemangioma of the liver presenting with fever of unknown origin.

    PubMed Central

    Lee, C. W.; Chung, Y. H.; Lee, G. C.; Kim, J. Y.; Lee, J. S.

    1994-01-01

    A 37 year-old-woman was admitted to the hospital because of 15 days' duration of continuous fever. Routine studies for detection of fever foci were negative. Imaging studies revealed giant hemangioma of the liver with central thrombosis. The fever persisted for a period of 4 weeks, and subsided after conservative management. We report a case of hepatic hemangioma presenting with fever of unknown origin. The condition is very rare, but should be regarded as one of the causes of fever of unknown origin. PMID:7986396

  19. [Sclerosing hemangioma presenting as a solitary lung nodule. Report of one case].

    PubMed

    Cardemil, Gonzalo; Fernández, Eduardo; Riffo, Paola; Reyes, Diego; Ledezma, Rodrigo; Mira, Magdalena; Morales, Claudia; Salguero, Jorge

    2004-07-01

    Lung sclerosing hemangioma is an uncommon tumor that presents as a solitary asymptomatic nodule and that affects middle age women. It derives from type II pneumocytes. We report a 52 years old female with a solitary lung nodule detected in a chest X ray requested for the diagnosis of an acute respiratory disease. The nodule was excised by video thoracoscopy and the frozen section biopsy was informed as a non small cell undifferentiated carcinoma. Therefore an inferior right lobectomy with lymph node resection was performed. The definitive biopsy was informed as a lung sclerosing hemangioma.

  20. [Experimental study of magnetic pingyangmycine-bearing microspheres in the treatment of cavernous hemangioma].

    PubMed

    Zhang, Sheng; Wu, Han-jiang; Ling, Tian-you

    2003-02-28

    To investigate the probability and mechanism magnetic pingyangmycine-bearing microspheres(MPMs) in the treatment of cavernous hemangioma. Twenty rabbits were divided into four groups. MPMs, pingyangmycine and magnetic nonpingyangmycine-bearing microspheres were injected into marginal ear veins respectively. All animals were killed after 21 days and histological varations of the veins were observed under the light microscope and transmission electron microscope. The occlusion of the veins in the group of MPMs with the external magnetic field was more prominent than that in the other groups. MPMs can occlude veins by means of its embolized effect and PYM drug effect. MPMs may be better used in the therapy of cavernous hemangioma.

  1. Generalized enchondromatosis with unusual complications of soft tissue calcifications and hemangiomas

    SciTech Connect

    Kaibara, N.; Katsuki, I.; Hotokebuchi, T.; Takagishi, K.; Mitsuyasu, M.

    1982-03-01

    Generalized enchondromatosis is a newly delineated type of enchondromatosis. Radiographically there are multiple enchondromata in almost all metaphyses of the long and short tubular bones and the lesions are in almost the same stage of development with mild platyspondyly and skull deformity. The pelvic changes are characteristic and, together with the metaphyseal changes of the long and short tubular bones, are probably diagnostic of this disorder. The present case demonstrates advanced radiographic features of this disorder associated with unusual soft tissue calcifications and hemangiomas. The presence of hemangiomas in our case as well as three cases in the literature suggests this feature is more than a coincidence.

  2. A hydrogel-endothelial cell implant mimics infantile hemangioma: modulation by survivin and the Hippo pathway.

    PubMed

    Tsuneki, Masayuki; Hardee, Steven; Michaud, Michael; Morotti, Raffaella; Lavik, Erin; Madri, Joseph A

    2015-07-01

    Microvascular endothelial cells cultured in three-dimensional hydrogel scaffolds form a network of microvessel structures when implanted subcutaneously in mice, inosculate with host vessels, and over time remodel into large ectatic vascular structures resembling hemangiomas. When compared with infantile hemangiomas, similarities were noted, including a temporal progression from a morphological appearance of a proliferative phase to the appearance of an involuted phase, mimicking the proliferative and involutional phases of infantile hemangioma. Consistent with the progression of a proliferative phase to an involuted phase, both the murine implants and human biopsy tissue exhibit reduced expression of Ajuba, YAP, and Survivin labeling as they progressed over time. Significant numbers of CD45+, CD11b+, Mac3+ mononuclear cells were found at the 2-week time point in our implant model that correlated with the presence of CD45+, CD68+ mononuclear cells observed in biopsies of human proliferative-phase hemangiomas. At the 4-week time point in our implant model, only small numbers of CD45+ cells were detected, which again correlated with our findings of significantly diminished CD45+, CD68+ mononuclear cells in human involutional-phase hemangiomas. The demonstration of mononuclear cell infiltration transiently in the proliferative phase of these lesions suggests that the vascular proliferation and/or regression may be driven in part by an immune response. Gross and microscopic morphological appearances of human proliferative and involutional hemangiomas and our implant model correlate well with each other as do the expression levels of Hippo pathway components (Ajuba and YAP) and Survivin and correlate with proliferation in these entities. Inhibitors of Survivin and Ajuba (which we have demonstrated to inhibit proliferation and increase apoptosis in murine hemangioendothelioma cell tissue culture) may have potential as other beneficial treatments for proliferating

  3. Evaluation of hemangiomas with technetium 99m-labeled RBCs: the perfusion-blood pool mismatch

    SciTech Connect

    Front, D.; Israel, O.; Joachims, H.; Brown, Y.; Eliachar, I.

    1983-03-18

    A case report is presented of a woman with a tumor mass in the nasopharynx. Early and delayed scintigraphy with Technetium 99m-labeled RBCs showed a large area of increased uptake which was later shown to be a hemangioma by contrast angiography. The perfusion-blood pool mismatch observed in hemangiomas is characteristic of these lesions and has not been described in any other abnormalities. The Tc-RBC using both early and delayed scintigraphy is a simple, noninvasive method for assessing the vascular characteristics of these tumors. (JMT)

  4. Cavernous Hemangioma of the External Canal, Tympanic Membrane, and Middle Ear Cleft: A Case Report.

    PubMed

    Odat, Haitham; Al-Qudah, Mohannad; Al-Qudah, Mohammad A

    2016-06-01

    Cavernous hemangioma involving the external canal, tympanic membrane, and middle ear cavity is extremely rare. We present a case of a 45-year-old woman who had progressive right sided decreased hearing, pulsatile tinnitus, and aural fullness of 7 months duration. Microscopic examination, imaging studies, surgical treatment, and histological evaluation are reported. To the best of our knowledge, this is the first case of cavernous hemangioma with simultaneous involvement of the external ear, tympanic membrane, middle ear, and attic reported in English literature.

  5. Challenging Pitfalls and Mimickers in Diagnosing Anastomosing Capillary Hemangioma of the Kidney: Case Report and Literature Review

    PubMed Central

    Al-Maghrabi, Haneen Adnan; Rashed, Abdullatif Sami Al

    2017-01-01

    Patient: Female, 55 Final Diagnosis: Anastomosing capillary hemangioma in the left kideny Symptoms: Left flank pain Medication: — Clinical Procedure: Partial nephrectomy Specialty: Diagnostics • Laboratory Objective: Rare disease Background: Vascular tumors of the kidney are rare tumors that are usually diagnosed and confirmed by histopathological examination due to the difficulty in definitive diagnosis by clinical and radiological examination. Anastomosing hemangioma is a rare variant of capillary hemangioma that mimics angiosarcoma. Case Report: Here, we present a case of a 55-year-old female with a history of partial nephrectomy due to clear cell renal cell carcinoma three years earlier, who presented with a contralateral anastomosing capillary hemangioma. The diagnosis was confirmed by histopathology and immunohistochemistry studies. Conclusions: Anastomosing hemangioma is a rare variant of capillary hemangioma. It has a sinusoidal growth pattern which resembles splenic parenchyma. It mimics malignant neoplasms, thus, clinical and radiological examination are not enough for accurate diagnosis. In this paper, we discuss the most crucial differential diagnoses and the pitfalls in diagnosing this rare variant of hemangioma. Furthermore, we present a literature review of all cases reported in the English-language literature. PMID:28286335

  6. Planar and SPECT Tc-99m red blood cell imaging in hepatic cavernous hemangiomas and other hepatic lesions

    SciTech Connect

    Intenzo, C.; Kim, S.; Madsen, M.; Desai, A.; Park, C.

    1988-04-01

    The utility of Tc-99m RBC imaging in the diagnosis of hepatic cavernous hemangiomas has been established. Of the 25 patients with various focal hepatic lesions evaluated, 16 were diagnosed as having hemangiomas: eight proven by surgery, two proven by angiography, and six proven by maintaining a stable clinical course ranging from 6 to 12 months with normal follow-up liver function tests. Although fourteen of these were detected by planar imaging, two were detected by SPECT only. Two patients with large hemangiomas had false-negative scans, whereas the remaining seven patients had other liver lesions.

  7. Gamma Knife radiosurgery for hemangioma of the cavernous sinus.

    PubMed

    Lee, Cheng-Chia; Sheehan, Jason P; Kano, Hideyuki; Akpinar, Berkcan; Martinez-Alvarez, Roberto; Martinez-Moreno, Nuria; Guo, Wan-Yuo; Lunsford, L Dade; Liu, Kang-Du

    2017-05-01

    OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare vascular tumors. A direct microsurgical approach usually results in massive hemorrhage and incomplete tumor resection. Although stereotactic radiosurgery (SRS) has emerged as a therapeutic alternative to microsurgery, outcome studies are few. Authors of the present study evaluated the role of SRS for CSH. METHODS An international multicenter study was conducted to review outcome data in 31 patients with CSH. Eleven patients had initial microsurgery before SRS, and the other 20 patients (64.5%) underwent Gamma Knife SRS as the primary management for their CSH. Median age at the time of radiosurgery was 47 years, and 77.4% of patients had cranial nerve dysfunction before SRS. Patients received a median tumor margin dose of 12.6 Gy (range 12-19 Gy) at a median isodose of 55%. RESULTS Tumor regression was confirmed by imaging in all 31 patients, and all patients had greater than 50% reduction in tumor volume at 6 months post-SRS. No patient had delayed tumor growth, new cranial neuropathy, visual function deterioration, adverse radiation effects, or hypopituitarism after SRS. Twenty-four patients had presented with cranial nerve disorders before SRS, and 6 (25%) of them had gradual improvement. Four (66.7%) of the 6 patients with orbital symptoms had symptomatic relief at the last follow-up. CONCLUSIONS Stereotactic radiosurgery was effective in reducing the volume of CSH and attaining long-term tumor control in all patients at a median of 40 months. The authors' experience suggests that SRS is a reasonable primary and adjuvant treatment modality for patients in whom a CSH is diagnosed.

  8. Rebound Growth of Infantile Hemangiomas After Propranolol Therapy.

    PubMed

    Shah, Sonal D; Baselga, Eulalia; McCuaig, Catherine; Pope, Elena; Coulie, Julien; Boon, Laurence M; Garzon, Maria C; Haggstrom, Anita N; Adams, Denise; Drolet, Beth A; Newell, Brandon D; Powell, Julie; García-Romero, Maria Teresa; Chute, Carol; Roe, Esther; Siegel, Dawn H; Grimes, Barbara; Frieden, Ilona J

    2016-04-01

    Propranolol is first-line therapy for problematic infantile hemangiomas (IHs). Rebound growth after propranolol discontinuation is noted in 19% to 25% of patients. Predictive factors for rebound are not completely understood and may alter the management approach. The goal of the study was to describe a cohort of patients with IHs treated with propranolol and to identify predictors for rebound growth. A multicenter retrospective cohort study was conducted in patients with IHs treated with propranolol. Patient demographic characteristics, IH characteristics, and specifics of propranolol therapy were obtained. Episodes of rebound growth were recorded. Patients' responses to propranolol were evaluated through a visual analog scale. A total of 997 patients were enrolled. The incidence of rebound growth was 231 of 912 patients (25.3%). Mean age at initial rebound was 17.1 months. The odds of rebound among those who discontinued therapy at <9 months was 2.4 (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.3 to 4.5; P = .004) compared with those who discontinued therapy between 12 to 15 months of life. Female gender, location on head and neck, segmental pattern, and deep or mixed skin involvement were associated with rebound on univariate analysis. With multivariate analysis, only deep IHs (OR: 3.3; 95% CI: 1.9 to 6.0; P < .001) and female gender (OR: 1.7; 95% CI: 1.1 to 2.6; P = .03) were associated. Of those with rebound growth, 83% required therapeutic modification including 62% of patients with modifications in their propranolol therapy. Rebound growth occurred in 25% of patients, requiring modification of systemic therapy in 15%. Predictive factors for rebound growth included age of discontinuation, deep IH component, and female gender. Patients with these predictive factors may require a prolonged course of therapy. Copyright © 2016 by the American Academy of Pediatrics.

  9. Photodynamic therapy of choroidal hemangioma in sturge-weber syndrome, with a review of treatments for diffuse and circumscribed choroidal hemangiomas.

    PubMed

    Tsipursky, Michael S; Golchet, Pamela R; Jampol, Lee M

    2011-01-01

    We report three new cases of patients with Sturge-Weber Syndrome and symptomatic retinal detachments from diffuse choroidal hemangiomas successfully treated with photodynamic therapy (PDT) and review medical literature on the available treatment options for choroidal hemangiomas. All patients were treated with a single session of PDT with verteporfin infused at a concentration of 6 mg/m(2) and treated for 83 seconds with 689-nm Zeiss laser that was delivered with total energy level of 50 J/cm(2) with an intensity of 600 mW/cm(2). The exudative retinal detachment (RD) and macular edema completely resolved in all cases by 1-4 months after PDT treatment. Visual acuity improved in all three cases with diminished tumor size in the areas of treatment. One case was followed for 5 months, another for 2 years, and the third case for 6 years, with no recurrence of exudative RD. PDT is an effective treatment option for visual deterioration from exudative retinal detachment in patients with diffuse choroidal hemangiomas.

  10. Delayed-onset of multiple cutaneous infantile hemangiomas due to propranolol: a case report.

    PubMed

    Porcel Chacón, Rocío; del Boz González, Javier; Navarro Morón, Juan

    2015-04-01

    Infantile hemangiomas are the most common vascular tumors in childhood. In view of its proven effectiveness in such cases, propranolol is the drug of choice. We present the case of a male infant who started treatment with propranolol shortly after birth due to heart disease. After 7 months, when the patient had suffered various respiratory exacerbations, this treatment was suspended. One week later, multiple skin lesions (ie, multifocal infantile hemangiomas) began to appear, with no extracutaneous involvement. It was decided to resume treatment with propranolol, although at lower doses than before, and the skin lesions improved rapidly, with some disappearing completely. Treatment was definitively withdrawn at age 16 months, with only slight recurrence of the lesions. The case described is of multifocal infantile hemangiomas without extracutaneous involvement appearing beyond the neonatal period after treatment with propranolol beginning in the first days of life. The details of the case support the hypothesis that this drug is not only therapeutic but also plays a prophylactic role against infantile hemangiomas. In turn, this supports the recent proposal that this drug may be useful in preventing the growth and spread of tumors with high angiogenic potential. It is postulated that the inhibition of β-adrenergic receptors is associated with multiple intracellular processes related to the progression and metastasis of different tumors.

  11. Treatment with interferon-alpha-2b in children with life-threatening hemangiomas.

    PubMed

    Jiménez-Hernández, Elva; Dueñas-González, María Teresa; Quintero-Curiel, José Luis; Velásquez-Ortega, José; Magaña-Pérez, José A; Berges-García, Adolfina; Arellano-Galindo, José

    2008-05-01

    Childhood hemangiomas are benign tumors of endothelial cells, characterized by a rapidly proliferating initial phase and followed by a slow involution. However, some grow and may reach a massive size, threatening a patient's functions or life. These require immediate medical treatment. The objective was to determine the therapeutic effectiveness of interferon (IFN)-alpha-2b in children with hemangiomas threatening the patient's functions or life. All patients were treated with IFN-alpha-2b at a dosage of 3 million U/m(2) corporal surface, applied subcutaneously, 5 days a week for the first 6 months and subsequently three times a week for 6 to 24 months. RESULTS The study included 20 patients with hemangiomas localized in different sites and with diverse functional alterations: ages varied between 3 and 48 months (median, 12.8 months), and 8 were male and 12 female. An excellent response was observed in 17 (85%) patients. Side effects were slight and transitory; there was a follow-up from 7 to 10 years, and no late toxicity was observed. We can conclude that IFN-alpha-2b is an effective option for treating alarming hemangiomas that are resistant to steroids and that endanger proper functioning of the affected organ or the patient's life.

  12. Vulvar Lobular Capillary Hemangioma: A Rare Location for a Frequent Entity

    PubMed Central

    Câmara, S.; Reis, F.; Gaspar, H.; Cordeiro, M.

    2016-01-01

    Lobular capillary hemangioma, or pyogenic granuloma, is an acquired hemorrhagic benign vascular lesion of the skin and mucous membranes. The pyogenic granuloma of the vulva is a rare finding and a limited number of case reports are available in the literature. To the best of our knowledge this is the first case described as a single pyogenic granuloma on the vulva. PMID:28127485

  13. Normalisation of asymmetric astigmatism after intralesional steroid injection for upper eye lid hemangioma in childhood.

    PubMed

    Langmann, A; Lindner, S

    1994-01-01

    Infantile hemangiomas affect about 5% (3%-8%) of the population, showing a predilection for the face. After a phase of rapid enlargement between the 3rd and the 9th month of life, 70% regress by the age of six after a period of stability. 43%-60% of the children with eye lid hemangiomas develop strabismic, anisometropic, or deprivation amblyopia. Previous studies found the majority of cases resulting from anisometropia (especially asymmetric astigmatism) rather than strabism or occlusion of the visual axis. Several methods of treatment--surgical excision, irradiation, sclerosing agents, systemic steroids, ligation, cryotherapy--have been used but all with a risk of local or systemic complications. Local injections of steroids are a simple method of therapy with a high rate of resolution of hemangiomas, but still with a high degree of bad visual output because of persistent astigmatism. In four children with asymmetric astigmatism (axis of astigmatism towards the hemangioma) in which the injection was given at the beginning of the phase of enlargement, amblyopia could be avoided by preventing corneal steepening from becoming permanent.

  14. Utilization of Optical Coherence Tomography in the Evaluation of Cherry Hemangiomas.

    PubMed

    Aldahan, Adam S; Mlacker, Stephanie; Shah, Vidhi V; Chen, Lucy L; Nouri, Keyvan; Grichnik, James M

    2016-06-01

    Cherry hemangiomas are common vascular proliferative lesions that can be concerning from a cosmetic perspective. Laser therapy is often used to eradicate cherry hemangiomas, but some lesions require multiple treatments or do not resolve at all. The suboptimal response to laser treatment may be due to limitations in penetration depth by vascular lasers such as the pulsed dye laser. Optical coherence tomography is a low-energy, light-based imaging device that can evaluate the depth and extent of vascular lesions such as cherry hemangiomas by allowing visualization of tissue structure and blood vessel architecture, which cannot be appreciated by clinical or dermatoscopic examination alone. We present optical coherence tomography images of a cherry hemangioma to demonstrate the precision and resolution of this imaging modality. Optical coherence tomography provides valuable information that has the potential to predict response to laser therapy without unnecessary attempts. Future prospective studies will determine its value for this purpose.

    J Drugs Dermatol. 2016;15(6):713-714.

  15. A case of liver hemangioma with markedly reduced tumor size after metformin treatment: a case report.

    PubMed

    Ono, Minoru; Sawada, Koji; Okumura, Toshikatsu

    2017-02-01

    A 52-year-old man with a 9-year history of hepatic hemangioma was treated with the anti-diabetic drug metformin, resulting in complete remission of the tumor. In 2006, a hemangioma with diameter of 20 × 25 mm was detected incidentally in the liver. The results of imaging studies including ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) were all compatible with that of hepatic hemangioma. The patient consequently underwent imaging annually from 2006 to 2015. The tumor size increased slightly, to 30 × 35 mm in 2012; however, the general tumor characteristics in imaging were not changed. Beginning May 2012, metformin (750 mg/day) was administered because of an increase in blood sugar and hemoglobin A1c levels. After the start of metformin treatment, the tumor size on US gradually decreased. Finally, in October 2015, the tumor was no longer detected. Dynamic CT study also demonstrated markedly reduced tumor size, with a decrease of 2-3 mm in diameter. These results indicate that metformin treatment strongly suppressed cell proliferation in liver hemangioma. The anti-angiogenic effect of metformin was indicated as a possible cause of the reduction in tumor size.

  16. A rare case of pure primary hemangioma of the scapula: A case report

    PubMed Central

    LI, WEI; ZOU, FAN; DAI, MIN; ZHANG, BIN; NIE, TAO

    2015-01-01

    Hemangioma is a benign vascular tumor, which may occur in any bone of the body. The most common locations are the spine and craniofacial bone; however, occurrence is extremely rare in the scapula. The current study presented the case of a 58-year-old female, with scapula hemangioma in the left shoulder who presented with joint ache that had lasted for ~1 year. The main clinical manifestations included local tenderness, an osseous lump and limited shoulder movement with a little pain, which was alleviated by rest. Roentgenogram, computed tomography and magnetic resonance imaging of the left acromion revealed a mass along the inner surface of the scapula of the left shoulder with polycystic expansion and bone destruction. The results of computed tomography and magnetic resonance imaging indicated a pure primary tumor and the lesion was subsequently resected. Notably, the postoperative pathological diagnosis was capillary hemangioma. The aim of the present study was to analyze the clinical and imaging features of scapula hemangioma, which must be considered for the differential diagnosis of scapula tumors. In the present case, no recurrence was identified by X-ray examination 1 year after surgery. The long-term efficacy of surgical treatment requires continuous observation of the patient. PMID:26622831

  17. Bone erosion caused by sinonasal cavernous hemangioma: CT findings in two patients.

    PubMed

    Kim, H J; Kim, J H; Kim, J H; Hwang, E G

    1995-05-01

    We report two cases of cavernous hemangioma originating in the sinonasal cavity. Although CT showed some enhancing areas within both tumors, the substantial bone destruction caused by these tumors made it difficult to differentiate them from the more common malignant epithelial tumors. Angiography was performed in one patient and showed characteristic pooling of contrast material.

  18. Colonic cavernous hemangiomas: a report of two cases treated by laparoscopic surgery.

    PubMed

    Rodríguez-Zentner, H; Castañeda-Argáiz, R; Tapia, H; Vergara-Fernandez, O; González, Q H

    2011-05-01

    Hemangiomas are rare vascular tumors. They most commonly appear in the small bowel, as well as the colon and the rectum. Here, we report two cases of male patients who were admitted to our hospital for low rectal painless bleeding, misdiagnosed of hemorrhoid bleeding. Colonoscopy reported vascular tumors in both cases, which we surgically removed.

  19. Multilevel vertebral hemangiomas: two episodes of spinal cord compression at separate levels 10 years apart.

    PubMed

    Karaeminogullari, Oguz; Tuncay, Cengiz; Demirors, Huseyin; Akin, Kayihan; Sahin, Orcun; Ozyurek, Ayhan; Tandogan, Nevzat Reha

    2005-09-01

    This case report presents a 66-year-old woman with multiple vertebral hemangiomas causing spinal cord compression at different levels with a long symptom-free interval between episodes of compression. She presented with back pain and progressive weakness and numbness in her lower limbs for 3 months. Ten years earlier, she had had a symptomatic T4 vertebral hemangioma operated successfully, and had made a full recovery. Magnetic resonance imaging (MRI) of the thoracic and lumbar spine revealed multiple thoracic and lumbar vertebral hemangiomas. Extraosseous extension of a hemangioma at T9 was causing spinal cord compression. Selective embolization was performed preoperatively, and cord decompression was achieved via anterior T9 corpectomy. The patient's neurological status improved rapidly after surgery. After a course of radiotherapy, she was neurologically intact and could walk independently. One year later, MRI showed complete resolution of the cord edema at T9, and showed regression of the high signal intensity that had been observed at unoperated levels. These findings indicated diminished vascularity and reduced aggression of the tumor.

  20. Rapid regrowth of a capillary hemangioma of the thoracic spinal cord.

    PubMed

    Kaneko, Yoichi; Yamabe, Kazutoshi; Abe, Masamitsu

    2012-01-01

    A 48-year-old man presented with a 2-week history of progressive gait disturbance. Neurological examinations showed mild weakness in his lower extremities and depreciation of deep sensation. Magnetic resonance (MR) imaging showed an intradural extramedullary enhanced lesion at the levels of the T10 and T11 vertebrae. Laminectomy of the T10 and T11 vertebrae was performed, and the vascular tumor on the spinal cord surface was completely resected. Histological analysis indicated that the lesion was a capillary hemangioma with an elevated proliferative index. Postoperatively, the patient showed rapid motor and sensory improvement. However, 6 months after the operation, MR imaging showed regrowth of the tumor although the clinical symptoms of the patient had not deteriorated. The patient has shown no tumor regrowth 9 years after the second operation. Capillary hemangiomas in the skin and soft tissues are often associated with high proliferative activity, and recurrence/regrowth is not infrequent. On the other hand, recurrence/regrowth of capillary hemangioma in the neuraxis after tumor resection has rarely been observed, even in cases of incomplete resection. The present case illustrates the treatment of recurrent capillary hemangioma of the spinal cord.

  1. Urea immunoliposome inhibits human vascular endothelial cell proliferation for hemangioma treatment

    PubMed Central

    2013-01-01

    Background Urea injection has been used in hemangioma treatment as sclerotherapy. It shrinks vascular endothelial cells and induces degeneration, necrosis, and fibrosis. However, this treatment still has disadvantages, such as lacking targeting and difficulty in controlling the urea dosage. Thus, we designed a urea immunoliposome to improve the efficiency of treatment. Methods The urea liposome was prepared by reverse phase evaporation. Furthermore, the urea immunoliposome was generated by coupling the urea liposome with a vascular endothelial growth factor receptor (VEGFR) monoclonal antibody using the glutaraldehyde cross-linking method. The influence of the urea immunoliposome on cultured human hemangioma vascular endothelial cells was observed preliminarily. Results Urea immunoliposomes showed typical liposome morphology under a transmission electron microscope, with an encapsulation percentage of 54.4% and a coupling rate of 36.84% for anti-VEGFR. Treatment with the urea immunoliposome significantly inhibited the proliferation of hemangioma vascular endothelial cells (HVECs) in a time- and dose-dependent manner. Conclusions The urea immunoliposome that we developed distinctly and persistently inhibited the proliferation of HVECs and is expected to be used in clinical hemangioma treatment. PMID:24266957

  2. [Effects of propranolol on proliferation of hemangioma-derived mesenchymal stem cells ].

    PubMed

    Tinghui, Zhao; Xiaorong, Ma; Yingying, Huang; Huiping, Chen; Yan, Xiao; Tianxiang, Ouyang

    2014-09-01

    To explore the new mechanism of propranolol for treatment of hemangioma and the effects of propranolol on proliferation of hemangioma-derived mesenchymal stem cells ( Hem- MSCs). We isolated Hem-MSCs from hemangioma in the proliferating phase by their selective adhesion to plastic culture dishes. Immunofluorescence staining was used to examine the expression of marker antigens in Hem-MSCs. Human umbilical vein endothelial cells(HUVECs) were used as control. Indiuction of multi-lineage differentiation including osteogenesis and adipogeneis was performed with appropriate medium to identify the multi-lineage differentiation potential. MTT cell counting was used to observe the effects of different concentrations of propranolol on proliferation of Hem-MSCs. Hem- MSCs were fibroblast-like morphology. All of them expressed vimentin, most expressed α-SMA,CD133, some expressed Glutl, and none of them expressed VEGF. Osteogenic, adipogenic differentiations of Hem- MSCs were induced successfully. Effects of low concentration of propranolol on proliferation of Hem-MSCs were not obvious, while high concentration of propranolol can inhibit the proliferation of Hem-MSCs. The cells we isolated from hemangioma are Hem-MSCs. High concentration of propranolol can inhibit the proliferation of Hem-MSCs.

  3. Efficacy and rebound rates in propranolol-treated subglottic hemangioma: A literature review.

    PubMed

    Schwartz, Tyler; Faria, John; Pawar, Sachin; Siegel, Dawn; Chun, Robert H

    2017-08-23

    Propranolol has recently become the treatment of choice for management of subglottic and airway hemangiomas. This literature review aimed to determine the success rate of propranolol for managing these lesions as well as the rate of rebound growth following propranolol treatment cessation. Literature search involving MEDLINE and Scopus to identify English-language articles. Studies were identified using hemangioma, subglottic or airway, and propranolol for search terms. Studies were eligible for inclusion if they reported the treatment used, individual deidentified patient data, and contained patients without medical or surgical treatment prior to propranolol therapy RESULTS: Initial review included 107 abstracts. Twenty-four articles including case reports and case series met inclusion criteria and were included in the qualitative analysis. Forty-nine patients were included. Twenty-eight (57%) were treated with propranolol alone, and 20 (41%) were treated with a combination of propranolol and a corticosteroid. Thirty-seven (76%) of patients were treated with a dose of 2 mg/kg/d of propranolol. The initial treatment was successful in 43 (88%) of patients. Rebound growth occurred in four (9%) patients. Overall, six (12%) patients underwent surgical resection. Propranolol is efficacious for treating subglottic hemangiomas. Rebound growth does occur in a small subset of patients during the propranolol wean. Close observation for children during weaning of propranolol therapy for subglottic hemangioma is essential. Adjunctive management strategies need to be used in patients with rebound growth. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Acquired capillary hemangioma of the eyelid in a 49-year-old woman from Turkey

    PubMed Central

    Kıvanç, Sertaç Argun; Olcaysu, Osman Okan; Gelincik, Ibrahim

    2014-01-01

    A 49-year-old woman developed a dark brown nodular mass in the lower eyelid. The lesion had grown fast for 2 months and then had remained stable in size. Excisional biopsy was performed. Histopathological examination of an excisional biopsy specimen pointed to proliferative vessels lined by increased endothelial cells without nuclear atypism. The nodular mass evaluated as a capillary hemangioma. PMID:25370407

  5. Detection of an ileal cavernous hemangioma by technetium-99m red blood cell imaging

    SciTech Connect

    Holloway, H.; Johnson, J.; Sandler, M.

    1988-01-01

    Patients with arteriovenous malformations of the bowel may have multiple symptoms secondary to chronic blood loss. A case of ileal cavernous hemangioma detected by Tc-99m labeled red blood cell imaging in the absence of active gastrointestinal bleeding is presented.

  6. Ovarian Hemangiomas Do Not Harbor EWSR1 Rearrangements: Clinicopathologic Characterization of 10 Cases.

    PubMed

    Schoolmeester, John Kenneth; Greipp, Patricia T; Keeney, Gary L; Soslow, Robert A

    2015-09-01

    Hemangiomas of the ovary are rare with a majority described as individual reports of unusual clinical presentations or morphologic findings. Both the expected and unexpected pathologic features of these tumors in the ovary are not well detailed. Therefore, we collected the largest series of ovarian hemangiomas to comprehensively define their clinicopathologic associations and examine the significance of hormone receptors in their pathogenesis. In addition, a novel EWSR1-NFATC1 fusion has recently been described in a case of hemangioma of bone. To our knowledge, EWSR1 rearrangement has not been evaluated in hemangiomas of other sites or in a case series. Accordingly, we used fluorescence in situ hybridization to investigate EWSR1 status in a majority of our cases. Clinical presentation was variable and dependent on tumor size. Patient age ranged 48 to 87 yr (median 63 yr). Tumors involved the right (n=6) and left (n=3) ovaries with laterality unknown in 1 case, and size ranged from 0.2 to 5.0 cm (median 1.0 cm). Three of 4 radiologic reports were either equivocal or could not exclude malignancy. Seven cases were of the cavernous type and 3 were mixed cavernous and capillary type. All lesions formed a single discrete, circumscribed mass that displaced the surrounding cortical stroma. The cavernous type showed dilated, thin-walled vessels and vascular thrombi, some of which were associated with dystrophic calcification. In addition to cavernous morphology, the mixed form exhibited features of capillary hemangioma such as lobulated growth of capillary-sized vascular spaces that lacked atypia or multilayering and were linked to a larger feeding vessel. Each tumor expressed CD31, CD34, FLI-1, ERG, but not D240. The hemangioma stromal cells, but not endothelium, expressed estrogen and progesterone receptors in every case. Stromal luteinization was seen in 2 cases. Follow-up ranged 1 to 139 mo and all patients were disease free. All cases were negative for EWSR1

  7. Minimal invasive method to treat hemangiomas of the oral cavity with a CO2 laser

    NASA Astrophysics Data System (ADS)

    Nicola, Ester M. D.; Nicola, Jorge H.; Gusmao, Reinaldo J.; Coutinho, Adriana A.; Cassitas, Nilceu P.

    1997-05-01

    During the last six years we have developed a new CO2 laser technique for the treatment of symptomatic oral cavity hemangioma. Our new technique, named 'laser encircling technique', has especially succeeded during hemangioma buccal maxillary surgeries. The treatment consisted in the application of a line of points of CO2 laser circling the lesion. Depending on the position and size of the lesion, we used from 0.4 to 4.0 Joules/mm2 laser energy density per pulse, causing reduction in the size of the lesion throughout the sclerosis of nutritional vessels which led to reduction in size, volume and color of the hemangiomas with no significant bleeding or inflammatory reaction. In this work forty male and female patients, twelve to fifty years old, presenting medium to small size hemangiomas situated in different sites of the oral cavity such as the tongue, mouth vestibule, pharynx, tonsil area and lips were treated by the procedure described above. The number of laser applications was defined by the peculiarities of each case, varying form 3 to 6 sessions at 4 week intervals, always under local or topic anesthesia. The patients complained about minimal posit operative discomfort and had good cicatrix evolution. The good results achieved by this technique lead to the conclusion that CO2 laser for these types of hemangioma is an efficient and very secure method of treatment. An important aspect of our technique is the fact that using relatively low laser power we do not perform real surgery but a less aggressive alternative of treatment.

  8. Proton or photon irradiation for hemangiomas of the choroid? A retrospective comparison

    SciTech Connect

    Hoecht, Stefan . E-mail: stefan.hoecht@charite.de; Wachtlin, Joachim; Bechrakis, Nikolaos E.; Schaefer, Christiane; Heufelder, Jens; Cordini, Dino; Kluge, Heinz; Foerster, Michael; Hinkelbein, Wolfgang

    2006-10-01

    Purpose: The aim of this study was to compare, on a retrospective basis, the results of therapy in patients with uveal hemangioma treated with photon or proton irradiation at a single center. Methods and Materials: From 1993 to 2002 a total of 44 patients were treated. Until 1998 radiotherapy was given with 6 MV photons in standard fractionation of 2.0 Gy 5 times per week. In 1998 proton therapy became available and was used since then. A dose of 20 to 22.5 Cobalt Gray Equivalent (CGE) 68 MeV protons was given on 4 consecutive days. Progressive symptoms or deterioration of vision were the indications for therapy. Results: Of the 44 patients treated, 36 had circumscribed choroidal hemangiomas and 8 had diffuse choroidal hemangiomas (DCH) and Sturge-Weber syndrome. Of the patients, 19 were treated with photons with a total dose in the range of 16 to 30 Gy. A total of 25 patients were irradiated with protons. All patients with DCH but 1 were treated with photons. Stabilization of visual acuity was achieved in 93.2% of all patients. Tumor thickness decreased in 95.4% and retinal detachment resolved in 92.9%. Late effects, although generally mild or moderate, were frequently detected. In all, 40.9% showed radiation-induced optic neuropathy, maximum Grade I. Retinopathy was found in 29.5% of cases, but only 1 patient experienced more than Grade II severity. Retinopathy and radiation-induced optic neuropathy were reversible in some of the patients and in some resolved completely. No differences could be detected between patients with circumscribed choroidal hemangiomas treated with protons and photons. Treatment was less effective in DCH patients (75%). Conclusions: Radiotherapy is effective in treating choroidal hemangiomas with respect to visual acuity and tumor thickness but a benefit of proton therapy could not be detected. Side effects are moderate but careful monitoring for side effects should be part of the follow-up procedures.

  9. Efficacy, safety and feasibility of ultrasound-guided percutaneous microwave ablation for large hepatic hemangioma.

    PubMed

    Tang, Xiao Yin; Wang, Zhi; Wang, Tao; Cui, Dan; Zhai, Bo

    2015-09-01

    To evaluate the efficacy, safety and feasibility of microwave ablation (MWA) for large (5-10 cm in diameter) hepatic hemangioma. In all, 46 patients with 47 large hepatic hemangiomas were treated with ultrasound-guided percutaneous MWA. The effect of MWA for all patients was evaluated by enhanced magnetic resonance imaging or computed tomography within two months after ablation. A total of 27 male and 19 female patients were enrolled, with an average age of 46 ± 11 years. The average size of hemangiomas was 6.3 ± 1.4 cm (range 5.0-9.6 cm). The initial complete ablation rate was 91.5% (43/47) and the volume of ablated lesions was significantly reduced. The rate of complete necrosis was not associated with the tumor size or location (P = 0.899 and 0.758, respectively). The total complete ablation rate was 95.7% (45/47). Major complications included acute renal dysfunction, hyperbilirubinemia and pleural effusion. No procedure-related death occurred. The average hospitalization stay was 5.7 ± 2.5 days (range 3-17 days). During a follow-up period of 18.2 months (range 4-40 months), one patient developed local tumor progression at the radiofrequency ablation site. Three patients had new hemangiomas in other sites of the liver. At the end of the study all patients were alive and no severe complications occurred. Image-guided MWA is an effective and safe treatment for large hepatic hemangiomas, and can potentially be regarded as the first-line therapy. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  10. Large cavernous hemangioma of the adrenal gland: Laparoscopic treatment. Report of a case.

    PubMed

    Agrusa, A; Romano, G; Salamone, G; Orlando, E; Di Buono, G; Chianetta, D; Sorce, V; Gulotta, L; Galia, M; Gulotta, G

    2015-01-01

    Cavernous hemangioma of the adrenal gland is a rare benign tumor. The diagnosis is often postoperative on histological exam with the presence of blood-filled, dilated vascular spaces. We report the clinical case of a 49 years-old woman who came to our observation with aspecific abdominal pain. A computed tomography (CT) abdominal scan revealed a 11cm right adrenal mass. This lesion was well circumscribed, round, encapsulated. After iodinated-contrast we observed a progressive, inhomogeneous enhancement without evidence of active bleeding and with pre-operative diagnosis of adrenal hemangioma. Laparoscopic adrenalectomy was performed by a transperitoneal flank approach. Pathological examination revealed a 11cm adrenal mass with extensive central necrotic areas mixed to sinusoidal dilation and fibrotic septa. Postoperative diagnosis was adrenal hemangioma. Adrenal hemangiomas occur infrequently. Generally these adrenal masses are non-functioning and there is no specific symptoms. Recent records demonstrate that laparoscopic adrenalectomy is technically safe and feasible for large adrenal tumors, but controversy exists in cases of suspected malignancy. We choose laparoscopic approach to adrenal gland on the basis of preoperative CT abdominal scan that excludes radiological signs of adrenocortical carcinoma (ACC) such as peri-adrenal infiltration and vascular invasion. Laparoscopic adrenalectomy is considered the standard treatment in case of diagnosis of benign lesions. In this case report we discussed a large adrenal cavernous hemangioma treated with laparoscopic approach. Fundamental is the study of preoperative endocrine disorders and radiologic findings to exclude signs of malignancy. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Oral propranolol therapy for infantile hemangiomas beyond the proliferation phase: a multicenter retrospective study.

    PubMed

    Zvulunov, Alex; McCuaig, Catherine; Frieden, Ilona J; Mancini, Anthony J; Puttgen, Kate B; Dohil, Magdalene; Fischer, Gayle; Powell, Julie; Cohen, Bernard; Ben Amitai, Dan

    2011-01-01

    Pharmacological therapies for infantile hemangiomas were considered effective only during the proliferative phases. Recently reported beneficial effects of propranolol may extend beyond the proliferative phase of infantile hemangiomas. The purpose of the study was to assess the effect of oral propranolol therapy for infantile hemangiomas beyond the proliferative phase of these lesions. Members of the Society for Pediatric Dermatology were invited to participate in a multicenter retrospective study. Only children with infantile hemangiomas with documented cessation of lesions' growth or those older than 12 months of age were eligible for the study. Clinical and demographic information and digital photographs before, at the start, and following the treatment were collected. Scaled panels of photographs were distributed among preselected experienced pediatric dermatologists. Visual analog scale was used to assess photographs for each case. Paired t-test was used for statistical analyses. Data on 49 eligible patients from eight pediatric dermatology centers was collected. Seven cases were excluded because of insufficient photographic documentation. The age of the patients at the start of propranolol therapy ranged 7 to 120 months (mean 28 mos, median 22 mos). The duration of propranolol therapy ranged 1 to 8 months (mean 3.6 mos). The mean visual analog scale score before the treatment was 6.8 ± 2.15, and mean reduction in the visual analog scale score at the assessment was 2.6 ± 1.74 (p < 0.001). The rate of visual analog scale reduction was 0.4 per month before the start of the therapy, while this rate was accelerated to 0.9 per months following the therapy (p < 0.001). No significant side effects were reported. We conclude that propranolol is effective in infantile hemangiomas, including post-proliferative phase, and should be considered as the first-line therapy in that setting.

  12. Case report: living donor liver transplantation for giant hepatic hemangioma using a right lobe graft without the middle hepatic vein

    PubMed Central

    2014-01-01

    Hepatic hemangioma patients with Kasabach-Merritt syndrome have reportedly been cured by liver transplantation. However, liver transplantation as a potential cure for a stable patient without Kasabach-Merritt syndrome remains debatable. We report the case of a 27-year-old female patient with a giant hepatic hemangioma. The hemangioma measured 50 × 40 × 25 cm in size and weighed 15 kg, which is the largest and heaviest hemangioma reported in the literature. The patient showed jaundice, ascites, anemia, and appetite loss; but no disseminated intravascular coagulation was observed through laboratory findings. We successfully operated using a right lobe graft without the middle hepatic vein from a 55-year-old donor. At the long-term follow-up, the patient experienced two acute rejections, which were confirmed by biopsy. However, the patient still survives with good graft function after 50 months. PMID:24708716

  13. A rare coexistence of adrenal cavernous hemangioma with extramedullar hemopoietic tissue: a case report and brief review of the literature

    PubMed Central

    Arkadopoulos, Nikolaos; Kyriazi, Maria; Yiallourou, Anneza I; Stafyla, Vaia K; Theodosopoulos, Theodosios; Dafnios, Nikolaos; Smyrniotis, Vassilis; Kondi-Pafiti, Agathi

    2009-01-01

    Background Cavernous hemangiomas of the adrenal gland are rare, benign, non-functioning neoplastic tumors. To our knowledge, 55 cases have been reported in the literature to date. Case presentation We report the first case of a large, non-functioning adrenal cavernous hemangioma that was incidentally found during the preoperative staging workup of a 75 year old woman with left breast adenocarcinoma. Imaging with US, CT scan and MRI showed a heterogeneous 8 cm mass with non-specific radiological features that was located on the left adrenal gland. The mass was surgically excised and pathology revealed an adrenal hemangioma with areas of extramedullar hemopoiesis. Conclusion Although adrenal hemangiomas are rare and their preoperative diagnosis is difficult, they should always be included in the differential diagnosis of adrenal neoplasms. PMID:19193247

  14. Hobnail Hemangioma (Superficial Hemosiderotic Lymphovascular Malformation) in Children: A Series of 6 Pediatric Cases and Review of the Literature.

    PubMed

    AbuHilal, Mohn'd; Breslavet, Max; Ho, Nhung; Taylor, Glenn; Pope, Elena

    2016-05-01

    Hobnail hemangioma is a small benign vascular malformation of the superficial and mid-dermis with variable clinical presentation. To review the clinical characteristics of hobnail hemangioma in pediatric patients. A retrospective chart review performed of all histopathologically confirmed cases of hobnail hemangioma from May 2000 to December 2014. Data on demographics, clinical characteristics, and results of immunohistochemical staining were collected. Four male and 2 female patients identified. Congenital lesions were reported in 3 cases. The most common anatomic location was the extremities. Treatment options included observation and surgical excision. Hobnail hemangioma is an uncommon benign vascular malformation. Due to its benign nature, treatment is not required. If treatment is indicated, complete surgical excision appears to be the most effective option. © The Author(s) 2015.

  15. [Spontaneous rupture of giant subcapsular hemangioma of the liver with hemoperitoneum and hemorrhagic shock: a case report].

    PubMed

    Griffa, Baldovino; Basilico, Valerio; Bellotti, Raffaele; Griffa, Andrea; Senatore, Sergio; Capriata, Giulio

    2005-01-01

    Cavernous hemangioma is the most common benign tumour of the liver and is found quite commonly during abdominal ultrasonography performed for other diseases. It is often asymptomatic and undergoes enlargement in fewer than 10% of cases. Spontaneous rupture of a giant hepatic hemangioma (diameter > 4 cm) with hemoperitoneum occurs very rarely. Only 32 cases have been reported in a recent review of the medical literature, with an operative mortality of more than 35%. We describe a new case of a giant subcapsular hemangioma localised in hepatic segments II and III in an 84-year-old woman, which ruptured spontaneously into the abdominal cavity and presented with hemoperitoneum and hypovolaemic shock. The hemangioma was diagnosed preoperatively by spiral CAT and treated successfully with emergency hepatic bisegmentectomy.

  16. A hemangioma of the cervix in childhood can be a harbinger of menorrhagia and infertility as an adult.

    PubMed

    Gada, Ravi P; Simmons, Patricia S; Wilson, Timothy O; Coddington, Charles C

    2014-12-01

    Early diagnosis of uterine hemangiomas may direct management decisions improving long-term outcome in children, adolescents and adulthood. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  17. Diagnostics of hemangioma by the methods of correlation and fractal analysis of laser microscopic images of blood plasma

    NASA Astrophysics Data System (ADS)

    Boychuk, T. M.; Bodnar, B. M.; Vatamanesku, L. I.

    2011-09-01

    For the first time the complex correlation and fractal analysis was used for the investigation of microscopic images of both tissue images and hemangioma liquids. It was proposed a physical model of description of phase distributions formation of coherent radiation, which was transformed by optical anisotropic biological structures. The phase maps of laser radiation in the boundary diffraction zone were used as the main information parameter. The results of investigating the interrelation between the values of correlation (correlation area, asymmetry coefficient and autocorrelation function excess) and fractal (dispersion of logarithmic dependencies of power spectra) parameters are presented. They characterize the coordinate distributions of phase shifts in the points of laser images of histological sections of hemangioma, hemangioma blood smears and blood plasma with vascular system pathologies. The diagnostic criteria of hemangioma nascency are determined.

  18. Diagnostics of hemangioma by the methods of correlation and fractal analysis of laser microscopic images of blood plasma

    NASA Astrophysics Data System (ADS)

    Boychuk, T. M.; Bodnar, B. M.; Vatamanesku, L. I.

    2012-01-01

    For the first time the complex correlation and fractal analysis was used for the investigation of microscopic images of both tissue images and hemangioma liquids. It was proposed a physical model of description of phase distributions formation of coherent radiation, which was transformed by optical anisotropic biological structures. The phase maps of laser radiation in the boundary diffraction zone were used as the main information parameter. The results of investigating the interrelation between the values of correlation (correlation area, asymmetry coefficient and autocorrelation function excess) and fractal (dispersion of logarithmic dependencies of power spectra) parameters are presented. They characterize the coordinate distributions of phase shifts in the points of laser images of histological sections of hemangioma, hemangioma blood smears and blood plasma with vascular system pathologies. The diagnostic criteria of hemangioma nascency are determined.

  19. Hepatic cavernous hemangioma: diagnosis with /sup 99m/Tc-labeled red cells and single-photon emission CT

    SciTech Connect

    Brodsky, R.I.; Friedman, A.C.; Maurer, A.H.; Radecki, P.D.; Caroline, D.F.

    1987-01-01

    During the performance of high-resolution real-time abdominal sonography, small echogenic hepatic masses are frequently discovered. A second imaging test to confirm the suspected diagnosis of hemangioma is often required. Planar labeled red-cell imaging will often not detect hemangiomas smaller than 3 cm. We studied 14 patients with labeled red-cell scintigraphy and single-photon emission CT (SPECT). Six hemangiomas were diagnosed by SPECT that would have been missed by planar imaging alone. All six were smaller than 2.5 cm. With the addition of SPECT, labeled red-cell scintigraphy has specificity and sensitivity that make it at least as reliable as dynamic CT for the noninvasive diagnosis of hepatic cavernous hemangioma.

  20. Surgical Treatment of Giant Liver Hemangioma Larger Than 10 cm: A Single Center's Experience With 86 Patients

    PubMed Central

    Zhang, Wei; Huang, Zhi-Yong; Ke, Chang-Shu; Wu, Chao; Zhang, Zhi-Wei; Zhang, Bi-Xiang; Chen, Yi-Fa; Zhang, Wan-Guang; Zhu, Peng; Chen, Xiao-Ping

    2015-01-01

    Abstract The ideal surgical treatment of giant liver hemangioma is still controversial. This study aims to compare the outcomes of enucleation with those of resection for liver hemangioma larger than 10 cm in different locations of the liver and establish the preoperative predictors of increased intraoperative blood loss. Eighty-six patients underwent enucleation or liver resection for liver hemangioma larger than 10 cm was retrospectively reviewed. Patient demographic, tumor characteristics, surgical indications, the outcomes of both surgical treatment, and the clinicopathological parameters influencing intraoperative blood loss were analyzed. Forty-six patients received enucleation and 40 patients received liver resection. Mean tumor size was 14.1 cm with a range of 10–35 cm. Blood loss, blood product usage, operative time, hepatic vascular occlusion time and frequency, complications and postsurgical hospital stay were similar between liver resections and enucleation for right-liver and left-liver hemangiomas. There was no surgery-related mortality in either group. Bleeding was more related to adjacency of major vascular structures than the size of hemangioma. Adjacency to major vascular structures and right or bilateral liver hemangiomas were independently associated with blood loss >550 mL (P = 0.000 and 0.042, respectively). Both enucleation and liver resection are safe and effective surgical treatments for liver hemangiomas larger than 10 cm. The risk of intraoperative blood loss is related to adjacency to major vascular structures and the location of hemangioma. PMID:26313792

  1. Large benign de novo conjunctival hemangioma in an 11-year-old boy: case report and literature review.

    PubMed

    Godfrey, Kyle J; Kinori, Michael; Lin, Johnathan H; Snyder, Vivian S; Granet, David B; Heichel, Christopher W; Robbins, Shira L

    2016-10-01

    Benign hemangiomas are rare vascular tumors of the conjunctiva that typically present clinically in the first few weeks of life and resolve spontaneously. De novo presentation later in childhood has not been well documented. We present the unusual case of an 11-year-old boy with a rapidly growing benign de novo conjunctival hemangioma that was treated with surgical excision. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. Identification of Signaling Systems in Proliferating and Involuting Phase Infantile Hemangiomas by Genome-Wide Transcriptional Profiling

    PubMed Central

    Calicchio, Monica L.; Collins, Tucker; Kozakewich, Harry P.

    2009-01-01

    Infantile hemangiomas are characterized by rapid capillary growth during the first year of life followed by involution during early childhood. The natural history of these lesions creates a unique opportunity to study the changes in gene expression that occur in the vessels of these tumors as they proliferate and regress. Here we use laser capture microdissection and genome-wide transcriptional profiling of vessels from proliferating and involuting hemangiomas to identify differentially expressed genes. Relative to normal placental vessels, proliferating hemangiomas were characterized by increased expression of genes involved in endothelial-pericyte interactions, such as angiopoietin-2 (ANGPT2), jagged-1 (JAG1), and notch-4 (NOTCH4), as well as genes involved in neural and vascular patterning, such as neuropilin-2 (NETO2), a plexin domain containing receptor (plexinC1), and an ephrin receptor (EPHB3). Insulin-like growth factor binding protein-3 (IGFBP3) was down-regulated in proliferating hemangiomas. Involuting hemangiomas were characterized by the expression of chronic inflammatory mediators, such as the chemokine, stromal cell-derived factor-1 (SDF-1), and factors that may attenuate the angiogenic response, such as a member of the Down syndrome critical region (DSCR) family. The identification of genes differentially expressed in proliferating and involuting hemangiomas in vivo will contribute to our understanding of this vascular lesion, which remains a leading cause of morbidity in newborn children. PMID:19349369

  3. Giant Cavernous Hepatic Hemangioma Diagnosed Incidentally in a Perimenopausal Obese Female with Endometrial Adenocarcinoma: A Case Report.

    PubMed

    Bara, Tivadar; Gurzu, Simona; Jung, Ioan; Muresan, Mircea; Szederjesi, Janos; Bara, Tivadar

    2016-02-01

    Hemangiomas are the most common benign tumors of the liver, considered giant when they exceed 50-100 mm in diameter. In the present report, we present a case of a 5.2-kg hemangioma of the right hepatic lobe, with hemangiomatous foci in the left lobe, which was incidentally diagnosed in a 53-year-old obese female hospitalized for uterine bleeding. The computed tomographic scan and physical examination revealed a giant abdominal tumor and hepatic hemangioma of the right hepatic lobe was suspected. Right hepatectomy and total hysterectomy with bilateral ovariectomy was performed. The histological examination of the surgical specimens confirmed the extremely giant cavernous hepatic hemangioma, and a synchronous pT1a endometrioid endometrial adenocarcinoma was also diagnosed. The patient remains alive without postoperative disorders, 6 months after surgery. To our knowledge, this is the first reported case of such huge hemangioma incidentally diagnosed in an obese female, with a synchronous endometrial adenocarcinoma of the uterus. Because obesity may cause hyperestrogenism, it might both increase the growth rate of hemangioma and the genesis of endometrial cancer in perimenopausal females. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  4. Pharmacological therapies for infantile hemangiomas: A clinical study in 853 consecutive patients using a standard treatment algorithm.

    PubMed

    Zhang, Ling; Yuan, Wei-En; Zheng, Jia-Wei

    2016-02-15

    Infantile hemangiomas are the most common infantile benign vascular tumor. While most infantile hemangiomas proliferate then involute, some may persist and require treatment for reasons including risk of disfigurement or functional impairment. Treatments currently include observation, pharmacological therapy, laser, cryosurgery, surgery and radiotherapy. Although pharmacological therapy is a well accepted treatment option, limited studies have evaluated the efficacy of different drug therapies. In this study, we compare different pharmacological modalities in the management of infantile hemangiomas. The study included 853 infants with proliferative infantile hemangiomas who were treated with topical timolol, oral propranolol, intralesional pingyangmycin, or intravenous vincristine from 2009 to 2012. Treatment stratification was based on clinical severity of the tumor. Response to the treatment was clinically evaluated and graded as: excellent, good, poor, or no response. Response to pharmacological therapies was excellent in almost all infantile hemangiomas. In addition, patients younger than 8 months responded highly to pharmacological treatment (89.1%), while patients older than 8 months were less responsive to treatment (36.3%). There were no instances of life-threatening complications. Overall, these findings support the efficacy of timolol, propranolol, pingyangmycin and vincristine in the treatment of infantile hemangiomas, especially in the youngest patient cohort (8 months or younger).

  5. Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis.

    PubMed

    Rizzo, Carina; Brightman, Lori; Chapas, Anne M; Hale, Elizabeth K; Cantatore-Francis, Julie L; Bernstein, Leonard J; Geronemus, Roy G

    2009-12-01

    Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes. To evaluate outcomes of hemangiomas treated with the most current laser technology. A retrospective chart analysis of 90 patients with a median age of 3.0 months and a total of 105 hemangiomas were enrolled over a 2.5-year period. All were treated with the 595-nm long-pulse pulsed-dye laser (LP-PDL) with dynamic epidermal cooling at 2- to 8-week intervals depending on the stage of growth. Exclusion criteria were previous laser, surgical, or corticosteroid treatment. Three reviewers assessed outcomes. Near-complete or complete clearance in color were achieved for 85 (81%) and in thickness for 67 (64%) hemangiomas. There was no scarring or atrophy. Ulceration occurred in one case and resolved during treatment. Hyperpigmentation and hypopigmentation occurred in 4% and 14% of hemangiomas, respectively. Early treatment of childhood hemangiomas with the 595-nm LP-PDL with dynamic cooling may reduce the proliferative phase and result in excellent rates of clearing and few adverse events.

  6. Phase II Study to Assess the Efficacy of Hypofractionated Stereotactic Radiotherapy in Patients With Large Cavernous Sinus Hemangiomas

    SciTech Connect

    Wang Xin; Liu Xiaoxia; Mei Guanghai; Dai Jiazhong; Pan Li; Wang Enmin

    2012-06-01

    Purpose: Cavernous sinus hemangioma is a rare vascular tumor. The direct microsurgical approach usually results in massive hemorrhage. Although radiosurgery plays an important role in managing cavernous sinus hemangiomas as a treatment alternative to microsurgery, the potential for increased toxicity with single-session treatment of large tumors is a concern. The purpose of this study was to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas. Methods: Fourteen patients with large (volume >20 cm{sup 3}) cavernous sinus hemangiomas were enrolled in a prospective Phase II study between December 2007 and December 2010. The hypofractionated stereotactic radiotherapy dose was 21 Gy delivered in 3 fractions. Results: After a mean follow-up of 15 months (range, 6-36 months), the magnetic resonance images showed a mean of 77% tumor volume reduction (range, 44-99%). Among the 6 patients with cranial nerve impairments before hypofractionated stereotactic radiotherapy, 1 achieved symptomatic complete resolution and 5 had improvement. No radiotherapy-related complications were observed during follow-up. Conclusion: Our current experience, though preliminary, substantiates the role of hypofractionated stereotactic radiotherapy for large cavernous sinus hemangiomas. Although a longer and more extensive follow-up is needed, hypofractionated stereotactic radiotherapy of 21 Gy delivered in 3 fractions is effective in reducing the tumor volume without causing any new deficits and can be considered as a treatment modality for large cavernous sinus hemangiomas.

  7. Laser treatment of infantile hemangioma: A systematic review.

    PubMed

    Chinnadurai, Sivakumar; Sathe, Nila A; Surawicz, Tanya

    2016-03-01

    To systematically review studies of laser treatment of infantile hemangioma (IH). We searched multiple databases including MEDLINE® and EMBASE from 1982 to June 2015. Two investigators independently screened studies against predetermined criteria and extracted key data. Investigators independently assessed study risk of bias and the strength of the evidence of the body of literature. We identified 29 studies addressing lasers: 4 randomized controlled trials, 8 retrospective cohort studies, and 17 case series. Lasers varied across studies in type, pulse width, or cooling materials. Most comparative studies (n = 9) assessed variations of pulsed dye laser (PDL) and examined heterogeneous endpoints. Most studies reported on treatment of cutaneous lesions. Overall, longer pulse PDL with epidermal cooling was the most commonly used laser for cutaneous lesions; Nd:YAG was the most commonly used intralesionally. Most studies reported a higher success rate with longer pulse PDL compared with observation in managing the size of IH, although the magnitude of effect differed substantially. CO2 laser was used for subglottic IH in a single study, and was noted to have a higher success rate and lower complication rate than both Nd:YAG and observation. Studies comparing laser with β-blockers or in combination with β-blockers reported greater improvements in lesion size in combination arms versus β-blockers alone and greater effects of lasers on mixed superficial and deep IH. Strength of the evidence for outcomes after laser treatments ranged from insufficient to low for effectiveness outcomes. Strength of the evidence was insufficient for the effects of laser compared with β-blockers or in combination with β-blockers as studies evaluated different agents and laser types. Studies assessing outcomes after CO2 and Nd:YAG lasers typically reported some resolution of lesion size, but heterogeneity among studies limits our abilities to draw conclusions. Studies of laser

  8. Use of Propranolol for Treating Hemangiomas in Infants with Previously Diagnosed Hypoglycemic Conditions.

    PubMed

    Yang, Ting-Lin B; McMahon, Patrick; De Léon, Diva D; Treat, James R

    2016-11-01

    Infantile hemangiomas (IHs) are the most common pediatric vascular tumors. They require therapy when they cause severe complications such as ulceration, amblyopia, or airway constriction. Propranolol is the only treatment that the U.S. Food and Drug Administration has approved for complicated IHs and has become first-line therapy for IHs that need to be treated. Older therapies such as systemic corticosteroids and surgery are now rarely used. Propranolol can have potentially serious adverse side effects, including bradycardia, hypotension, and hypoglycemia. There is sparse literature on the use of propranolol for IHs in patients with preexisting hypoglycemic conditions. We report three cases of infants with preexisting hypoglycemic conditions requiring diazoxide whose complicated hemangiomas were successfully and safely treated with oral propranolol. © 2016 Wiley Periodicals, Inc.

  9. Arborizing vessels in a targetoid hemosiderotic hemangioma: mistaken dermoscopic diagnosis of basal cell carcinoma

    PubMed Central

    Enei, María L.; Paschoal, Francisco M.; Valdes, Rodrigo

    2017-01-01

    Targetoid hemosiderotic hemangioma (THH) or hobnail hemangioma (HH) is a benign vascular lesion that presents with the classical clinical presentation of a ring-shaped tumor having a targetoid appearance, with a central purple-brown papule surrounded by a thin pale area and an ecchymotic ring on the outside. Dermoscopic features and patterns of HH have been documented and have proven to be sufficient to establish a clinical diagnosis in many cases. We present a facial lesion in which both the clinical presentation and dermoscopy were atypical. The presence of arborizing vessels in the dermoscopic pattern, never before described for this lesion, led us to the diagnosis of basocellular carcinoma (BCC). We also report the changes in this pattern experienced over 12 months of progression and their correlation with the histopathologic findings. PMID:28243494

  10. Giant primary calvarial hemangioma over torcula: Radiological features and operative nuances

    PubMed Central

    Mohindra, Sandeep; Kapoor, Ankur; Mitra, Suvradeep; Nahar, Uma

    2016-01-01

    Background: Although rare, primary calvarial hemangioma is a known entity, surgical excision of which usually results in massive blood loss. Successful total excision of such a lesion remains a challenge, especially when these are in close vicinity of major venous sinuses. Case Description: Authors describe a rare case of intra-osseous occipital cavernoma along with radiological findings in a 50-year-old male. En bloc resection of tumor was performed using a high-speed pneumatic drill and no recurrence was noted at 6 months of follow-up. Conclusion: Intra-osseous cavernous hemangiomas have classical radiological features and can be excised completely, even when lying above major venous drainage channels like torcula. PMID:27308094

  11. Aggressive hemangioma of the spine in a pregnant female: a case report and literature review.

    PubMed

    Demirkale, İsmail; De Iure, Federico; Terzi, Silvia; Gasbarrini, Alessandro

    2016-01-01

    Type and timing of treatment for symptomatic hemangiomas in pregnant females are challenging due to fetus survival and conflicts in neurological recovery. In this article, we report a 40-year-old female patient at pregnancy week 23 with a complicated hemangioma at T1 level. Physical examination revealed an incomplete spastic paraplegia. Patient did not accept any surgery due to child's death risk. Patient was started corticoid treatment and no more weight bearing was allowed. At the 28th week of pregnancy, the patient underwent cesarean section immediately followed by selective arterial embolization, decompression, fixation, and radiotherapy. At two-year follow-up, the patient was pain free, without any signs of local recurrence and with complete neurological recovery. A multidisciplinary approach is mandatory to save the life of the fetus without damaging the spinal cord functions of the mother.

  12. Ruptured Hemangioma of a Native Kidney: An Unusual Cause of Postoperative Hemorrhage in Kidney Transplant Recipients.

    PubMed

    Poznańska, Grażyna; Wlazlak, Michał; Hogendorf, Piotr; Szymański, Dariusz; Strzelczyk, Janusz; Durczyński, Adam

    2017-03-14

    BACKGROUND Retroperitoneal bleeding as a consequence of non-traumatic kidney or allograft rupture is well known, but there are no reports on hemorrhagia from a native kidney after allogeneic renal transplantation. Therefore, we present the first such case to be published and highlight the possibility of this complication after renal transplantation. CASE REPORT We report the case of a 28-year-old male patient who developed early post-transplant hemorrhagia from a ruptured native kidney. The patient underwent left-sided nephrectomy. Histopathological examination revealed ruptured hemangioma of the patient's native left kidney. The further postoperative period was not complicated. The patient was discharged on the 18th postoperative day, with good transplant function. CONCLUSIONS Transplantologists should be aware of the fact that in patients with uncontrolled blood pressure, native kidney hemangioma may rupture in the early post-transplant period, and it can be a life-threating and difficult to diagnose complication.

  13. Interventional Treatment of a Symptomatic Neonatal Hepatic Cavernous Hemangioma Using the Amplatzer Vascular Plug

    SciTech Connect

    Kretschmar, Oliver Knirsch, Walter; Bernet, Vera

    2008-03-15

    Percutaneous intervention is one treatment option for symptomatic hepatic hemangioma in infants. We report the case of a newborn (birth weight 4060 g) with a large hepatic cavernous hemangioma, which presented early with high cardiac output failure due to arteriovenous shunting and signs of incipient Kasabach-Merritt syndrome. We performed a successful superselective transcatheter coil embolization of three feeding arteries on the seventh day of life. Because of remaining diffuse very small arteries causing a relevant residual shunt, additional occlusion of the three main draining veins was necessary with three Amplatzer vascular plugs. Cardiac failure resolved immediately. Without any additional therapy the large venous cavities disappeared within the following months. The tumor continues to regress in size 8 months after the intervention.

  14. Near-infrared laser treatment of complicated hemangiomas in children: ten-year clinical experience

    NASA Astrophysics Data System (ADS)

    Abushkin, Ivan A.; Privalov, Valeriy A.; Lappa, Alexander V.

    2011-03-01

    Results of application of low invasive laser technology (developed by authors: Proc. SPIE 5863, 107-115 (2005), Russian Federation patent No.2290228 of.27.12.06) to treatment of hemangiomas in children are presented and analyzed in this work. From 2001 the technology was applied to about 1500 children with more than 2000 hemangiomas. Majority of them were complicated ones: belong to cavernous or combined types or (and) were localized on problem places: on face near eyes, nose, and lips, on auricles, on perineum near anus and genitals, in respiratory and gastrointestinal tracts. Diode laser with wavelength 920, 970, and 1060 nm at distant and interstitial irradiation were applied. In case of need there applied endoscopes. Excellent and good results have been achieved in 94% cases; there was a significant improvement in the rest cases.

  15. Social Impact of Facial Infantile Hemangiomas in Preteen Children.

    PubMed

    Costa, Victoria A; Haimowitz, Rachel; Cheng, Yao I; Wang, Jichuan; Silverman, Robert A; Bauman, Nancy M

    2016-01-01

    Involuted infantile facial hemangiomas (IHs) may adversely affect the social skills of children. To assess the social impact of involuted facial IHs, with or without prior treatment, in preteen children. An observational, cross-sectional study of social anxiety and skills in preteen children with facial IHs diagnosed during infancy. The study took place in an academic institution and a community dermatology practice between January 1, 2013, and July 30, 2014. Records on 236 children with IHs located in a cosmetically sensitive area were identified; of those, 144 potential participants (parents) were reached by telephone and mailed study packets. Thirty completed questionnaires were returned. Data analysis was performed from August 1, 2014, to September 7, 2015. The questionnaires included the following psychiatric scales: (1) Social Anxiety Scale for Children-Revised (SASC-R), completed by parents and children, including the domains of Fear of Negative Evaluation and Social Avoidance/Distress in New Situations (SAD-New) (higher scores indicate greater social anxiety), and (2) Social Competency Inventory (SCI), completed by parents, including the domains of Prosocial Behavior and Social Initiative (lower scores indicate poorer social competency). Demographics, clinical details, and survey responses were collected. Analysis was conducted using t tests to compare scores for each survey domain with established normative data and between sex as well as between treatment vs nontreatment groups. Of the 144 potential participants, 30 (21%) responded. The mean age of the preteen subjects was 10.0 years (range, 5.4-12.9 years) with a 2:1 female to male ratio. Twenty-five children (83%) had a single IH, and the remaining 5 participants (17%) had multiple IHs, with at least 1 IH in a cosmetically sensitive area. The periocular region was the most common site of the IH (10 [33%]), followed by the nose (6 [20%]), cheek (5 [17%]), forehead (4 [13%]), lip or perioral region (4 [13

  16. Role of oral propranolol in the treatment of infantile subglottic hemangioma.

    PubMed

    Li, Xiao-Yan; Wang, Ying; Jin, Lei; Chen, Jia-Rui

    2016-09-01

    To determine the efficacy of oral propranolol for the treatment of infantile subglottic hemangioma. 17 children (13 females and 4 males) with a median age at onset of treatment of 5 months were included in this study. Propranolol was administered after the presence of subglottic hemangioma was confirmed by laryngoscopy and a CT scan of the trachea with contrast. Propranolol was started at 1 mg/kg per day divided into 3 doses. Heart rate and blood pressure were monitored during treatment. If no side effects were observed, then the dose was increased to 1.5 mg/kg per day on the second day. 14 patients (82%) showed clinical improvement within 1 week of treatment initiation. In each of these patients, the diameter of the subglottic stenosis caused by the hemangioma decreased, and the hemangioma became lighter in color. Two children with cutaneous hemangiomata also exhibited significant improvements in their cutaneous lesions after treatment. One patient's treatment was stopped after 2 weeks for personal reasons (family issue). After treatment cessation, this patient's respiratory symptoms recurred and increased in severity over the next 2 weeks. The patient was restarted on propranolol, and the symptoms disappeared. One patient only partially responded to propranolol. One patient continued with a tracheostomy for 15 months due to the diffuse nature of the lesion and was just recently decannulated. One patient initially did not respond to propranolol and developed residual disease after open resection; this patient finally responded to propranolol after 6 months of therapy and was recently weaned off the drug. Oral propranolol is a safe and effective treatment for infantile subglottic hemangiomata and may be used as a first-line therapeutic modality.

  17. Alveolar soft part sarcoma following radiotherapy for a spinal hemangioma. A case report

    SciTech Connect

    Wang, S.; Mirra, J.; Bhuta, S.

    1984-06-15

    A case of alveolar soft part sarcoma arising some 20 years later in a site previously irradiated as a treatment for a spinal cord hemangioma is described. This is the first known case of radiation-associated alveolar soft part sarcoma, and it fulfills the criteria for a tumor to be radiation-induced. The coincidental finding of ''viral-like'' particles within some of the tumor cells was noted.

  18. Subcutaneous Lobular Capillary Hemangioma on 68Ga-PSMA PET/CT.

    PubMed

    Jochumsen, Mads Ryø; Vendelbo, Mikkel Holm; Høyer, Søren; Bouchelouche, Kirsten

    2017-04-01

    We present a case of a subcutaneous process in the abdominal wall with high prostate-specific membrane antigen (PSMA) activity on Ga-PSMA PET/CT. Histology demonstrated a benign lobular capillary hemangioma with a high vascular density, with highly PSMA-positive endothelial cells. It is well known that PSMA is expressed in different tissue, including neovasculature in various malignant tumors, and the knowledge is rapidly evolving as new discoveries appear.

  19. Propranolol therapy for infantile hemangioma is less toxic but longer in duration than corticosteroid therapy

    PubMed Central

    Sawa, Kathryn; Yazdani, Arjang; Rieder, Michael J; Filler, Guido

    2014-01-01

    BACKGROUND: Infantile hemangioma is the most common benign, self-limiting tumour of childhood. Treatment is reserved for hemangiomas that obstruct vital structures or cause significant disfigurement. Traditionally, corticosteroids have been the medical treatment of choice. Since 2008, however, propranolol has been rapidly adopted as an effective pharmacological treatment for infantile hemangioma. Published data regarding the long-term side effects of propranolol are currently lacking. OBJECTIVE: To describe the long-term effects of propranolol and corticosteroids on anthropometric measurements (height, body mass index [BMI]) and blood pressure in children. METHODS: A prospective database analysis of all infantile hemangioma patient visits to the pediatric vascular abnormality clinic at the authors’ institution between October 2007 and February 2012 was performed. Anthropometric measures (height and BMI) and blood pressure were analyzed. RESULTS: A total of 290 visits (119 patients) to the pediatric vascular abnormality clinic were reviewed. Of these, 18 patients received medical treatment and their anthropometry was analyzed. BMI percentile increased significantly in patients treated with corticosteroids (P=0.0039). Corticosteroid treatment also resulted in a significant decrease in height percentile (P=0.0078). Anthropometric measures did not cross percentiles in children treated with propranolol. A significant decrease in systolic blood pressure was noted in the propranolol group (P=0.03), but no hypotensive values were recorded. Median treatment duration was significantly longer when patients received propranolol (372 versus 133 days; P=0.0033). CONCLUSION: Propranolol for the treatment of infantile vascular abnormalities does not share the unfavourable effects on patient anthropometry that corticosteroids exhibit; however, a longer duration of therapy is required. PMID:25535459

  20. Incidentally Diagnosed Multiple Vascular Lesions of the Spleen: Littoral Cell Angioma or Hemangioma?

    PubMed

    Aydin, Emrah

    2016-01-01

    Vascular lesions of the solid abdominal viscera may pose diagnostic and management issues. A 16-year old girl admitted to emergency department due to recurrent abdominal pain and diagnosed to have multiple vascular malformations of the spleen on imaging investigations. Littoral cell angioma was preoperative suspicion owing to no response of the vascular lesion to the propranolol. It turned out to be cavernous hemangioma on histopathology.

  1. Propranolol inhibits endothelial progenitor cell homing: a possible treatment mechanism of infantile hemangioma.

    PubMed

    Zou, Hai-Xiao; Jia, Jun; Zhang, Wen-Feng; Sun, Zhi-Jun; Zhao, Yi-Fang

    2013-01-01

    Propranolol effectively treats infantile hemangioma, but its mechanisms of action remain poorly understood. Although the antiangiogenesis role of propranolol has been previously demonstrated, several lines of evidence suggest that this therapeutic agent may affect the neovascular formation in infantile hemangioma by targeting vasculogenesis. In addition, the homing of endothelial progenitor cells to the lesion of infantile hemangioma plays an important role during the process of vasculogenesis. The purpose of this study was to investigate whether propranolol inhibits the vasculogenesis in infantile hemangioma by targeting endothelial progenitor cells recruitment. Endothelial progenitor cells were treated with different concentrations (0, 1, 5, 10, 20, 40, 60, 80, 100 μM) of propranolol for indicated times (24, 48, 72 h). Cell proliferation and viability were assessed by MTT assay and trypan blue staining. Cell migration was determined by wound healing assay and Boyden chamber assay. The expression levels of extracellular signal regulated kinase, phospho-extracellular signal regulated kinase, Akt, and phospho-Akt were measured by Western blot analysis to explore the molecular mechanism of propranolol on endothelial progenitor cells. In addition, the expression of CXCR4 was measured by Western blot and reverse transcriptase polymerase chain reaction. Propranolol did not significantly affect the proliferation of endothelial progenitor cells. It inhibited stromal-cell-derived factor 1α-induced migration of endothelial progenitor cells through the Akt and MAPK pathways and the expression of CXCR4 in a dose- and time-dependent manner. In addition, the expression of CXCR4 was suppressed by propranolol most likely through the Akt and MAPK pathways. Propranolol inhibits stromal-cell-derived factor 1α-induced endothelial progenitor cell homing by suppressing the expression of CXCR4 most likely through the Akt and MAPK pathways. Copyright © 2013 Elsevier Inc. All rights

  2. Intracranial Capillary Hemangioma in the Posterior Fossa of an Adult Male

    PubMed Central

    2016-01-01

    Intracranial capillary hemangioma (ICH) is a rare entity, with approximately 24 reported cases in the literature. There are only three reported cases of ICH in an adult male. In this case report, we describe the fourth documented case of ICH in an adult male and, to the best of our knowledge, the first ever documented case of ICH in the posterior fossa of an adult male. We also discuss its imaging appearance and differential diagnosis. PMID:27747124

  3. Giant hepatic hemangioma and cross-fused ectopic kidney in a spaceflight participant.

    PubMed

    Jennings, Richard T; Garriott, Owen K; Bogomolov, Valery V; Pochuev, Vladimir I; Morgun, Valery V; Garriott, Richard A

    2010-02-01

    Commercial spaceflight participants are typically older than traditional astronauts and often have medical conditions that make medical certification for flight difficult. This case report considers a 43-yr-old spaceflight participant who planned a short-duration Soyuz flight to the International Space Station (ISS). While he participated in many hazardous activities such as parachuting, hang gliding, scuba diving, Antarctic and jungle exploration, and deep sea submersible operations, he knew that several of his medical conditions precluded serving as a career astronaut. At the time of his initial spaceflight prescreen examination, he was known to have previous bilateral photorefractive keratectomy (PRK) for myopia and a cross-fused left ectopic kidney that would be disqualifying for a career astronaut. During the evaluation for the left single cross-fused ectopic kidney, a giant hepatic hemangioma was also discovered. In order to medically qualify for flight, the giant hepatic hemangioma was surgically removed. This case summary investigat*es the implications of a single cross-fused left ectopic kidney and the decision process and treatment implications for spaceflight medical certification in an individual with an asymptomatic giant hepatic hemangioma.

  4. Effects of systemic propranolol treatment on physical growth of patients with infantile hemangiomas.

    PubMed

    Hu, Li; Zhou, Bingrui; Huang, Huizhen; Chang, Lei; Qiu, Yajing; Ma, Gang; Chen, Hui; Jin, Yunbo; Xu, Xiu; Lin, Xiaoxi; Li, Wei

    2016-10-01

    Propranolol has been widely used in the treatment of infantile hemangiomas since 2008. This study aimed to investigate complications of systemic propranolol therapy for infantile hemangiomas, especially its effect on infants' physical growth. In this study, propranolol was given at a dose of 2 mg/kg per day. Abnormal symptoms and growth parameters were recorded in detail during the therapy. Follow-up visits were arranged to continue at least through the age of 2 years. A total of 76 patients with complete growth parameters were enrolled into the study. Complications of propranolol were minor, and mainly included sleeping disorders, diarrhea, decrease in fasting glucose, bronchial hyperactivity and hyperkalemia. Four (5.26%) patients' growth curve dropped off more than 20 percentiles during therapy and half of them returned to normal after withdrawal of the medications. None of them suffered from underweight, wasting or stunning when medication was stopped. Systemic propranolol was proved to be a safe treatment for problematic infantile hemangiomas and did not affect the physical growth. © 2016 Japanese Dermatological Association.

  5. Glomeruloid hemangioma. A distinctive cutaneous lesion of multicentric Castleman's disease associated with POEMS syndrome.

    PubMed

    Chan, J K; Fletcher, C D; Hicklin, G A; Rosai, J

    1990-11-01

    A histologically distinctive cutaneous hemangioma occurring in two patients with biopsy-proven multicentric Castleman's disease associated with POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) syndrome are reported. The lesions were multiple, and appeared as red to purple papules over the trunk and proximal limbs. Microscopically, ecstatic dermal vascular spaces were seen filled with aggregates of capillaries, resulting in structures reminiscent of renal glomeruli. Interspersed between the blood-filled capillary loops were plump "stromal" cells possessing clear vacuoles and periodic acid-schiff-positive eosinophilic globules. These cells had the immunohistochemical profile of endothelial cells (positivity for factor VIII-related antigen, and negativity for leukocyte common antigen, macrophage marker, and muscle-specific actin), and probably represented immature elements that had accumulated immunoglobulins and other proteinaceous material from the circulation. Because vascular lesions may appear before the full-blown POEMS syndrome develops, we suggest careful evaluation and follow-up of all patients presenting with glomeruloid hemangioma or cherry-type capillary hemangioma with focal glomeruloid features for potential development of this syndrome.

  6. Cryogen spray cooling and pulsed dye laser treatment of cutaneous hemangiomas.

    PubMed

    Chang, C J; Kelly, K M; Nelson, J S

    2001-06-01

    When a cryogen spurt is applied to the skin surface for tens of milliseconds, cooling remains localized in the epidermis, leaving the temperature of deeper hemangioma vessels unchanged. The objective of this study was to compare the efficacy and safety of noncooled laser treatment (NC-LT) vs. cryogen spray cooling plus laser treatment (CSC-LT) for cutaneous hemangiomas in a large series of patients. A retrospective review was conducted of 164 patients treated with the pulsed dye laser (lambda = 585 nm; taurho = 450 microsec) over an 8-year period. Eighty-two patients received NC-LT using light doses of 5.5 to 8 J per square centimeter. Subsequently, 82 patients received CSC-LT using light doses of 9 to 10 J per square centimeter. The primary efficacy measure was quantitative assessment of improvements in lesional volume, texture, and color. Safety was evaluated for each treatment group by monitoring for adverse effects. Based on chi-squared analysis, there were clinical and significant differences in the number of treatments (p = 0.001), and improvement in volume (p = 0.008) and texture (p = 0.001) of the CSC-LT group compared with the NC-LT group. Permanent adverse effects were not observed in either group. In conclusion, CSC permitted the use of higher incident light doses for treatment of cutaneous hemangiomas, resulting in fewer treatments required and better improvement in lesional volume and texture.

  7. Rare case of adult pancreatic hemangioma and review of the literature

    PubMed Central

    Lu, Tao; Yang, Cheng

    2015-01-01

    Pancreatic hemangiomas are a rare type of cystic tumor, with very few cases reported in the literature. Herein, we present the case of a 28-year-old woman who was admitted to our hospital for abdominal pain. A physical examination failed to reveal any abnormalities that could explain her symptoms. A contrast-enhanced computed tomography showed a multilocular cyst with moderately enhanced septa and fluid-fluid levels in the body and tail of the pancreas. A serous cystadenoma or pseudocyst of the pancreas was initially suspected, and the patient underwent a subtotal pancreatectomy and splenectomy. The pathologic diagnosis was a pancreatic hemangioma. This is the second case of pancreatic hemangioma with fluid-fluid levels reported in the literature. Upon imaging, the presentation of this tumor can resemble serous or mucinous cystadenomas, pseudocysts of the pancreas, and side-branch type intraductal papillary mucinous neoplasms. This report reviews the clinical symptoms, radiologic features, pathologic characteristics, differential diagnoses, and treatment of this rare lesion type. PMID:26290651

  8. Differentiation of hepatic metastases from hepatic hemangiomas and cysts by using MR imaging.

    PubMed

    Wittenberg, J; Stark, D D; Forman, B H; Hahn, P F; Saini, S; Weissleder, R; Rummeny, E; Ferrucci, J T

    1988-07-01

    T1-weighted and T2-weighted pulse sequences were employed for MR imaging of hepatic metastatic tumors (98 patients), hemangiomas (24 patients), and cysts (seven patients); a 0.6-T superconducting magnet was used. In a retrospective study, signal intensity and morphology were used to establish criteria for differentiating metastases from hemangiomas and cysts. The signal intensity of the lesion alone failed to be an etiologic discriminator because over 96% of all masses had a signal intensity less than that of liver on T1-weighted sequences, and at least 90% had a signal intensity greater than that of liver on T2-weighted sequences. Morphologic features depicted on T2-weighted images were more specific than those depicted on T1-weighted images in differential diagnosis. Amorphous, target, and halo signs and a change in morphology were present only in metastatic disease, with a frequency of 45%, 27%, 13%, and 12%, respectively. Two other morphologic patterns--doughnut and lightbulb signs--were found to have overlapping causes. Overall, at least one of the specific signs was observed in 92% of patients with metastatic disease. These data suggest that T2-weighted pulse sequences are essential for discriminating between hepatic metastases and hepatic hemangiomas and cysts. MR imaging is a promising technique for distinguishing these lesions.

  9. The transconjunctival approach to a large retrobulbar cavernous hemangioma of the orbit.

    PubMed

    Kim, Yeong Hoon; Baek, Sun Hee; Choi, Woong Chul

    2002-06-01

    Cavernous hemangiomas are one of the most common benign tumors of the orbit in adults. We report a case of a longstanding retrobulbar hemangioma that was removed successfully through a temporal transconjunctival approach combined with lateral canthotomy. A 45-year-old female patient, with a 15-year history of slowly progressive proptosis and decreased visual acuity of the left eye, had a corrected visual acuity of finger count at 50 cm OS, compared with 1.0 OD. Exophthalmometry by the Nagle's method measured 15 mm OD by 26 mm OS. Magnetic resonance imaging (MRI) revealed a well-encapsulated retrobulbar main mass, 2.3 x 3.0 x 3.7 cm in size along with multiple small satellite nodules that were displacing the optic nerve and globe superiorly. The tumors were removed through a superotemporal transconjunctival approach combined with lateral canthotomy. Pathological examination revealed an intraorbital cavernous hemangioma. The patient was free of visible scars, proptosis and any other noticeable complications at her last follow-up, 6 months after surgery.

  10. Utility of the Hemangioma Severity Scale as a Triage Tool and Predictor of Need for Treatment.

    PubMed

    Mull, Jamie L; Chamlin, Sarah L; Lai, Jin-Shei; Beaumont, Jennifer L; Cella, David; Rancour, Elizabeth A; Baselga, Eulalia; Haggstrom, Anita N

    2017-01-01

    Infantile hemangiomas (IHs) are commonly encountered in primary care and most often remain asymptomatic, resolving without sequelae. Certain characteristics are associated with a greater risk of complications, associated anomalies, and disfigurement. The heterogeneous presentation poses a clinical challenge for physicians in determining the need for treatment and subspecialty referral. This study aims to evaluate the utility of the previously published Hemangioma Severity Scale (HSS) to predict the need for treatment. This retrospective study included 106 patients with IHs seen in the Indiana University Dermatology Clinic in 2011. Data from electronic medical records and clinical photographs taken at patients' initial visits were used to score the hemangiomas using the HSS. Treatments used over 9 to 14 months of follow-up were recorded. Four HSS score subgroups were identified. Higher HSS scores correlated with the need for treatment; 98% of patients with HSS scores of 10 or greater received local or systemic therapy. Higher HSS scores also correlated with greater frequency of complications and risks of associated structural anomalies and permanent disfigurement. Scores did not correlate with sex, age at initial presentation, history of bleeding or pain, or IH size. The HSS may be a useful tool for primary care physicians in identifying high-risk IHs that may benefit from therapy. This easy-to-use scale can improve clinical outcomes by identifying which patients need intervention to minimize complications. IHs with total HSS scores of 6 or greater should be referred for subspecialty evaluation. © 2016 Wiley Periodicals, Inc.

  11. New dosimetry for childhood skin hemangioma treatments with (226)Ra needles or tubes.

    PubMed

    Lundell, Marie; Karlsson, Mattias; Carlsson Tedgren, Åsa

    2015-07-01

    The Stockholm Hemangioma Cohort is important for evaluation of late effects after exposure to ionizing radiation during childhood. Dose estimates in this cohort were based on both measurements and calculations using an old treatment planning system. We compare previously published and calculated dose estimates with new ones, obtained by Monte Carlo simulations, which mimic the hemangioma treatments with (226)Ra needles and tubes. The distances between the (226)Ra sources and the thyroid and breasts, respectively, were reassessed. The Monte Carlo calculations showed significantly lower dose values than those obtained earlier. The differences depended both on the modeling of the sources and on further individualized distances from the sources. The mean value of the new calculated doses was 25% of the old breast doses and 46% of the old thyroid doses. New dosimetry for hemangioma treatments gives significantly lower organ doses for the few cases receiving the highest absorbed dose values. This implies that radiation risk estimates will increase and have to be recalculated. For retrospective studies it is now possible to calculate organ doses from radium treatments using modern treatment planning systems by modeling the source geometry carefully and apply the TG-43 formalism. It is important to be aware of the large uncertainties in calculated absorbed dose values. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Development and Validation of a Quality-of-Life Instrument for Infantile Hemangiomas.

    PubMed

    Chamlin, Sarah L; Mancini, Anthony J; Lai, Jin-Shei; Beaumont, Jennifer L; Cella, David; Adams, Denise; Drolet, Beth; Baselga, Eulalia; Frieden, Ilona J; Garzon, Maria; Holland, Kristin; Horii, Kimberly A; Lucky, Anne W; McCuaig, Catherine; Metry, Denise; Morel, Kimberly D; Newell, Brandon D; Nopper, Amy J; Powell, Julie; Siegel, Dawn; Haggstrom, Anita N

    2015-06-01

    Infantile hemangiomas (IH) are common tumors for which there is no validated disease-specific instrument to measure the quality of life in infants and their parents/caregivers during the critical first months of life. This study prospectively developed and validated a quality-of-life instrument for patients with IH and their parents/caregivers and correlated demographic and clinical features to the effects on the quality of life. A total of 220 parents/caregivers completed the 35-item Infantile Hemangioma Quality-of-Life (IH-QoL) instrument and provided demographic information. The dimensionality of the items was evaluated using factor analysis, with results suggesting four factors: child physical symptoms, child social interactions, parent emotional functioning, and parent psychosocial functioning. Each factor fit the Rasch measurement model with acceptable fit index (mean square <1.4) and demonstrated excellent internal consistency, with alpha ranging from 0.76 to 0.88. The final instrument consists of four scales with a total of 29 items. Content validity was verified by analyzing parents' responses to an open-ended question. Test-retest reliability at a 48-hour interval was supported by a total IH-QoL intraclass correlation coefficient of 0.84. Certain clinical characteristics of hemangioma, including those located on the head and neck, in the proliferative stage, and requiring treatment, are associated with a greater impact on QoL.

  13. Beard infantile hemangioma and subglottic involvement: are median pattern and telangiectatic aspect the clue?

    PubMed

    Piram, M; Hadj-Rabia, S; Boccara, O; Couloigner, V; Hamel-Teillac, D; Bodemer, C

    2016-12-01

    Identification of patient at risk of subglottic infantile hemangioma (IH) is challenging because subglottic IH can grow fast and cause airway obstruction with a fatal course. To refine the cutaneous IH pattern at risk of subglottic IH. Prospective and retrospective review of patients with cutaneous IH involving the beard area. IHs were classified in the bilateral pattern group (BH) or in the unilateral pattern group (UH). Infantile hemangioma topography, subtype (telangiectatic or tuberous), ear, nose and throat (ENT) manifestations and subglottic involvement were recorded. Thirty-one patients (21 BH and 10 UH) were included during a 20-year span. Nineteen patients (16 BH and 3 UH) had subglottic hemangioma. BH and UH group overlap on the median pattern (tongue, gum, lips, chin and neck). Median pattern, particularly the neck area and telangiectatic subtype of IH were significantly associated with subglottic involvement. Patients presenting with telangiectatic beard IH localized on the median area need early ENT exploration. They should be treated before respiratory symptoms occur. © 2016 European Academy of Dermatology and Venereology.

  14. [Involvement of splenic hemangioma and rectal varices in a patient with klippel: trenaunay syndrome].

    PubMed

    Choi, Youn Jung; Jee, Sam Ryong; Park, Kwan Sik; Ryu, Choong Heon; Seo, Hyo Rim; Ha, Seoung In; Lee, Sang Heon; Ok, Kyung Sun

    2011-09-25

    Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.

  15. Klippel-Trenaunay syndrome with gastrointestinal bleeding, splenic hemangiomas and left inferior vena cava.

    PubMed

    Wang, Zhen-Kai; Wang, Fang-Yu; Zhu, Ren-Min; Liu, Jiong

    2010-03-28

    Klippel-Trenaunay syndrome is a congenital vascular anomaly characterized by a triad of varicose veins, cutaneous capillary malformation, and hypertrophy of bone and (or) soft tissue. Gastrointestinal vascular malformations in Klippel-Trenaunay syndrome may present with gastrointestinal bleeding. The majority of patients with splenic hemangiomatosis and/or left inferior vena cava are asymptomatic. We herein report a case admitted to the gastroenterology clinic with life-threatening hematochezia and symptomatic iron deficiency anemia. Due to the asymptomatic mild intermittent hematochezia, splenic hemangiomas and left inferior vena cava, the patient did not seek any help for gastrointestinal bleeding until his admittance to our department for evaluation of massive gastrointestinal bleeding. He was referred to angiography because of his serious pathogenetic condition and inefficiency of medical therapy. The method showed that hemostasis was successfully achieved in the hemorrhage site by embolism of corresponding vessels. Further endoscopy revealed vascular malformations starting from the stomach to the descending colon. On the other hand, computed tomography revealed splenic hemangiomas and left inferior vena cava. To the best of our knowledge, this is the first Klippel-Trenaunay syndrome case presenting with gastrointestinal bleeding, splenic hemangiomas and left inferior vena cava. The literature on the evaluation and management of this case is reviewed.

  16. Surgical Outcomes of Transconjunctival Anterior Orbitotomy for Intraconal Orbital Cavernous Hemangioma

    PubMed Central

    Cho, Kyong Jin; Paik, Ji-Sun

    2010-01-01

    Purpose To describe surgical outcomes for transconjunctival anterior orbitotomy for intraconal cavernous hemangiomas. Methods The medical records of 9 consecutive patients with intraconal cavernous hemangiomas who underwent surgical removal by transconjunctival anterior orbitotomy were retrospectively reviewed. The conjunctiva was incised and retracted with a traction suture. For large tumors, a rectus muscle was temporarily disinserted. Tenon's capsule was separated and the tumor was removed with a cryoprobe or clamp. Surgical outcomes, positions of the tumors, methods of approach, and intra- and post-operative complications were evaluated. Results The mean follow-up period was 33 ± 6.8 months. No bony orbitotomy was used in this technique and the cosmetic results were very satisfactory. All tumors were removed intact. In 4 patients, tumors were extirpated with the aid of a cryoprobe. No patients had residual proptosis or limitation of ocular movement. No signs of recurrence were noted in any cases at 33 months follow-up. No serious or permanent complications were observed during or after the operation. Conclusions Transconjunctival anterior orbitotomy is an important surgical procedure in the treatment of intraconal cavernous hemangiomas. It can produce an excellent result, even if the posterior border of the tumor abuts the orbital apex. PMID:21052506

  17. Facial nerve hemangioma of the geniculate ganglion: an endoscopic surgical approach.

    PubMed

    Marchioni, Daniele; Soloperto, Davide; Genovese, Elisabetta; Rubini, Alessia; Presutti, Livio

    2014-12-01

    Facial nerve hemangiomas are rare benign tumors arising from the venous plexus surrounding the facial nerve. Surgical management of these tumors is controversial. The goal of surgery is complete tumor removal with restoration of facial nerve function and preservation of hearing, wherever possible. The approaches most used are the translabyrinthine and middle cranial fossa approaches. In this report, we describe the first facial hemangioma treated with an endoscopic transcanal approach, combined with a retroauricular transmastoid minicraniotomy for closure of the dural defect. A great auricular nerve graft was used to reconnect interrupted nerve segments. Histopathological examination confirmed the diagnosis of a hemangioma of the first genu of the facial nerve. With magnification of the structures, the transcanal endoscopic approach allowed a radical excision of the neoplasm permitting hearing function preservation, with the possibility to work with a minimally invasive approach with respect to the labyrinthine block and cochlea. Compared to a middle cranial fossa approach, the transcanal endoscopic approach avoided labyrinthine block removal and brain retraction. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Pulsed dye laser therapy for infantile hemangiomas: a systemic review and meta-analysis.

    PubMed

    Shen, L; Zhou, G; Zhao, J; Li, P; Xu, Q; Dong, Y; Zhang, Z

    2015-06-01

    Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the treatment of IH. Seven databases were searched, including PubMed, OvidSP, Karger, Elsevier, EMBASE, Web of Science and Wiley Online Library. The review collected the characteristics of year of publication, hemangiomas cases, prior treatment, laser parameters, adverse side, pretreatment symptom, and number of response from all articles. A total of 1580 studies were identified, the first round search retrieved 39 articles met inclusion criteria. Of those, only 13 articles with 1529 hemangiomas were included in the meta-analysis. This meta-analysis demonstrated an overall resolution rate of 89.1% with 6.28% incidence of adverse effect. PDL may be the effective modality to decrease the proliferative phase and accelerate rates of involution and resolution with few adverse events. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Central Retinal and Posterior Ciliary Artery Occlusion After Intralesional Injection of Sclerosant to Glabellar Subcutaneous Hemangioma

    SciTech Connect

    Matsuo, Toshihiko; Fujiwara, Hiroyasu; Gobara, Hideo; Mimura, Hidefumi; Kanazawa, Susumu

    2009-03-15

    The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

  20. Anti-angiogenic property of edible berry in a model of hemangioma.

    PubMed

    Atalay, Mustafa; Gordillo, Gayle; Roy, Sashwati; Rovin, Brad; Bagchi, Debasis; Bagchi, Manashi; Sen, Chandan K

    2003-06-05

    Hemangiomas represent a powerful model to study in vivo angiogenesis. Monocyte chemotactic protein 1 (MCP-1) is known to be responsible for recruiting macrophages to sites of infection or inflammation and facilitate angiogenesis. Recently we have demonstrated that edible berry extracts potently suppress inducible vascular endothelial growth factor expression and in vitro angiogenesis. Comparative analysis of several berry extracts led to the observation that wild blueberry and a berry mix were most effective. Our goal was to follow up on our findings with wild blueberry and the berry mix (OptiBerry). The present work rests on our current finding that these two berry powders significantly inhibit inducible MCP-1 expression in endothelioma cells. Therefore, we sought to examine the effects of wild blueberry and berry mix in an in vivo model of experimental angiogenesis. Reporter studies showed that the berry powders significantly inhibited basal MCP-1 transcription and inducible nuclear factor kappaB transcription. Endothelioma cells pre-treated with berry powders showed diminished ability to form hemangioma. Histological analysis demonstrated markedly decreased infiltration of macrophages in hemangioma of treated mice compared to placebo-treated controls. The current results provide the first in vivo evidence substantiating the anti-angiogenic property of edible berries.

  1. Propranolol enhanced adipogenesis instead of induction of apoptosis of hemangiomas stem cells

    PubMed Central

    Ma, Xiaorong; Zhao, Tinghui; Ouyang, Tianxiang; Xin, Shujia; Ma, Yueting; Chang, Mengling

    2014-01-01

    Propranolol has been widely used in treating infantile hemangiomas (IHs). But recurrence of IHs was found in some cases on cessation of propranolol treatment. The other is that Chinese individuals reacted to propranolol differently from American Whites. Whether the difference of sensitivity is due to the β adrenoceptor (β-AR) expression pattern of hemangioma initiating cells remains unclear. In the present study, we isolated hemangioma-derived stem cells (hemSCs) from proliferative IHs and analyzed the biological characteristics and β-AR expression pattern of hemSCs by immunostaining, Western blotting and multilineage differentiation assay as well. We also tested the effects of propranolol on hemSCs by evaluating VEGF expression, proliferation and apoptosis related parameters. Our results indicated that CD133+ hemSCs located pre-vascular in proiferative IH tissues. Both β1 and β2-AR were expressed, while β2-AR was dominant on hemSCs. Propranolol at 100-150 μM inhibited proliferation of hemSCs, not did 50 μM. Propranolol down-regulated VEGF expression of hemSCs, instead of inducing apoptosis. The adipogenic potential was enhanced by propranolol. Therefore, our current results suggested propranolol could not induce apoptosis of hemSCs, but played a curative role though suppressing VEGF synthesis and enhancement of adipogenesis of hemSCs. Our results might partially provide the insight of mechanism of relapse in some cases on cessation of propranolol treatment. PMID:25120757

  2. Propranolol enhanced adipogenesis instead of induction of apoptosis of hemangiomas stem cells.

    PubMed

    Ma, Xiaorong; Zhao, Tinghui; Ouyang, Tianxiang; Xin, Shujia; Ma, Yueting; Chang, Mengling

    2014-01-01

    Propranolol has been widely used in treating infantile hemangiomas (IHs). But recurrence of IHs was found in some cases on cessation of propranolol treatment. The other is that Chinese individuals reacted to propranolol differently from American Whites. Whether the difference of sensitivity is due to the β adrenoceptor (β-AR) expression pattern of hemangioma initiating cells remains unclear. In the present study, we isolated hemangioma-derived stem cells (hemSCs) from proliferative IHs and analyzed the biological characteristics and β-AR expression pattern of hemSCs by immunostaining, Western blotting and multilineage differentiation assay as well. We also tested the effects of propranolol on hemSCs by evaluating VEGF expression, proliferation and apoptosis related parameters. Our results indicated that CD133(+) hemSCs located pre-vascular in proiferative IH tissues. Both β1 and β2-AR were expressed, while β2-AR was dominant on hemSCs. Propranolol at 100-150 μM inhibited proliferation of hemSCs, not did 50 μM. Propranolol down-regulated VEGF expression of hemSCs, instead of inducing apoptosis. The adipogenic potential was enhanced by propranolol. Therefore, our current results suggested propranolol could not induce apoptosis of hemSCs, but played a curative role though suppressing VEGF synthesis and enhancement of adipogenesis of hemSCs. Our results might partially provide the insight of mechanism of relapse in some cases on cessation of propranolol treatment.

  3. Dubin-Johnson syndrome with multiple liver cavernous hemangiomas: report of a familial case.

    PubMed

    Li, Peifeng; Wang, Yingmei; Zhang, Jinmei; Geng, Ming; Li, Zengshan

    2013-01-01

    Dubin-Johnson syndrome (DJS) is a rare autosomal recessive inheritance disorder of bilirubin metabolism. Herein we reported a complicated but interesting case which is readily resulted in misdiagnosis or an indefinite diagnosis, and this is the first reported familial case of DJS with multiple liver cavernous hemangiomas. A 49-year-old man was referred to our hospital for jaundice and multiple low-density liver masses. Extensive laboratory investigations showed conjugated hyperbilirubinaemia and positive urine bilirubin. Microscopically, lesions were composed of blood-filled vascular channels of various sizes lined by a single layer of flat endothelial cells supported by fibrous tissue. Coarse brown granules presented in the hepatocytes of the liver lobules locating beside the tumor, particularly in the centrilobular hepatocytes, and the granules showed blue-green with Schmorl's reaction lipofuscin staining. Interestingly, one of the patient's six siblings (female) shared the same condition with him. The relationship between DJS and hemangiomas remains unclear, and it might be contributed to some hereditary factors, or probably occurred simultaneously by chance. It was certified that the true reason for the long-term unclear jaundice was DJS, which was presumed clinically to be caused by bile excretion obstacles associated with the hemangiomas. Liver biopsy and histochemical stain may be helpful to identify the reason of jaundice and avoid misdiagnosis or an indefinite diagnosis.

  4. Collagenous nodule mixed simple cyst and hemangioma coexistence in the liver.

    PubMed

    Zheng, Zhen-Jiang; Zhang, Shu; Cao, Yang; Pu, Guang-Chun; Liu, Hong

    2015-04-14

    A 20-year-old female patient presented with two masses located in the left liver. In this patient, a computed tomography (CT) scan revealed a hypodense mass and a second well-defined mass with a calcified nodule in the left hepatic lobe. No enhancements were apparent in or around the masses. A laparotomy was performed due to the patient's symptoms, namely, the atypical CT findings and a risk of rupture of the subcapsular lesion. The operation revealed two masses in the left hepatic lobe and a left liver resection was subsequently performed. One of the masses involved segment III and the other mass was located in segment IV. The histopathologic findings supported a diagnosis of collagenous nodule mixed simple cyst and hemangioma. A diagnosis of collagenous nodule mixed simple hepatic cyst is extremely rare and radiologically mimics a teratoma, hepatolithiasis, parasitic cyst, or hemangioma. Although hepatic hemangiomas are the most common benign tumors found in the liver, the present case showed atypical radiographic features.

  5. Co-existing squamous cell carcinoma and hemangioma on the ocular surface of a cat.

    PubMed

    Perlmann, Eduardo; da Silva, Enry Garcia; Guedes, Pedro Mancini; Barros, Paulo Sergio de Moraes

    2010-01-01

    A 14-year-old spayed female domestic short-haired cat was presented for evaluation of a mass in the right eye. Ophthalmic examination revealed a blind right eye and presence of two distinct masses: a pink and a red-to-brown mass, the latter occupying most of the cornea and part of the conjunctiva. Exenteration was performed under general anesthesia, and the ocular tissues were processed routinely for histopathology. Upon microscopic examination, a malignant epithelial neoplasm and a benign vascular neoplasm were present in the cornea. The conjunctiva and the third eyelid were also affected. Upon immunohistochemistry, the epithelial tumor was positive for cytokeratin and negative for vimentin and the endothelial tumor was negative for cytokeratin and positive for vimentin. A diagnosis of squamous cell carcinoma (SCC) and hemangioma was made. The SCC was affecting the cornea, bulbar conjunctiva (lateral and inferior) and the base of the third eyelid, whereas the hemangioma was affecting the cornea and medial limbus. To the authors' knowledge, this is the first report of concomitant SCC and hemangioma affecting the ocular surface in a cat.

  6. Ultrasound-guided interstitial Nd:YAG laser therapy of cavernous hemangiomas

    NASA Astrophysics Data System (ADS)

    Hoffmann, Peter; Offergeld, Christian F.; Huettenbrink, Karl-Bernd; Hackert, I.; Scholz, A.

    1995-05-01

    Preoperative embolization and excision used to be standard therapy amongst a wide range of other more or less successful methods for the treatment of voluminous hemangiomas. Nowadays a combination of argon, tunable dye, copper vapor and Nd:YAG laser therapy achieves better cosmetic and functional results. Due to its limited penetration depth percutaneous laser therapy can only be utilized for superficial vascular malformations. Interstitial laser therapy, as performed with the Nd:YAG laser, allows treatment of voluminous hemangiomas in their full extent. The localization of these vascular lesions is evaluated by high resolution ultrasound with a new anular array scanner which ensures the precise intraoperative placement of the laser light fiber in the target tissue. Modified new light applicators improve the interstitial thermotherapy of hemangiomas. The tip design of the scattering-dome fiber allows diffuse circumferential irradiation with larger defined coagulation volume and minimized carbonization. Continuous intraoperative sonographic monitoring lowers the risk of damaging adjacent intact anatomical structures, helps to reach all tumor areas an to estimate the effect of the applied laser light caused by changes of sonomorphology. The postoperative outcome is evaluated by B-mode sonography and the new technique of ultrasound color angiography.

  7. Holmium YAG laser ablation of a hemangioma involving a lower pole renal calyx - using the new-generation flexible ureteroscope URF type P5: a case report.

    PubMed

    Nakamura, Kogenta; Yamada, Yoshiaki; Rosser, Charles J; Aoki, Shigeyuki; Taki, Tomohiro; Honda, Nobuaki

    2009-06-17

    Hemangioma of the renal calyx is a rare disease, which is difficult to diagnose and an even greater challenge to treat. We report the use of the new-generation flexible ureteroscope, in the management of a 37-year-old Asian male with a lower pole renal calyx hemangioma, which was previously inaccessible.

  8. Holmium YAG laser ablation of a hemangioma involving a lower pole renal calyx - using the new-generation flexible ureteroscope URF type P5®: a case report

    PubMed Central

    Yamada, Yoshiaki; Rosser, Charles J; Aoki, Shigeyuki; Taki, Tomohiro; Honda, Nobuaki

    2009-01-01

    Hemangioma of the renal calyx is a rare disease, which is difficult to diagnose and an even greater challenge to treat. We report the use of the new-generation flexible ureteroscope, in the management of a 37-year-old Asian male with a lower pole renal calyx hemangioma, which was previously inaccessible. PMID:19830012

  9. Complete genome sequence of an avian leukosis virus isolate associated with hemangioma and myeloid leukosis in egg-type and meat-type chickens

    USDA-ARS?s Scientific Manuscript database

    A new virus isolate was separated from a commercial egg-type flock of chickens in China and was determined as subgroup J avian leukosis virus (ALV-J). ALV-J is known to cause myeloid leukosis. But this new isolate of viruses causes both hemangioma and myeloid leukosis in chickens. Hemangioma is an a...

  10. Radiofrequency ablation in the treatment of large hepatic hemangiomas: a comparison of multitined and internally cooled electrodes.

    PubMed

    Gao, Jun; Ding, Xuemei; Ke, Shan; Xin, Zonghai; Ning, Chunmin; Sha, Qi; Sun, Wenbing

    2014-07-01

    Radiofrequency (RF) ablation is an accepted nonsurgical treatment of hepatic hemangiomas, but with an appreciable complication rate. Our study aimed to assess the safety and efficacy of RF ablation, administered with either multitined expandable electrodes or with internally cooled cluster electrodes, in the treatment of large (≥10 cm diameter) hepatic hemangiomas. We retrospectively reviewed our sequential experience of treating 43 large hepatic hemangiomas in 42 patients with RF ablation/multitined expandable electrodes or with RF ablation/internally cooled electrodes. Twenty-two hemangiomas in 21 patients were treated with expandable electrode (multitined electrode group), and 21 hemangiomas in 21 patients were treated with internally cooled cluster electrode (internally cooled electrode group). Among the 43 large hepatic hemangiomas, 27 subcapsular lesions were treated by a laparoscopic approach, and 16 lesions located in liver parenchyma were treated by a computed tomography-guided percutaneous approach. In the multitined electrode group, RF ablation treatment was performed in all 21 patients in 1 session. In the internally cooled electrode group, 18 patients were treated by RF ablation in 1 session, and 3 patients, with ≥14.0-cm single hemangioma, were treated with RF ablation in 2 sessions. Complete ablation was achieved in 81.8% (18/22) and 90.5% (19/21) in the multitined electrode group and the internally cooled electrode group, respectively (P>0.05). Ablation time for single hemangioma was shorter with the internally cooled electrode than with the multitined electrode (P<0.05). There were 79 complications related to ablation (2 major and 77 minor) in 31 patients. All 21 patients in the multitined electrode group experienced complications, compared with 10 of 21 patients (47.6%) in the internally cooled electrode group (P<0.05). Both of the 2 major complications occurred in the multitined electrode group. All the complications were treated successfully

  11. Hemangioma curative effect of PDL, alexandrite, Er:YAG and CO(2) lasers.

    PubMed

    Remlova, Eva; Dostalová, Tatjana; Michalusová, Iva; Vránová, Jana; Navrátil, Leoš; Rosina, Jozef

    2011-12-01

    Hemangioma is a mesenchymal benign tumor formed by blood vessels. Anomalies affect up to 10% of children and they are more common in females than in males. The aim of this study was to evaluate hemangioma treatment using four different types of lasers, namely, alexandrite, Er:YAG, CO(2), and pulsed dye laser (PDL). The argon laser was the first to be used for dermatological patients, namely, with port wine stains (PWS) in the late 1960s and early 1970s. A variety of different lasers and light sources were useful in the treatment of vascular lesions, e.g., KTP, Nd:YAG, CO(2), PDL, and Er:YAG. A group of 869 consecutive patients with hemangioma was retrospectively reviewed. The patients including in our study were divided into four groups according to the type of laser used: Alexandrite laser (n=85, 58 women and 20 men), CO(2) laser (n=78, 58 women and 20 men), Er:YAG laser (n=105, 87 women and 18 men), and PDL laser (n=601, 453 women and 148 men). All patients were treated in one session without anesthesia application. The ablative systems vaporized the tissues until the hemangioma was removed. The non-ablative systems used one shot, which destroyed the hemangioma blood vessels. For the treatment efficacy analysis, the following factors were evaluated: therapeutic effect (yes vs. no), loss of pigment (yes vs. no), and appearance of scar (yes vs. no). From results it was evident that the therapeutic effect of all the lasers except alexandrite was very high; almost 100%. In the CO(2) and the Er:YAG laser groups a high percentage of side effects was also observed. Exposure to these lasers caused loss of pigment and scar formation in many cases. The best therapeutic effect, with only minor side effects, has been achieved with the PDL laser. It was confirmed that PDL (595 nm, 1.5 ms, 7 mm, 9 - 11 J/cm(2)) had optimal effect without scars. Er:YAG or CO(2) laser radiation with specific characteristics was also useful for small superficial lesions.

  12. Definitive diagnosis of hepatic hemangiomas: MR imaging versus Tc-99m-labeled red blood cell SPECT

    SciTech Connect

    Birnbaum, B.A.; Weinreb, J.C.; Megibow, A.J.; Sanger, J.J.; Lubat, E.; Kanamuller, H.; Noz, M.E.; Bosniak, M.A. )

    1990-07-01

    Thirty-seven patients with 69 suspected hemangiomas found by means of computed tomography (CT) and/or ultrasound were studied with both 0.5-T magnetic resonance (MR) imaging and single photon emission CT (SPECT) with technetium-99m-labeled red blood cells. Using a criterion of perfusion-blood pool mismatch, SPECT readers diagnosed 50 of 64 hemangiomas and all five nonhemangiomas (sensitivity, 78% (95% confidence interval, 0.664 - 0.864); accuracy, 80% (0.69 - 0.877)). Qualitative analysis of lesion signal intensity on T2-weighted spin-echo MR images allowed readers to diagnose 58 of 64 hemangiomas and four of five nonhemangiomas (sensitivity, 91% (0.814 - 0.96); accuracy, 90% (0.807 - 0.951)). Because of the significantly higher cost of MR imaging and its inability to categorically differentiate hemangiomas from hypervascular metastases, the authors consider SPECT to be the method of choice for diagnosing hepatic hemangiomas. MR imaging should be reserved for the diagnosis of lesions smaller than 2.0 cm and for those 2.5 cm and smaller adjacent to the heart or major hepatic vessels; in such cases MR imaging was found superior to SPECT.

  13. Treatment of lip hemangioma using forced dehydration with induced photocoagulation via diode laser: report of three cases.

    PubMed

    Jasper, Juliana; Camilotti, Renata Stifelman; Pagnoncelli, Rogério Miranda; Poli, Vladimir Dourado; da Silveira Gerzson, Alexandre; Gavin Zakszeski, Ana Maria

    2015-03-01

    Several vascular lesions are related to the lip area. There is no universally accepted protocol for the treatment of hemangiomas and vascular malformations. In the oral cavity, high-power lasers represent an excellent therapeutic option for this type of lesion. Their coagulative properties allow for the performance of procedures without the risk of bleeding, which promotes a better healing pattern and a differentiated postoperative appearance. This study describes three cases of lip hemangioma treated with forced dehydration with induced photocoagulation (FDIP) via diode laser. All the reported cases were followed up until complete healing of the operated area had total remission of lesions, with no complications or adverse effects. The findings of the present study suggest that FDIP is effective and useful in the treatment of hemangiomas in the oral cavity. Laser treatment of these lesions prevents their recurrence and is well tolerated by patients.

  14. Nasal Lobular Capillary Hemangioma as a Complication after an Endoscopic Transsphenoidal Gonadotrophin-Producing Pituitary Adenoma Resection

    PubMed Central

    Forte, Dalila; Irañeta, Amets Sagarribay; Nabais, Anabela; Figueiredo, António; Mafra, Manuela; Gonçalves, Victor

    2017-01-01

    Background Lobular capillary hemangioma is a rare benign tumor, most frequently located in the head or neck region, the nasal cavity being uncommonly affected. Its etiopathogenesis is not fully established, although traumatic and hormonal factors have been implied. Case Description A 50-year-old female patient underwent an uneventful endoscopic transsphenoidal removal of a pituitary cystic macroadenoma at our institution. Nasal packing was used in postoperative hemostasis. Histopathology was compatible with a gonadotrophin-producing adenoma. One month after the surgery, the patient presented with frequent episodes of epistaxis and a progressively growing nasal mass, which was removed endoscopically. Its pathological examination confirmed a lobular capillary hemangioma. Conclusions The authors present a clinical case combining two possible predisposing factors to the development of a nasal lobular capillary hemangioma: local traumatic injury through surgery and postoperative nasal packing and hormonal influence. This lesion is a rare complication of endoscopic transsphenoidal resections of pituitary adenomas. PMID:28326242

  15. Nasal Lobular Capillary Hemangioma as a Complication after an Endoscopic Transsphenoidal Gonadotrophin-Producing Pituitary Adenoma Resection.

    PubMed

    Forte, Dalila; Irañeta, Amets Sagarribay; Nabais, Anabela; Figueiredo, António; Mafra, Manuela; Gonçalves, Victor

    2017-01-01

    Background Lobular capillary hemangioma is a rare benign tumor, most frequently located in the head or neck region, the nasal cavity being uncommonly affected. Its etiopathogenesis is not fully established, although traumatic and hormonal factors have been implied. Case Description A 50-year-old female patient underwent an uneventful endoscopic transsphenoidal removal of a pituitary cystic macroadenoma at our institution. Nasal packing was used in postoperative hemostasis. Histopathology was compatible with a gonadotrophin-producing adenoma. One month after the surgery, the patient presented with frequent episodes of epistaxis and a progressively growing nasal mass, which was removed endoscopically. Its pathological examination confirmed a lobular capillary hemangioma. Conclusions The authors present a clinical case combining two possible predisposing factors to the development of a nasal lobular capillary hemangioma: local traumatic injury through surgery and postoperative nasal packing and hormonal influence. This lesion is a rare complication of endoscopic transsphenoidal resections of pituitary adenomas.

  16. Scintigraphy of hepatic hemangiomas: the value of Tc-99m-labeled red blood cells - concise communication

    SciTech Connect

    Front, D.; Royal, H.D.; Israel, O; Parker, J.A.; Kolodny, G.M.

    1981-08-01

    Fourteen patients with hepatic hemangiomas were evaluated by Tc-99m colloid scintigraphy and Tc-99m RBC angiography, including flow studies and early and delayed static studies. On colloid scintigraphy, the liver appeared enlarged, with single or multiple focal defects. During the flow and early static Tc-99m RBC studies, the lesions showed poor perfusion and were filled only partially or not at all. Delayed Tc-99m RBC studies demonstrated the whole extent of the lesion and all the lesions when multiple hemangiomas were present. A flow study showing decreased perfusion and a late blood-pool study showing increased local blood volume appear characteristic of hemangiomas. Liver biopsy should not be attempted in such cases.

  17. Scintigraphy of hepatic hemangiomas: the value of Tc-99m-labeled red blood cells: concise communication

    SciTech Connect

    Royal, H.D.; Israel, O.; Parker, J.A.; Kolodny, G.M.

    1981-08-01

    Fourteen patients with hepatic hemangiomas were evaluated by Tc-99m colloid scintigraphy and Tc-99m RBC angiography, including flow studies and early and delayed static studies. On colloid scintigraphy, the liver appeared enlarged, with single or multiple focal defects. During the flow and early static Tc-99m RBC studies, the lesions showed poor perfusion and were filled only partially or not at all. Delayed Tc-99m RBC studies demonstrated the whole extent of the lesion and all the lesions when multiple hemangiomas were present. A flow study showing decreased perfusion and a late blood-pool study showing increased local blood volume appear characteristic of hemangiomas. Liver biopsy should not be attempted in such cases.

  18. Frontal Bone Hemangioma in an 8-year-old Female: A Common Tumor in a Rare Location

    PubMed Central

    Sharma, Abhimanyu; Singh, Usha Rani; Sihag, Prateek

    2016-01-01

    Intraosseous hemangioma is a rare bone tumor accounting for 0.7%–1.0% of all bone tumors. In the skull, frontal bone is the commonly involved bone. An 8-year-old female presented to our outpatient department with complaints of pain and swelling over forehead for 4 months. X-ray revealed a lytic expansile lesion involving frontal bone with sunburst pattern of bony spicules radiating to periphery of the lesion. Magnetic resonance imaging revealed the presence of a well-circumscribed lesion with both intra as well as extracranial components. Histopathology revealed a vascular tumor consisting of both small (capillary) and large (cavernous) sized vessels. A diagnosis of mixed type of hemangioma of the frontal bone was given. Recognition of hemangioma on radiology and confirmation by histopathology is essential for proper management as it might be confused clinically with other locally aggressive/malignant lesions. PMID:28163515

  19. The use of propranolol in the treatment of subglottic hemangiomas: A literature review and meta-analysis.

    PubMed

    Hardison, Scott; Wan, Wen; Dodson, Kelley M

    2016-11-01

    1) Describe the origins of the use of propranolol in the treatment of subglottic hemangiomas, 2) Perform meta-analysis of all case reports and series in which propranolol was used to treat subglottic hemangiomas. Literature review and meta-analysis. A total of 61 cases were identified from 19 scholarly articles. Cases were assessed by parameters including age at diagnosis, presence of other hemangiomas, percent airway obstructed, dose of propranolol, treatment duration, age at therapy termination, use of steroids, and treatment failure. Treatment failure was defined as: 1) Need for surgery after initiation of propranolol, 2) Return of symptoms, or 3) Endoscopic worsening/recurrence of hemangioma. All data was subjected to comprehensive statistical analysis. Though not statistically significant, a trend was noted towards a decreased treatment failure rate with increasing doses of propranolol (p = 0.0563). The use of concurrent steroids was associated with a higher failure rate (p = 0.0487). Notably, no associations were observed between the presence of additional hemangiomas, prior surgery, or increased initial percent airway obstruction with treatment failure. Propranolol is rapidly becoming the standard of care in the treatment of subglottic hemangiomas. Despite widespread adoption, the rarity of this condition has limited previous studies to case reports and small series. No evidence-based guidelines exist for proper dosing of propranolol. The results of this meta-analysis suggest a benefit to higher doses of propranolol (3 mg/kg/day), though further investigation is needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Psoriasiform Diaper Rash Possibly Induced by Oral Propranolol in an 18-Month-Old Girl with Infantile Hemangioma.

    PubMed

    Baggio, Raphaëlle; Le Treut, Claire; Darrieux, Laure; Vareliette, Amélie; Safa, Gilles

    2016-01-01

    Propranolol, a nonselective blocker of β-adrenergic receptors, has become the first-line treatment for complicated infantile hemangiomas. Therefore, its use in the pediatric population has expanded in recent years. In adults, β-blockers have been reported to be the most common causative agents for drug-induced psoriasis. In infants treated with propranolol for infantile hemangioma, the onset of psoriasiform diaper rash has not yet been reported. Here, to the best of our knowledge, we report the first case of psoriasiform diaper rash possibly induced by oral propranolol in an 18-month-old girl with no family history of psoriasis.

  1. Psoriasiform Diaper Rash Possibly Induced by Oral Propranolol in an 18-Month-Old Girl with Infantile Hemangioma

    PubMed Central

    Baggio, Raphaëlle; Le Treut, Claire; Darrieux, Laure; Vareliette, Amélie; Safa, Gilles

    2016-01-01

    Propranolol, a nonselective blocker of β-adrenergic receptors, has become the first-line treatment for complicated infantile hemangiomas. Therefore, its use in the pediatric population has expanded in recent years. In adults, β-blockers have been reported to be the most common causative agents for drug-induced psoriasis. In infants treated with propranolol for infantile hemangioma, the onset of psoriasiform diaper rash has not yet been reported. Here, to the best of our knowledge, we report the first case of psoriasiform diaper rash possibly induced by oral propranolol in an 18-month-old girl with no family history of psoriasis.

  2. Long noncoding RNA expression profile of infantile hemangioma identified by microarray analysis.

    PubMed

    Liu, Xiaowen; Lv, Renrong; Zhang, Linfeng; Xu, Guangqi; Bi, Jianhai; Gao, Feng; Zhang, Jian; Xue, Feng; Wang, Fagang; Wu, Yiliang; Fu, Cong; Wang, Qiang; Huo, Ran

    2016-10-05

    Infantile hemangioma (IH) is one of the most common vascular tumors of childhood. Long noncoding RNAs (lncRNAs) play a critical role in angiogenesis, but their involvement in hemangioma remains unknown. This study aimed to assess the expression profiles of lncRNAs in IH and adjacent normal tissue samples, exploring the biological functions of lncRNAs as well as their involvement in IH pathogenesis. The lncRNA expression profiles were determined by lncRNA microarrays. A total of 1259 and 857 lncRNAs were upregulated and downregulated in IH, respectively, at a fold change cutoff of 2.0 (p < 0.05); in addition, 1469 and 1184 messenger RNAs (mRNAs) were upregulated and downregulated, respectively (fold change cutoff of 2.0; p < 0.05). A total of 292 differentially expressed mRNAs were targeted by the lncRNAs with altered expression in hemangioma, including 228 and 64 upregulated and downregulated, respectively (cutoff of 2.0, p < 0.05). Gene ontology (GO) analyses revealed several angiogenesis-related pathways. An lncRNA-mRNA co-expression network for differentially expressed lncRNAs revealed significant associations of the lncRNAs MEG3, MEG8, FENDRR, and Linc00152 with their related mRNAs. The validation results of nine differentially expressed lncRNAs (MALAT1, MEG3, MEG8, p29066, p33867, FENDRR, Linc00152, p44557_v4, p8683) as well as two mRNAs (FOXF1, EGFL7) indicated that the microarray data correlated well with the QPCR results. Interestingly, MALAT1 knockdown induced apoptosis and S-phase cell cycle arrest in human umbilical vein endothelial cells (HUVECs). Overall, this study revealed the lncRNA expression profile of IH and that lncRNAs likely regulate several genes with important roles in angiogenesis.

  3. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference.

    PubMed

    Drolet, Beth A; Frommelt, Peter C; Chamlin, Sarah L; Haggstrom, Anita; Bauman, Nancy M; Chiu, Yvonne E; Chun, Robert H; Garzon, Maria C; Holland, Kristen E; Liberman, Leonardo; MacLellan-Tobert, Susan; Mancini, Anthony J; Metry, Denise; Puttgen, Katherine B; Seefeldt, Marcia; Sidbury, Robert; Ward, Kendra M; Blei, Francine; Baselga, Eulalia; Cassidy, Laura; Darrow, David H; Joachim, Shawna; Kwon, Eun-Kyung M; Martin, Kari; Perkins, Jonathan; Siegel, Dawn H; Boucek, Robert J; Frieden, Ilona J

    2013-01-01

    Infantile hemangiomas (IHs) are common neoplasms composed of proliferating endothelial-like cells. Despite the relative frequency of IH and the potential severity of complications, there are currently no uniform guidelines for treatment. Although propranolol has rapidly been adopted, there is significant uncertainty and divergence of opinion regarding safety monitoring, dose escalation, and its use in PHACE syndrome (PHACE = posterior fossa, hemangioma, arterial lesions, cardiac abnormalities, eye abnormalities; a cutaneous neurovascular syndrome characterized by large, segmental hemangiomas of the head and neck along with congenital anomalies of the brain, heart, eyes and/or chest wall). A consensus conference was held on December 9, 2011. The multidisciplinary team reviewed existing data on the pharmacologic properties of propranolol and all published reports pertaining to the use of propranolol in pediatric patients. Workgroups were assigned specific topics to propose protocols on the following subjects: contraindications, special populations, pretreatment evaluation, dose escalation, and monitoring. Consensus protocols were recorded during the meeting and refined after the meeting. When appropriate, protocol clarifications and revision were made and agreed upon by the group via teleconference. Because of the absence of high-quality clinical research data, evidence-based recommendations are not possible at present. However, the team agreed on a number of recommendations that arose from a review of existing evidence, including when to treat complicated IH; contraindications and pretreatment evaluation protocols; propranolol use in PHACE syndrome; formulation, target dose, and frequency of propranolol; initiation of propranolol in infants; cardiovascular monitoring; ongoing monitoring; and prevention of hypoglycemia. Where there was considerable controversy, the more conservative approach was selected. We acknowledge that the recommendations are conservative in

  4. α6-integrin is required for the adhesion and vasculogenic potential of hemangioma stem cells

    PubMed Central

    Smadja, David M.; Guerin, Coralie L.; Boscolo, Elisa; Bieche, Ivan; Mulliken, John B.; Bischoff, Joyce

    2013-01-01

    Background Infantile hemangioma (IH) is the most common tumor of infancy. Hemangioma stem cells (HemSC) are a mesenchymal subpopulation isolated from IH CD133+ cells. HemSC can differentiate into endothelial and pericyte/smooth muscle cells and form vascular networks when injected in immune-deficient mice. α6-Integrin subunit has been implicated in the tumorgenicity of glioblastoma stem cells and the homing properties of hematopoietic, endothelial and mesenchymal progenitor cells. Therefore, we investigated the possible function(s) of α6-integrin in HemSC. Methods/Results We documented α6-integrin expression in IH tumor specimens and HemSC by RT-qPCR and flow cytometry. We examined the effect of blocking or silencing α6-integrin on the adhesive and proliferative properties of HemSCin vitro and the vasculogenic and homing properties of HemSCin vivo. Targeting α6-integrin in cultured HemSC inhibited adhesion to laminin but had no effect on proliferation. Vessel-forming ability in Matrigel implants and hepatic homing after intravenous delivery were significantly decreased in α6-integrin siRNA transfected HemSC. Conclusion α6-Integrin is required for HemSC adherence to laminin, vessel formation in vivo and for homing to the liver. Thus, we uncovered an important role for α6 integrin in the vasculogenic properties of HemSC. Our results suggest that α6-integrin expression on HemSC could be a new target for anti-hemangioma therapy. PMID:24022922

  5. Retrospective case series of the imaging findings of facial nerve hemangioma.

    PubMed

    Yue, Yunlong; Jin, Yanfang; Yang, Bentao; Yuan, Hui; Li, Jiandong; Wang, Zhenchang

    2015-09-01

    The aim was to compare high-resolution computed tomography (HRCT) and thin-section magnetic resonance imaging (MRI) findings of facial nerve hemangioma. The HRCT and MRI characteristics of 17 facial nerve hemangiomas diagnosed between 2006 and 2013 were retrospectively analyzed. All patients included in the study suffered from a space-occupying lesion of soft tissues at the geniculate ganglion fossa. Affected nerve was compared for size and shape with the contralateral unaffected nerve. HRCT showed irregular expansion and broadening of the facial nerve canal, damage of the bone wall and destruction of adjacent bone, with "point"-like or "needle"-like calcifications in 14 cases. The average CT value was 320.9 ± 141.8 Hu. Fourteen patients had a widened labyrinthine segment; 6/17 had a tympanic segment widening; 2/17 had a greater superficial petrosal nerve canal involvement, and 2/17 had an affected internal auditory canal (IAC) segment. On MRI, all lesions were significantly enhanced due to high blood supply. Using 2D FSE T2WI, the lesion detection rate was 82.4 % (14/17). 3D fast imaging employing steady-state acquisition (3D FIESTA) revealed the lesions in all patients. HRCT showed that the average number of involved segments in the facial nerve canal was 2.41, while MRI revealed an average of 2.70 segments (P < 0.05). HRCT and MR findings of facial nerve hemangioma were typical, revealing irregular masses growing along the facial nerve canal, with calcifications and rich blood supply. Thin-section enhanced MRI was more accurate in lesion detection and assessment compared with HRCT.

  6. Adult onset flatfoot associated with an intramuscular hemangioma of the posterior tibialis muscle.

    PubMed

    Kryzak, Thomas John; DeGroot, Henry

    2008-03-01

    A 30-year-old man was referred for a painful mass in the left calf and planovalgus deformity of the left foot. The pain had been present for 15 years but recently had become severe. On examination there was a visible, exquisitely tender mass in the medial distal aspect of the lower leg. There was valgus deformity of the hindfoot, abduction of the forefoot, and complete loss of the longitudinal arch which was passively correctable to neutral. Magnetic resonance imaging showed a 3.035.5312.0-cm complex mass in the calf with a "bag of worms" appearance consistent with a vascular tumor. An incisional biopsy resulted in diagnosis of benign intermuscular hemangioma. A marginal resection of the mass was later performed. During operative resection, the tumor was found to involve the entire posterior tibialis muscle to the musculotendinous junction. The patient began full weight bearing 4 weeks postoperatively and was placed in an ankle-foot orthosis for correction of the planovalgus. At 19 months postoperative, he reported no pain and mild weakness of the left foot, and he had returned to full-time work. There was no recurrence of the tumor. Intermuscular hemangioma of the calf may cause acquired spasticity and equinus deformity of the foot. In addition, intramuscular hemangiomas have been reported to cause muscle weakness and tendon rupture. In this patient, the authors believe that the posterior tibialis muscle was weakened and elongated secondary to the replacement of the muscle tissue by the tumor, ultimately leading to the planovalgus deformity.

  7. Regression of infancy hemangiomas with recombinant IFN-alpha 2b.

    PubMed

    Garmendía, G; Miranda, N; Borroso, S; Longchong, M; Martínez, E; Ferrero, J; Porrero, P; López-Saura, P

    2001-01-01

    Interferon-alpha (IFN-alpha) has antitumor and antiangiogenic effects. The purpose of this work was to evaluate its efficacy and safety in the treatment of infancy hemangioma and to monitor the appearance of anti-IFN antibodies in these patients. Thirty-nine children (29 girls) aged 1.5-158 months, with 19 younger than 1 year and 9 older than 5, were treated with 3 x 10(6) IU/m(2) IFN-alpha 2b, subcutaneously (s.c.) daily. Inclusion criteria were life-threatening or life-limiting hemangioma and parents' informed consent. Regression was considered if tumor size diminished by 50% or more. Of the 38 patients who completed 6 months of treatment, 27 (71.1%) had regression and 11 (28.9%) had stable disease. No patient experienced progression. Regression was more frequent (100%) among patients between 1 and 5 years old, but it was particularly important (68%) among those under 1 year old, when spontaneous regression is rare. The main side effects were the IFN-related flulike syndrome (79%), increase in serum alanine aminotransferase (ALT) (28%), anorexia (19%), and mild inflammation at the injection site (19%). There was no effect on psychomotor or physical development. On the contrary, 1 patient with neurologic symptoms improved remarkably, including seizure disappearance. Eight patients developed anti-IFN-alpha 2 neutralizing antibodies, and 7 of them responded to IFN treatment. IFN-alpha 2b is a safe and efficacious treatment of infancy hemangioma. Further work should look for other treatment schedules and ways of administration and carefully monitor anti-IFN neutralizing antibodies, which does not seem to interfere with response.

  8. Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference

    PubMed Central

    Frommelt, Peter C.; Chamlin, Sarah L.; Haggstrom, Anita; Bauman, Nancy M.; Chiu, Yvonne E.; Chun, Robert H.; Garzon, Maria C.; Holland, Kristen E.; Liberman, Leonardo; MacLellan-Tobert, Susan; Mancini, Anthony J.; Metry, Denise; Puttgen, Katherine B.; Seefeldt, Marcia; Sidbury, Robert; Ward, Kendra M.; Blei, Francine; Baselga, Eulalia; Cassidy, Laura; Darrow, David H.; Joachim, Shawna; Kwon, Eun-Kyung M.; Martin, Kari; Perkins, Jonathan; Siegel, Dawn H.; Boucek, Robert J.; Frieden, Ilona J.

    2013-01-01

    Infantile hemangiomas (IHs) are common neoplasms composed of proliferating endothelial-like cells. Despite the relative frequency of IH and the potential severity of complications, there are currently no uniform guidelines for treatment. Although propranolol has rapidly been adopted, there is significant uncertainty and divergence of opinion regarding safety monitoring, dose escalation, and its use in PHACE syndrome (PHACE = posterior fossa, hemangioma, arterial lesions, cardiac abnormalities, eye abnormalities; a cutaneous neurovascular syndrome characterized by large, segmental hemangiomas of the head and neck along with congenital anomalies of the brain, heart, eyes and/or chest wall). A consensus conference was held on December 9, 2011. The multidisciplinary team reviewed existing data on the pharmacologic properties of propranolol and all published reports pertaining to the use of propranolol in pediatric patients. Workgroups were assigned specific topics to propose protocols on the following subjects: contraindications, special populations, pretreatment evaluation, dose escalation, and monitoring. Consensus protocols were recorded during the meeting and refined after the meeting. When appropriate, protocol clarifications and revision were made and agreed upon by the group via teleconference. Because of the absence of high-quality clinical research data, evidence-based recommendations are not possible at present. However, the team agreed on a number of recommendations that arose from a review of existing evidence, including when to treat complicated IH; contraindications and pretreatment evaluation protocols; propranolol use in PHACE syndrome; formulation, target dose, and frequency of propranolol; initiation of propranolol in infants; cardiovascular monitoring; ongoing monitoring; and prevention of hypoglycemia. Where there was considerable controversy, the more conservative approach was selected. We acknowledge that the recommendations are conservative in

  9. Efficacy of intralesional steroid injection in head and neck hemangioma: a systematic review.

    PubMed

    Prasetyono, Theddeus O H; Djoenaedi, Intania

    2011-01-01

    The purpose of this article was to discuss about the use of corticosteroids in head and neck hemangioma as one of the safest noninvasive therapy, focusing on intralesional steroid injection, including perilesional and infusion, for curing or reducing tumor size. A systematic review was done by means of all English publication in PubMed during the period of 1996 to 2008 using the keywords "hemangioma" and "intralesional steroid injection." The studies involved were retrospective and prospective case reviews on using intralesional steroid injection with or without other treatment modalities. Exclusion criteria included letter to the editor, comment, and discussion. Evaluation was done covering the indication, age and sex of the patients, location of the lesion, reduction in volume and resolution after intralesional steroid injection, including perilesional and infusion, the improvement of symptoms and signs, local and systemic complications, dose, and the number of injections required to achieve the desired clinical and aesthetic results. Using the 7th ed. EndNote program, 81 abstracts were successfully retrieved. Finally, this study limited our analysis to 22 studies. A total of 749 patients received intralesional steroid injections, including perilesional and infusion, with or without other treatment modalities. Age of the participants ranged from 10 days to 4 years (mean, 4.17 months). Six references evaluated the percentage of reduction in volume and size after intralesional steroid injection; 71% revealed excellent clinical response, 23.4% good, 2.96% poor, 2% no response, and 0.6% were lost to follow-up. From the remaining, 82% of the participants revealed improvement in sign and symptoms. Three articles mentioned aesthetic evaluation, and all stated excellent to good outcome. Intralesional steroid injection is a good option for treating head and neck hemangioma at proliferative phase with relatively low complications.

  10. Unilateral livedoid vasculopathy associated with involutional phase of cutaneous infantile hemangioma: the connection to coagulation disorders.

    PubMed

    Criado, Paulo Ricardo; Alavi, Afsaneh; Halpern, Ilana; Sotto, Mirian Nacagami; Kirsner, Robert S

    2013-12-01

    Livedoid vasculopathy is a bilateral painful and recurrent cutaneous ulcerative disorder of the legs that leads to atrophie blanche, atrophic white-porcelain scars, and is associated with disorders of fibrinolysis and/or coagulation. We present a young boy with an association between livedoid vasculopathy in the area of a previous involuted cutaneous hemangioma. We found 4 uncommon abnormalities associated with thrombo-occlusive events: heterozygous 20210 A→G genotype of prothrombin, reduced activity of anticoagulation proteins C and S, and elevated lipoprotein (a).

  11. [Thrombosed cavernous hemangioma of the anterior mediastinum. A report of one case].

    PubMed

    Alvarez-Zepeda, Carlos; Riveros, S Pedro; Lora, L Pilar; Barrera, C Rodrigo; Gatica, J Francisco; Castillo, A Jorge

    2004-01-01

    Mediastinum hemangioma is a rare benign tumor. We performed surgery and present the first reported case in Chile. The patient is a 24-year-old symptomatic woman, referred to our hospital from a rural health center. The patient had all routine preoperative studies, chest radiographs and computed tomography of the thorax. We performed a median sternotomy with a complete resection of the mass. During the 36-month follow-up, she was well, asymptomatic and without relapse evidence. A review of the most outstanding characteristics of this rare tumor is presented.

  12. Intradural Intramedullary Mixed Type Hemangioma: Optimizing the Surgical Management through Intraoperative Neurophysiological Monitoring

    PubMed Central

    Rahyussalim, Ahmad Jabir; Situmeang, Adrian; Safri, Ahmad Yanuar; Fadhly, Zulfa Indah K.

    2015-01-01

    Intradural intramedullary mixed type hemangioma is a rare histotype of primary spinal cord tumors, though it can carry a severe clinical burden leading to limb dysfunction or motor and sensory disturbances. Timely intervention with radical resection is the hallmark of treatment but achieving it is not an easy task even for experienced neurosurgeons. We herein present an exemplificative case presenting with sudden paraplegia in which total resection was achieved under intraoperative neurophysiology monitoring. A thorough discussion on the operative technique and the role of neuromonitoring in allowing a safe surgical management of primary spinal cord tumors is presented. PMID:26839729

  13. Percutaneous ethanol embolization and cement augmentation of aggressive vertebral hemangiomas at two adjacent vertebral levels.

    PubMed

    Cianfoni, Alessandro; Massari, Francesco; Dani, Genta; Lena, Jonathan R; Rumboldt, Zoran; Vandergrift, William A; Bonaldi, Giuseppe

    2014-10-01

    This report describes a case of successful percutaneous direct-puncture ethanol embolization, followed by vertebroplasty, of an aggressive vertebral hemangioma (VH) involving two adjacent thoracic vertebral levels. In this case, the 78-year-old male patient presented with a 6-month history of progressive paraparesis due to spinal cord compression by a T8-T9 VH with an extensive epidural component. Follow-up demonstrated epidural component shrinkage with complete regression of symptoms at 3 months. This case suggests that exclusive percutaneous treatment may be considered for symptomatic VH even when two adjacent vertebral levels are affected.

  14. Pulmonary angiomatosis and hemangioma in common dolphins (Delphinus delphis) stranded in Canary Islands.

    PubMed

    Díaz-Delgado, Josué; Arbelo, Manuel; Sacchini, Simona; Quesada-Canales, Óscar; Andrada, Marisa; Rivero, Miguel; Fernández, Antonio

    2012-08-01

    Vascular tumors and disorders, like angiomatosis, are rarely described in cetacean species. A retrospective histological study was carried out on lung samples from 35 common dolphins (Delphinus delphis) stranded in the Canary Islands coasts looking for morphological vascular changes and likely related causes. Twenty-five out of thirty-five (71%) common dolphins showed focal or multifocal angiomatosis-like lesions. A high association between this type of vascular proliferation and parasitic infestation was observed. In addition, a single pulmonary cavernous hemangioma not previously reported in common dolphins is presented.

  15. Epithelioid hemangioma of brachial artery: report of a case and review of the literature

    PubMed Central

    Moira, Ragazzi; Giuseppe, Falco; Riccardo, Valli; Nicola, Rocco; Daniele, Bordoni; Pierfrancesco, Cadenelli; Antonio, Della Corte Gianni; Antonello, Accurso; Bruno, Amato; Giovanni, Casali; Guglielmo, Ferrari

    2015-01-01

    Epithelioid hemangioma (EH) is an uncommon benign vascular lesion, also known as angioblastic lymphoid (or angiolymphoid) hyperplasia with eosinophilia, characterized by an unclear etiopathogenesis. It usually affects young to middle-aged adults and develops in the head and neck region, as painless cutaneous or subcutaneous reddish papules or nodules. Large vessels involvement is extremely rare, and to date only two cases affecting the brachial artery have been cited in literature. In this report we present a further case of EH of the brachial artery and review the pertinent literature. PMID:28352744

  16. Infantile Hemangiomas: An Updated Review on Risk Factors, Pathogenesis, and Treatment.

    PubMed

    Smith, Chelsey J Forbess; Friedlander, Sheila Fallon; Guma, Monica; Kavanaugh, Arthur; Chambers, Christina D

    2017-04-12

    Infantile hemangiomas (IHs) are the most common vascular tumors in infants, appearing in early infancy and ultimately regressing with time. Clinical presentation may vary, with a minority of lesions causing impairment of vital function (e.g., respiratory or visual obstruction), permanent scarring, and/or disfigurement. The pathogenesis of IH is complex and poorly understood. Risk factors implicated in their development include preterm birth and placental anomalies. IH presents a myriad of clinical challenges, including correct diagnosis and whether or not to pursue treatment. This article is a review of the current literature regarding pathogenesis, clinical presentation, treatment, and prognosis of IH. Birth Defects Research, 2017.© 2017 Wiley Periodicals, Inc.

  17. A handheld wireless device for diffuse optical spectroscopic assessment of infantile hemangiomas

    NASA Astrophysics Data System (ADS)

    Fong, Christopher J.; Flexman, Molly; Hoi, Jennifer W.; Geller, Lauren; Garzon, Maria; Kim, Hyun K.; Hielscher, Andreas H.

    2013-03-01

    Infantile hemangiomas (IH) are common vascular growths that occur in 5-10% of neonates and have the potential to cause disfiguring and even life-threatening complications. With no objective tool to monitor IH, a handheld wireless device (HWD) that uses diffuse optical spectroscopy has been developed for use in assessment of IH by measurements in absolute oxygenated and deoxygenated hemoglobin concentration as well as scattering in tissue. Reconstructions of these variables can be computed using a multispectral evolution algorithm. We validated the new system by experimental studies using phantom experiments and a clinical study is under way to assess the utility of DOI for IH.

  18. Down-Regulation of mir-424 Contributes to the Abnormal Angiogenesis via MEK1 and Cyclin E1 in Senile Hemangioma: Its Implications to Therapy

    PubMed Central

    Nakashima, Taiji; Jinnin, Masatoshi; Etoh, Tomomi; Fukushima, Satoshi; Masuguchi, Shinichi; Maruo, Keishi; Inoue, Yuji; Ishihara, Tsuyoshi; Ihn, Hironobu

    2010-01-01

    Background Senile hemangioma, so-called cherry angioma, is known as the most common vascular anomalies specifically seen in the aged skin. The pathogenesis of its abnormal angiogenesis is still unclear. Methodology/Principal Findings In this study, we found that senile hemangioma consisted of clusters of proliferated small vascular channels in upper dermis, indicating that this tumor is categorized as a vascular tumor. We then investigated the mechanism of endothelial proliferation in senile hemangioma, focusing on microRNA (miRNA). miRNA PCR array analysis revealed the mir-424 level in senile hemangioma was lower than in other vascular anomalies. Protein expression of MEK1 and cyclin E1, the predicted target genes of mir-424, was increased in senile hemangioma compared to normal skin or other anomalies, but their mRNA levels were not. The inhibition of mir-424 in normal human dermal microvascular ECs (HDMECs) using specific inhibitor in vitro resulted in the increase of protein expression of MEK1 or cyclin E1, while mRNA levels were not affected by the inhibitor. Specific inhibitor of mir-424 also induced the cell proliferation of HDMECs significantly, while the cell number was decreased by the transfection of siRNA for MEK1 or cyclin E1. Conclusions/Significance Taken together, decreased mir-424 expression and increased levels of MEK1 or cyclin E1 in senile hemangioma may cause abnormal cell proliferation in the tumor. Senile hemangioma may be the good model for cutaneous angiogenesis. Investigation of senile hemangioma and the regulatory mechanisms of angiogenesis by miRNA in the aged skin may lead to new treatments using miRNA by the transfection into senile hemangioma. PMID:21179471

  19. Disruption and inactivation of the PP2A complex promotes the proliferation and angiogenesis of hemangioma endothelial cells through activating AKT and ERK

    PubMed Central

    Xie, Furong; Bao, Xin; Yu, Jingshuang; Chen, Wantao; Wang, Lizhen; Zhang, Zhiyuan; Xu, Qin

    2015-01-01

    Hemangioma is a benign vascular neoplasm of unknown etiology. In this study, we generated an endothelial-specific PyMT gene-expressing transgenic mouse model that spontaneously develops hemangioma. Based on this transgenic model, a specific binding between PyMT and the core AC dimer of protein phosphatase 2A (PP2A) was verified in hemangioma vascular endothelial cells. The binding between PyMT and the PP2A AC dimer resulted in dissociation of the B subunit from the PP2A complex and inactivation of PP2A phosphatases, which in turn activated AKT and ERK signaling and promoted cell proliferation, migration and angiogenesis in vitro and tumorigenesis in vivo. Consistent with the in vitro findings, decreased PP2A phosphatase activity and disruption of the PP2A heterotrimeric complex were also observed in both primary transgene-positive TG(+) mouse hemangioma endothelial cells (TG(+) HEC cells) and human proliferating phase hemangioma endothelial (human HEC-P) cells, but not in transgene-negative TG(−) mouse normal vascular endothelial cells (TG(−) NEC cells) and human involuting phase hemangioma endothelial (human HEC-I) cells. Further, it was observed that in human hemangioma cells, endoglin could compete with the PP2A/A, C subunits for binding to the PP2A/B subunit, thereby resulting in dissociation of the B subunit from the PP2A complex. Treatment of Tie2/PyMT transgenic mice with the PP2A activator FTY720 significantly delayed the occurrence of hemangioma. Our data provide evidence of a previously unreported anti-proliferation and anti-angiogenesis effect of PP2A in vascular endothelial cells, and show the therapeutic value of PP2A activators in hemangioma. PMID:26308070

  20. Propranolol inhibits angiogenesis via down-regulating the expression of vascular endothelial growth factor in hemangioma derived stem cell

    PubMed Central

    Zhang, Ling; Mai, Hua-Ming; Zheng, Jing; Zheng, Jia-Wei; Wang, Yan-An; Qin, Zhong-Ping; Li, Ke-Lei

    2014-01-01

    Background: Oral propranolol (PRN) has recently been shown to be highly effective for infantile hemangiomas (IHs), and is currently recommended as the first-line treatment of complicated IHs. However, the therapeutic mechanism(s) still remain unclear. Methods: In this study, we tested hemangioma-derived stem cells for expression of vascular endothelial growth factor (VEGF) in vitro and studied the inhibition of VEGF expression. We used PCR, Elisa, Western blotting and immunohistochemistry in vivo and in vitro trial. Results: The study demonstrated that application of PRN at a “normal” concentration equivalent to plasma concentration did not inhibit proliferation or promote apoptosis of hemangioma derived stem cells (HemSCs) isolated from IH patients. PRN suppressed expression of vascular endothelial growth factor (VEGF) and basic Fibroblast Growth Factor (bFGF) in HemSCs in vitro. Morphological, histological and immunohistological improvement were observed in vivo using murine IH model in which HemSCs pre-treated with PRN were implanted into BALB/c-nu mice. In the pre-treated HemSC grafts, mean micro-vessel density (MVD) significantly decreased and protein levels of VEGF markedly decreased, while bFGF was still detectable. Conclusions: The results suggested PRN inhibited angiogenesis via down-regulating the expression of vascular endothelial growth factor in hemangioma derived stem cell. These findings provide critical insight into the potential mechanisms of PRN action on IH. PMID:24427325

  1. Anastomosing hemangioma arising from the kidney: a case of slow progression in four years and review of literature

    PubMed Central

    Zhang, Wei; Wang, Qiang; Liu, Yu-Lin; Yu, Wen-Juan; Liu, Yan; Zhao, Hui; Zhuang, Jie; Jiang, Yan-Xia; Li, Yu-Jun

    2015-01-01

    Reported herein is a renal anastomosing hemangioma which developed slowly in the past four years. A 25-year-old woman was found a mass localized in the upper portion four years ago, and only slow progression in the past four years. She underwent a laparoscopic partial nephrectomy of right kidney and diagnosed as anastomosing hemangioma. On histology the vascular components of the tumor had an anastomosing pattern without well-definite margins. Immunohistochemically, only endothelial markers (CD31, CD34) were expressed on the vascular components of tumor cells. Smooth muscle actin (SMA), cytokeratin (CK), EMA and S-100 and so on were all negative in the epithelioid tumor cells. The patient was alive at 16 months after operation, without any evidence recurrence or metastasis. Anastomosing hemangioma is an extremely rare vascular neoplasm; only 23 cases were previously described until now. Our report of anastomosing hemangioma arising from the kidney with slow progression will improve the knowledge of primary vascular tumors arising in the kidney. PMID:25973131

  2. Utility of the SPECT Tc-99m labeled RBC blood pool scan in the detection of hepatic hemangiomas

    SciTech Connect

    Guze, B.H.; Hawkins, R.A.

    1989-11-01

    The sensitivity of SPECT imaging of hepatic blood pool activity using Tc-99m labeled RBCs was contrasted with magnetic resonance and CT imaging in 22 cases. SPECT is a noninvasive technique with a high sensitivity for the diagnosis of hepatic hemangiomas. It is helpful for clarifying equivocal magnetic resonance imaging results.

  3. Calvarial bone cavernous hemangioma with intradural invasion: An unusual aggressive course—Case report and literature review

    PubMed Central

    Nasi, Davide; Somma, Lucia di; Iacoangeli, Maurizio; Liverotti, Valentina; Zizzi, Antonio; Dobran, Mauro; Gladi, Maurizio; Scerrati, Massimo

    2016-01-01

    Introduction Cavernous hemangioma of the skull is a rare pathological diagnosis, accounting for 0.2% of bone tumors and 7% of skull tumors. Usually calvarial bone cavernous hemangioma are associated with a benign clinical course and, despite their enlargement and subsequent erosion of the surrounding bone, the inner table of the skull remains intact and the lesion is completely extracranial. Presentation of a case The authors present the unique case of a huge left frontal bone cavernous malformation with intradural extension and brain compression determining a right hemiparesis. Discussion Calvarial cavernous hemangiomas are benign tumors. They arise from vessels in the diploic space and tend to involve the outer table of the skull with relative sparing of the inner table. More extensive involvement of the inner table and extradural space is very unusual and few cases are reported in literature. To the best of our knowledge, intradural invasion of calvarial hemangioma has not been previously reported. Conclusion Our case highlights the possibility of an aggressive course of this rare benign pathology. PMID:27061482

  4. Juxtapapillary hemangioma: a case report and review of clinical features and management of von Hippel-Lindau disease.

    PubMed

    Aumiller, Mira Silbert

    2005-08-01

    The phakomatose von Hipple-Lindau (VHL) disease is a multisystem disorder characterized by hemangioblastomas of the central nervous system (CNS), retinal angiomas, and multiple cysts and tumors of the viscera. Retinal capillary hemangiomas are the most common manifestation of VHL disease, which can occur in the optic nerve, where it may simulate disc edema, or in the retinal periphery, which is characterized by massive retinal exudation. Both locations can result in progressive accumulation of exudates leading to a decrease in visual acuity and potentially to a serous retinal detachment. A juxtapapillary hemangioma was observed in a 72-year-old man who presented for a routine examination. The patient was asymptomatic, despite the presence of a trace afferent papillary defect. This finding had to be carefully differentiated from sectoral disc edema. Blood tests, computed tomography (CT), and magnetic resonance imaging (MRI) all had normal results. Fluorescein angiography was a valuable secondary test showing early filling of the vascular network overlying the nerve head and characteristic late hyperfluorescence. There are 2 distinct forms of capillary hemangiomas--the juxtapapillary tumor or the peripheral capillary hemangioma. Although both types are similar histologically, they do vary in their appearance, differential diagnosis, and treatment. In both types, fluorescein angiography is an extremely helpful ancillary test in making the initial diagnosis. This case report reviews the ocular manifestations and systemic findings associated with VHL disease.

  5. Simple Preparation of Timolol 0.5% Gel from Eye Drop Solution for Superficial Infantile Hemangiomas.

    PubMed

    Choo, Winnie

    2017-01-01

    The discovery of beta-adrenergic blocker effects on infantile hemangiomas has affected the choice of treatment in recent years. Oral propranolol is effective in treating infantile hemangiomas, but the risk of systemic side effects remains a concern. Data from literature review reported positive clinical outcomes with no major adverse effects observed in children using topical beta-blocker such as timolol maleate. Topical application of timolol eye drop has been mentioned in few studies, most of which reported that the solution cannot stay on the site of application due to its fluidity. Adding hydroxyethyl cellulose into a timolol solution increased its viscosity by forming a hydrogel and thus changed the rheology property. The compounded timolol gel exhibited thixotropy property allowing better and longer contact at sites of application. Experimental data from literature review showed desirable characteristics and measurable flux of timolol across human stratum corneum. Gel dosage form allows easy and precise application and maximizes timolol's therapeutic efficacy at the sites of application. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  6. Oral capillary hemangioma: a clinical protocol of diagnosis and treatment in adults.

    PubMed

    da Silva, Walessa Brasil; Ribeiro, André Luis Ribeiro; de Menezes, Sílvio Augusto Fernandes; de Jesus Viana Pinheiro, João; de Melo Alves-Junior, Sérgio

    2014-12-01

    Hemangiomas are benign vascular anomalies characterized by benign proliferation of blood vessels. There are no well-defined criteria for the diagnosis and treatment of oral capillary hemangioma (OCH). The objective of this study is to report a safe, effective, and low-cost protocol for diagnosis and treatment of OCH. Eight patients were diagnosed with OCH, through two physical examination maneuvers-the diascopy and head lowering maneuver with abdominal compression (HLMAC). The treatment performed was sclerotherapy with ethanolamine oleate, weekly, until the disappearance of the lesion. No local anesthetics were administered prior to the sclerosing agent injection. All cases showed a complete remission of the lesions after sclerotherapy. There were no visible scars or compromise esthetics or normal function, and there was no evidence of recurrence. Only one patient had superficial ulceration, which remained asymptomatic and healed without specific treatment. This protocol was effective in the diagnosis of OCH through two physical examination maneuvers with low-cost and easy implementation, the diascopy and the HLMAC. The low concentration associated with a reduced amount of the sclerosing agent was responsible for the excellent results in the cases treated.

  7. A novel topical nano-propranolol for treatment of infantile hemangiomas.

    PubMed

    Chen, Zheng Gang; Zheng, Jia Wei; Yuan, Ming Lu; Zhang, Ling; Yuan, Wei En

    2015-07-01

    Topical propranolol has been used for the therapy of superficial infantile hemangiomas (IH). A retrospective investigation was conducted in 50 patients to evaluate the clinical effect of a new type of topical nano-propranolol-dispersed hydrogel. Participants were treated 3 times per day for 2 weeks to 11 months. 68% of patients were female and 12% had received other treatments before therapy. The nano-propranolol 0.5% hydrogel was initiated at a mean age of 5.010 months and for a mean duration of 3.610 months. The response rate was 86%. No recurrence and rebound growth occurred after withdrawal of hydrogel. Slight side effects (application site itching, erosion and crusting) were observed in only 2 cases. All the local irritations were evaluated as mild and were tolerated without discontinuing the medication. We suggest that topical nano-propranolol hydrogel could be an alternative option for the treatment of uncomplicated superficial IH with satisfactory tolerability and optimal effectiveness. The current recommended treatment for infantile hemangiomas is oral propranolol. Nonetheless, a small proportion of patients will have systemic side effects. In this article, the authors developed topical nano-propranolol hydrogel and tested this on clinical patients and found favorable response. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The "biker-glove" pattern of segmental infantile hemangiomas on the hands and feet.

    PubMed

    Weitz, Nicole A; Bayer, Michelle L; Baselga, Eulalia; Torres, Mauricio; Siegel, Dawn; Drolet, Beth A; Frieden, Ilona J; Haggstrom, Anita N

    2014-09-01

    Infantile hemangiomas (IH) on the extremities have not been systematically studied. We sought to describe the clinical characteristics and distribution patterns of IH affecting acral surfaces and to explore the relationship among these patterns, limb development, and IH pathogenesis. This was a retrospective multicenter cohort study. Photographic archives from 4 tertiary pediatric dermatology referral centers were searched for patients with IH larger than 1 cm and involving 1 or more digit. Hemangioma location, distribution, and morphologic subtype were recorded. Medical records were reviewed for demographic and clinical data. In all, 73 patients were identified. The most common IH pattern resembled that of a "biker glove" (73%), followed by localized IH on the distal digits (14%), segmental IH extending over the distal digits (8%), and intermediate patterns (5%). Overall, 63% of acral IH were segmental, 26% indeterminate, and 11% localized. Five patients had associated structural anomalies. Complications were noted in 33% of cases. Limitations were retrospective study design; selection bias based on recall and photography; documentation and follow-up were not standardized across institutions; and treatment information may not reflect current approaches. Acral IH display specific patterns and are associated with a relatively high risk of ulceration. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Pulmonary sclerosing hemangioma with a rare symptom: A case report and review of the literature

    PubMed Central

    Zhou, Le; Sun, Chuntang; Huang, Yan; Li, Qiao; Tang, Huairong; Wang, Youjuan

    2017-01-01

    Pulmonary sclerosing hemangioma (PSH) is a relatively rare benign tumor. However, as it occurs only rarely, the natural course of the tumor is not well understood. In the present study, a case is presented of a 35-year-old woman who underwent intermittent fevers for more than one year. This case highlighted fever as a rare symptom of PSH. Fever is possibly one of the symptoms of PSH, although it is less likely to occur. Another symptom of the patient was that the tumor grew quickly in two months. The lesion was diagnosed as multiple sclerosing hemangioma of the lung (i.e., PSH), in which papillary, solid and sclerotic patterns appeared. Immunohistochemical evaluation of the lesion revealed positive staining for thyroid transcription factor 1 (TTF1), epithelial membrane antigen (EMA), pancytokeratin (PCK) and cytoskeleton 7 (CK7). In the present case study, the biological activity of PSH was identified to be aggressive. A review of the literature was performed in order to comment further on the clinical and pathological features of this rare disease. PMID:28357098

  10. Glucose transporter 1-positive endothelial cells in infantile hemangioma exhibit features of facultative stem cells

    PubMed Central

    Huang, Lan; Nakayama, Hironao; Klagsbrun, Michael; Mulliken, John B.; Bischoff, Joyce

    2014-01-01

    Endothelial glucose transporter 1 (GLUT1) is a definitive and diagnostic marker for infantile hemangioma (IH), a vascular tumor of infancy. To date, GLUT1-positive endothelial cells in IH have not been quantified nor directly isolated and studied. We isolated GLUT1-positive and GLUT1-negative endothelial cells from IH specimens and characterized their proliferation, differentiation and response to propranolol, a first-line therapy for IH, and to rapamycin, an mTOR pathway inhibitor used to treat an increasingly wide array of proliferative disorders. Although freshly isolated GLUT1-positive cells, selected using anti-GLUT1 magnetic beads, expressed endothelial markers CD31, VE-Cadherin and VEGFR2, they converted to a mesenchymal phenotype after three weeks in culture. In contrast, GLUT1-negative endothelial cells exhibited a stable endothelial phenotype in vitro. GLUT1-selected cells were clonogenic when plated as single cells and could be induced to re-differentiate into endothelial cells, or into pericyte/smooth muscle cells or into adipocytes, indicating a stem cell-like phenotype. These data demonstrate that, although they appear and function in the tumor as bona fide endothelial cells, the GLUT1-positive endothelial cells display properties of facultative stem cells. Pretreatment with rapamycin for 4 days significantly slowed proliferation of GLUT1-selected cells, whereas propranolol pretreatment had no effect. These results reveal for the first time the facultative nature of GLUT1-positive endothelial cells in infantile hemangioma. PMID:25187207

  11. Resection of Giant Hemangioma of the Tongue Utilizing a Miniature Tourniquet Technique.

    PubMed

    Shuker, Sabri T

    2016-07-01

    With the progress of multidisciplinary vascular anomaly treatment, the use of radiotherapy, cryotherapy, laser therapy and medical treatments, the corticosteroid, sclerotherapy, and many more, the role of surgery has been refined. Surgical treatment has historically been the mainstay of treatment and will maintain.A miniature tourniquet technique applied to the tongue was successfully utilized in reducing bleeding to a minimum during surgical resection of a massive cavernous hemangioma involving the tongue and lower lip without any postoperative complications.Comprehensions of the neurovascular anatomy of the tongue, vasculature, innervations, and muscles physiological functions are very important for selecting the right surgical approach.A 9-year-old girl presented with giant hemangioma resulting in severe protrusions of the anterior and lateral two-thirds of the tongue with an extensive anterior open bite jaw deformity and oral physiological dysfunctions as speech, mastication, and deglutition. Such a presentation is a unique surgical challenge due to the high risk of bleeding, tongue swelling, and airway compromise.Postsurgical results showed oral physiological function improvement and the elimination of interaction effects on anterior open bite.

  12. Radiotherapy for maxillo-facial hemangiomas in children. Dental and periodontal long term effects.

    PubMed

    Colella, G; Vuolo, G; Siniscalchi, G; Moscariello, A; Itro, A

    2005-09-01

    Vascular maxillo-facial malformations, common pathologies in children, represent 7% of all benign tumors. They are divided into vascular malformations and hemangiomas. In the 70s-80s radiotherapy was the most applied technique, but because of its misuse or overdose, it could lead to relevant and hard consequences for the impact on the salivar glands, periodontium and growing maxillo-facial nuclei. The authors describe the case of a 38-year-old man, who, during infancy, was submitted to radiotherapy for a hemangioma to his chin and cheek. He was under observation for an agressive periodontitis, followed by a serious facial asimmetry, located in his irradiated side. They describe the therapy and the results obtained, underlying the particular difficulties detected in operating on tissues hardly and often irreversibly injured by radiotherapy. On the basis of this clinical case and of the most up-dated knowledge, therapeutical alternatives such as embolization, cryotherapy, cortisonic systemic and intralesional therapy, the use of interferon gamma 2 and the use of the most recent laser, are analyzed, and advantages and disadvantages and the most appropriate indications are underlined.

  13. Misdiagnosis of pathological femoral fracture in a patient with intramuscular hemangioma: A case report

    PubMed Central

    YU, XIAOLONG; NIE, TAO; ZHANG, BIN; DAI, MIN; LIU, HUCHENG; ZOU, FAN

    2016-01-01

    Hemangioma is a common disease; however, intramuscular hemangioma (IH) presenting with a pathological fracture is extremely rare. The present study reports a case of a 46-year-old male patient that suffered from IH of the right thigh, presenting with a pathological femoral fracture. The patient was initially diagnosed with a traumatic femoral fracture, and routine open reduction and internal fixation were performed at a local hospital. However, 20 days subsequent to surgery, gradual swelling and soreness around the incision were observed. The incision eventually ruptured during squatting for bowel movement, which led to extensive blood loss. Based on computed tomography (CT) and deep femoral artery arteriography, IH presenting with a pathological femoral fracture was diagnosed. The patient underwent artery embolization, from which he recovered well. At the 6-month follow-up, the femoral fracture was revealed to have healed, and a CT scan demonstrated no evidence of recurrence; however, continuous observation using CT is required in order to determine the long-term outcome. To the best of our knowledge, this is the first case of a misdiagnosed pathological femoral fracture in a patient with IH reported in the English literature. PMID:27347124

  14. Avian hemangioma retrovirus induces cell proliferation via the envelope (env) gene.

    PubMed

    Alian, A; Sela-Donenfeld, D; Panet, A; Eldor, A

    2000-10-10

    Several years ago, a field strain retrovirus, avian hemangioma virus (AHV), was isolated from hemangioma tumors in layer hens. Sequence analysis indicated that the AHV genome contains the three prototypic retroviral genes, gag, pol, and env, and is devoid of an oncogene. In cultured endothelial cells, however, AHV induced a significant cytopathic effect through a typical apoptotic cascade. We now demonstrate that AHV also induces cell proliferation and anchorage-independent growth of BSC-1 epithelial cells and NIH-3T3 fibroblasts. This was shown by measurements of (1) cell viability, (2) DNA synthesis, (3) flow cytometry analysis of the cell DNA content, and (4) clonogenic efficiency of the infected cells. Anchorage-independent cell growth was demonstrated by colony formation in soft agar. Moreover, the AHV env gene was cloned into a MuLV-based retroviral vector, and infection of NIH-3T3 cells with this vector induced cell proliferation as well as clonogenic growth. These results suggest that AHV, which is devoid of an oncogene, is a pleiotropic activator capable of inducing either apoptosis or cellular proliferation, depending on the infected cell type. Copyright 2000 Academic Press.

  15. Mandibule rehabilitation after embolization of hemangioma with implant overdenture using existing endosseous implants: A clinical report.

    PubMed

    Qian, Haixin; Zhang, Fuqiang; Jiao, Ting

    2016-10-01

    A fifty-year-old man received embolization for mandibular hemangioma two years ago, and the surgeon had placed four implants in his mandible and made a removable denture upon the implants. His denture however fractured repeatedly in the past years. After examination and communication with the patient, an implant-assisted overdenture incorporating bar attachment combined ERA attachment and Locator abutment was re-fabricated. A sixteen months follow-up showed acceptable outcome. There are some guidelines on design of implant over-denture, the site of implant will affect the final result. The unfavorable bone structure of mandibular hemangioma restricts the number and the site of implant, modification of design is essential to improve the final result. Multi-disciplinary cooperation should be established for extensive edentulous case. Overlay type prosthesis incorporating several types of attachments can be suitable for complex case because of acceptable results and easy maintenance. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  16. Altered Expression of EPO Might Underlie Hepatic Hemangiomas in LRRK2 Knockout Mice

    PubMed Central

    Xiao, Kaifu; Zhang, Zhuohua

    2016-01-01

    Parkinson's disease (PD) is a severe neurodegenerative disorder caused by progressive loss of dopaminergic neurons in the substantia nigra pars compacta of the midbrain. The molecular mechanism of PD pathogenesis is unclear. Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are a common genetic cause of familial and sporadic PD. However, studies on LRRK2 mutant mice revealed no visible dopaminergic neuronal loss in the midbrain. While surveying a LRRK2 knockout mouse strain, we found that old animals developed age-dependent hepatic vascular growths similar to cavernous hemangiomas. In livers of these hemangioma-positive LRRK2 knockout mice, we detected an increased expression of the HIF-2α protein and significant reactivation of the expression of the HIF-2α target gene erythropoietin (EPO), a finding consistent with a role of the HIF-2α pathway in blood vessel vascularization. We also found that the kidney EPO expression was reduced to 20% of the wild-type level in 18-month-old LRRK2 knockout mice. Unexpectedly, this reduction was restored to wild-type levels when the knockout mice were 22 months to 23 months old, implying a feedback mechanism regulating kidney EPO expression. Our findings reveal a novel function of LRRK2 in regulating EPO expression and imply a potentially novel relationship between PD genes and hematopoiesis. PMID:27872856

  17. Altered Expression of EPO Might Underlie Hepatic Hemangiomas in LRRK2 Knockout Mice.

    PubMed

    Wu, Ben; Xiao, Kaifu; Zhang, Zhuohua; Ma, Long

    2016-01-01

    Parkinson's disease (PD) is a severe neurodegenerative disorder caused by progressive loss of dopaminergic neurons in the substantia nigra pars compacta of the midbrain. The molecular mechanism of PD pathogenesis is unclear. Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are a common genetic cause of familial and sporadic PD. However, studies on LRRK2 mutant mice revealed no visible dopaminergic neuronal loss in the midbrain. While surveying a LRRK2 knockout mouse strain, we found that old animals developed age-dependent hepatic vascular growths similar to cavernous hemangiomas. In livers of these hemangioma-positive LRRK2 knockout mice, we detected an increased expression of the HIF-2α protein and significant reactivation of the expression of the HIF-2α target gene erythropoietin (EPO), a finding consistent with a role of the HIF-2α pathway in blood vessel vascularization. We also found that the kidney EPO expression was reduced to 20% of the wild-type level in 18-month-old LRRK2 knockout mice. Unexpectedly, this reduction was restored to wild-type levels when the knockout mice were 22 months to 23 months old, implying a feedback mechanism regulating kidney EPO expression. Our findings reveal a novel function of LRRK2 in regulating EPO expression and imply a potentially novel relationship between PD genes and hematopoiesis.

  18. Imaging Spectrum of Hemangioma and Vascular Malformations of the Head and Neck in Children and Adolescents

    PubMed Central

    Bhat, Venkatraman; Salins, Paul C; Bhat, Varun

    2014-01-01

    Vascular lesions of the head and neck region in children constitute an interesting group of lesions that benefit immensely from imaging techniques. Imaging is essential for identification, characterization, and delineation of the extent of lesion and subsequent follow-up. Infantile hemangiomas, which are vascular tumors with a specific evolution pattern, constitute a large majority of these lesions. On the other hand, there are vascular malformations, which are anomalies of the vascular system, consisting of a range of vascular tissues associated with various flow patterns. When diagnosis is clinically evident, imaging should utilize non-radiation techniques and address the issues necessary for management. Timing and interpretation of imaging methods employed in assessing childhood vascular lesion should also take into consideration the natural history so that imaging is performed to address a specific question. This review highlights the typical appearance of a hemangioma and a group of vascular malformations of the head and neck. For descriptive purpose, an attempt has been made to group lesions into specific subsites, with each one having specific clinical significance. Cases included illustrate the spectrum of the disease ranging from classical form in young children to slightly differing manifestations of the disease in adolescents and adults. The illustrations also provide a novel way of presenting image data using volume-rendering techniques of 3D data. Multi-modality team interaction and management strategies of these complex lesions are also emphasized. PMID:25161800

  19. Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature

    PubMed Central

    Sakai, Toshinori; Higashino, Kosaku; Goda, Yuichiro; Tezuka, Fumitake; Sairyo, Koichi

    2014-01-01

    Capillary hemangiomas are benign tumors found in the skin and soft tissues in younger people. They occur in the central nervous system only rarely, and intradural occurrence is extremely rare. We report here a 60-year-old man presenting with thoracic girdle pain and progressive gait disturbance. Magnetic resonance images of the thoracic spine showed a 12 × 8 × 20 mm, well-defined intradural mass at the T2 level, compressing the spinal cord laterally. Relative to the spinal cord, the mass was hypo- to isointense on T1-weighted images and relatively hyperintense on T2-weighted images, with strong enhancement on contrast-enhanced T1-weighted images. The patient underwent T1-2 hemilaminectomy with resection of the intradural extramedullary tumor, which showed characteristics of a capillary hemangioma on histologic examination. The patient's symptoms improved following the surgery and no clinical or radiological evidence of recurrence was noted at the 2-year follow-up. We present this case with a review of the literature, highlighting features for differential diagnosis. PMID:25045565

  20. Intramuscular Cavernous Hemangioma of Medial Rectus Muscle in Paediatric Age Group

    PubMed Central

    Mehta, Anuj; Butola, Shalini; Abrol, Sangeeta; Kumari, Anju

    2017-01-01

    An 11-year-old male child presented with a mass on the nasal aspect of the right eye that has been there for the last 2 years. Extraocular movements were decreased in the right eye on levoversion, levoelevation, and levodepression. Local examination revealed a bluish mass with irregular surface and ill-defined margins located in the medial rectus muscle. The mass was 10 × 20 mm in size, firm, nodular, nontender, nonpulsatile, noncompressible, and nonreducible. MRI of the orbit revealed a well-defined mass of approximately 23 × 13 mm along the medial rectus (MR) muscle. It was hyperintense on T2W images with very minimal contrast enhancement. A provisional diagnosis of hemangioma or lymphangioma with intralesional haemorrhage was made. During surgical excision, the mass was found to be encapsulated by MR fibres. The MR fibres were separated, and the mass measuring 20 × 8 × 6.5 mm was removed and sent for histopathology. The histopathological examination revealed an intramuscular cavernous hemangioma. PMID:28386496

  1. PDGFR-β (+) perivascular cells from infantile hemangioma display the features of mesenchymal stem cells and show stronger adipogenic potential in vitro and in vivo

    PubMed Central

    Yuan, Si-Ming; Guo, Yao; Zhou, Xiao-Jun; Shen, Wei-Min; Chen, Hai-Ni

    2014-01-01

    Infantile hemangioma, a common benign tumor of infancy, grows quickly in the first year of life, and then regresses slowly to fibrofatty tissue in childhood. The accumulation of fibrofatty tissue in hemangioma involution indicates adipogenesis during this period. Perivascular cells (PCs) from multiple organs display multi-lineage differentiation, including adipogenesis. So we supposed that PCs in hemangioma may contribute to the adipogenesis in the involution. In this study, PDGFR-β (+) PCs was isolated from hemangioma tissue (hemangioma-derived perivascular cells, Hem-PCs) by fluorescence-activated cell sorter. In vitro, Hem-PCs showed fibroblast-like morphology. Immunofluorescence staining and flow cytometry showed Hem-PCs expressed MSCs markers CD105, CD90, CD29 and vimentin, pericyte markers α-SMA and PDGFR-β, stem cell marker CD133, and the adipogenic transcription factor PPAR-γ, but not hematopoietic/endothelial markers CD45, CD34, CD31, and flt-1. In vitro inductions confirmed multi-lineage differentiation of Hem-PCs, especially strong adipogenic potential. Then a murine model was established to observe in vivo differentiation of Hem-PCs by subcutaneous injection of cells/Matrigel compound into nude mice. The results showed Hem-PCs differentiated into adipocytes in vivo. To the best of our knowledge, this is the first study reporting the isolation of multipotential PDGFR-β (+) PCs from hemangioma, and observing their adipogenic differentiation in vivo. PCs may be the cellular basis of adipogenesis in hemangioma involution, and may be the target cells of adipogenic induction to promote hemangioma involution. PMID:25031705

  2. Argon-pumped tunable dye laser therapy for facial port-wine stain hemangiomas in adults--a new technique using small spot size and minimal power

    SciTech Connect

    Scheibner, A.; Wheeland, R.G.

    1989-03-01

    A low power, argon-pumped tunable dye laser was used to deliver yellow light of 577 nm. Individual blood vessels within port-wine stain hemangiomas were treated with a 0.1-mm beam of light using 8 X magnification. This technique permits excellent resolution of facial and nuchal port-wine stain hemangiomas in adults without the adverse complications of textural change, permanent pigmentation abnormality, or hypertrophic scarring.

  3. PDGFR-β (+) perivascular cells from infantile hemangioma display the features of mesenchymal stem cells and show stronger adipogenic potential in vitro and in vivo.

    PubMed

    Yuan, Si-Ming; Guo, Yao; Zhou, Xiao-Jun; Shen, Wei-Min; Chen, Hai-Ni

    2014-01-01

    Infantile hemangioma, a common benign tumor of infancy, grows quickly in the first year of life, and then regresses slowly to fibrofatty tissue in childhood. The accumulation of fibrofatty tissue in hemangioma involution indicates adipogenesis during this period. Perivascular cells (PCs) from multiple organs display multi-lineage differentiation, including adipogenesis. So we supposed that PCs in hemangioma may contribute to the adipogenesis in the involution. In this study, PDGFR-β (+) PCs was isolated from hemangioma tissue (hemangioma-derived perivascular cells, Hem-PCs) by fluorescence-activated cell sorter. In vitro, Hem-PCs showed fibroblast-like morphology. Immunofluorescence staining and flow cytometry showed Hem-PCs expressed MSCs markers CD105, CD90, CD29 and vimentin, pericyte markers α-SMA and PDGFR-β, stem cell marker CD133, and the adipogenic transcription factor PPAR-γ, but not hematopoietic/endothelial markers CD45, CD34, CD31, and flt-1. In vitro inductions confirmed multi-lineage differentiation of Hem-PCs, especially strong adipogenic potential. Then a murine model was established to observe in vivo differentiation of Hem-PCs by subcutaneous injection of cells/Matrigel compound into nude mice. The results showed Hem-PCs differentiated into adipocytes in vivo. To the best of our knowledge, this is the first study reporting the isolation of multipotential PDGFR-β (+) PCs from hemangioma, and observing their adipogenic differentiation in vivo. PCs may be the cellular basis of adipogenesis in hemangioma involution, and may be the target cells of adipogenic induction to promote hemangioma involution.

  4. A Rare Case of Left Ventricular Intramural Hemangioma Diagnosed Using 1.5-T Cardiac MRI with Histopathological Correlation and Successfully Treated by Surgery

    SciTech Connect

    Marrone, Gianluca; Sciacca, Sergio D'Ancona, Giuseppe Pilato, Michele; Luca, Angelo; Gridelli, Bruno

    2010-02-15

    Hemangiomas are vascular tumors composed of blood vessels, frequently localized in the skin and subcutaneous muscles; their localization in the heart is exceptional. The most common localizations are the lateral walls of the left ventricle, the anterior wall, and the septum. Mostly, these tumors grow intracavitarily, rarely intramurally. We describe a singular case of left ventricular intramural hemangioma, detected and diagnosed using newer magnetic resonance imaging (MRI) modalities, confirmed by histopathological results, and treated successfully by surgery.

  5. Treatment for Infantile Hemangiomas: Selection Criteria, Safety, and Outcomes Using Oral Propranolol During the Early Phase of Propranolol Use for Hemangiomas.

    PubMed

    MacIsaac, Zoe M; Nayar, Harry S; Gehris, Robin; Mehta, Deepak; Geisler, Susan; Grunwaldt, Lorelei J

    2016-01-01

    Despite the increasing popularity of propranolol for treatment of infantile hemangioma (IH), there is need for further evidence of efficacy and safety. This study is a retrospective review of one institution's experience treating IH with propranolol using a standard protocol. Between 2009 and 2014, patients with IH were evaluated for treatment with propranolol. Exclusion criteria included a history of hypoglycemia, respiratory disorders, and cardiovascular disorders. Propranolol, 2 mg/kg/d, was initiated during 48-hour inpatient stay. Weight and complications were monitored. Appearance was assessed by Visual Analog Cosmetic Scale (VACS) via serial photography. Twenty-three patients were treated with propranolol. Average age at initiation of therapy was 14.9 weeks. Twenty-two lesions were on the head and neck, and 1 was on the trunk. Average treatment duration was 54.3 weeks (range 24-148 wk). Treatment was confirmed to be complete in 23 patients at the time of review (91.3%). Two patients were lost to follow-up. Posttreatment color, size, and VACS improved significantly (P < 0.05). There was no significant difference between first and most recent weight. Two patients experienced hypoglycemia, 1 during a diarrheal illness and 1 during inpatient treatment initiation. The authors present a series of patients with IH safely treated with 2 mg/kg/d of propranolol. Using a strict protocol, few complications were observed. Patients achieved significant reduction in size and improvement of the overall appearance of IH.

  6. Infantile hemangioma-like vascular lesion in a 26-year-old woman after abortion.

    PubMed

    Lu, Yang; Wang, Shu Jun; Li, Xin; Hu, Li; Zhang, Wen Jie; Li, Wei

    2014-01-01

    A 26-year-old woman (G2P1A1) presented with a 5-week history of multiple red marks on her body after a therapeutic abortion. A physical examination found 15 palpable red marks on her head, neck, chest, arms and legs. Proliferating endothelial cells, which expressed CD31, CD34, von Willebrand factor, but not Glut-1 and merosin, were observed in the lesional area by histopathological analyses. Histocompatibility antigen typing of 2 lesions was identical to a sample from peripheral blood. Accelerated regression was observed in 2 lesions treated by intralesional injection of betamethasone, while spontaneous regression was observed within 9 months in the remaining lesions without any treatment. Rapid growth, spontaneous regression and histological analyses in this case support the diagnosis of 'infantile hemangioma-like vascular lesion'.

  7. Imaging and therapeutic approach of hemangiomas and vascular malformations in the pediatric age group.

    PubMed

    Dubois, J; Garel, L

    1999-12-01

    Terminology regarding the vascular lesions of the soft tissues remains confusing. A single classification is necessary in order to decide on the proper investigation and the best treatment. At the Workshop on Vascular Anomalies in Rome in June 1996, the membership accepted the Mulliken and Glowacki classification, which differentiates vascular lesions into vascular tumors, including hemangiomas and vascular malformations. At Sainte-Justine, we have set up a multidisciplinary clinic for the discussion of problem patients with vascular anomalies, both in terms of diagnosis and treatment. In this review, we present our experience regarding the classification, the imaging modalities and the treatment of vascular anomalies. In our experience, Doppler ultrasound should be the initial imaging modality for recognizing vascular tumors from vascular malformations. CT scan or magnetic resonance imaging is best to evaluate the extent of the lesions prior to treatment. A multidisciplinary approach is essential to establish a correct diagnosis and define accordingly the appropriate treatment and follow-up.

  8. Vertebral Hemangioma Mimicking Bone Metastasis in 68Ga-PSMA Ligand PET/CT.

    PubMed

    Artigas, Carlos; Otte, François-Xavier; Lemort, Marc; van Velthoven, Roland; Flamen, Patrick

    2017-05-01

    Ga-PSMA PET/CT was performed in a 68-year-old man to evaluate recurrent prostate cancer due to elevated serum prostate-specific antigen level. Images showed a focal uptake in the prostatic gland, suggesting local relapse, and an intense uptake in the 12th thoracic vertebra, with no morphological abnormalities in CT slices. In order to confirm extraprostatic disease and before radiotherapy planning, a full-spine MRI was performed, resulting with the morphological pattern of a vertebral hemangioma. Hystological analysis confirmed the local relapse in the prostate. No radiotherapy treatment was given to the vertebra, and after 1 year of follow-up without systemic treatment, prostate-specific antigen is still undetectable.

  9. Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child.

    PubMed

    de Queiroz, Sormani Bento Fernandes; de Lima, Valthierre Nunes; Amorim, Pedro Henrique Gonçalves Holanda; Statkievicz, Cristian; Magro-Filho, Osvaldo

    2016-09-01

    Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.

  10. Clinical and imaging findings in patients with aggressive spinal hemangioma requiring surgical treatment.

    PubMed

    Urrutia, Julio; Postigo, Roberto; Larrondo, Roberto; Martin, Aliro San

    2011-02-01

    Vertebral hemangiomas (VHs) are frequently asymptomatic lesions found incidentally during investigations for other spinal problems. Symptomatic VHs are less common, and there are few reports of compressive VHs in the literature. VHs with aggressive behavior present with low signal intensity on T1-weighted and high signal intensity on T2-weighted MRI. We present a case series of four patients with compressive VH, all of whom were neurologically compromised. Each of the four patients underwent preoperative arterial embolization followed by surgical treatment of their VHs. All patients recovered normal motor function after surgery. At follow-up (average 53 months), one patient had a recurrent tumor requiring reoperation and radiotherapy. Although it is rare, aggressive VH can be a devastating condition. Total surgical resection or subtotal resection with radiotherapy may be warranted.

  11. Improved Vision from Severe Compressive Optic Neuropathy by Apical Cavernous Hemangioma

    PubMed Central

    Kang, Hyera; Takahashi, Yasuhiro; Nishimura, Kunihiro; Yasuda, Muneyoshi; Akutsu, Hiroyoshi; Kakizaki, Hirohiko

    2016-01-01

    A 59-year-old woman had a 1-year history of right vision loss. Her visual acuity was then 0.01 OD, and the critical flicker frequency (CFF) was 8 Hz OD. Goldmann perimetry examination showed inferior suppression of the right visual field center. Funduscopic examination revealed normal coloring of the right optic disc. Imaging studies showed an apical oval tumor. The optic nerve was compressed by both the tumor and the superior rectus muscle/levator palpebrae superioris complex. The tumor was dissected from the surrounding tissues and completely extracted. Histopathologic examination confirmed a cavernous hemangioma. The patient underwent three cycles of postoperative steroid pulse therapy. One year after the surgery, her visual acuity and CFF improved to 1.0 and 32 Hz OD, respectively. Her right visual field was within the normal range. PMID:27099610

  12. Gastrointestinal Pyogenic Granuloma (Lobular Capillary Hemangioma): An Underrecognized Entity Causing Iron Deficiency Anemia

    PubMed Central

    Kamal, Umar M.; Hammami, Muhammad B.; Taylor, Jason R.; Omran, M. Louay; Chen, Yongxin; Lai, Jin-Ping

    2016-01-01

    Pyogenic granuloma (PG), more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection. PMID:27403353

  13. [State of the art of classification, diagnostics and therapy for cervicofacial hemangiomas and vascular malformations].

    PubMed

    Werner, J A; Eivazi, B; Folz, B J; Dünne, A-A

    2006-12-01

    The successful treatment of vascular anomalies depends on profound knowledge of the biologic behavior of vascular lesions and their correct classification. On the base of the clinical course Mulliken and Glowacki developed a biologic classification that was accepted as official classification by the ISSVA (International Society for the Study of Vascular Anomalies). Based on an extended literature research, this manuscript will give an overview of different internationally accepted treatment concepts. Even if a wait-and-see strategy can be recommended in many cases of uneventful hemangiomas in infants the proliferative growth of such lesions requires an adequate treatment indication. Vascular malformations that persist lifelong require treatment in the majority of the cases, especially when clinical symptoms occur. Based on individual parameters such as the diameter, location or growth behavior, different therapeutic options as cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgical intervention and/or embolisation can be performed successfully. None of those treatment concepts, however, represents the only treatment method of choice.

  14. Propranolol Targets Hemangioma Stem Cells via cAMP and Mitogen-Activated Protein Kinase Regulation

    PubMed Central

    Munabi, Naikhoba C.O.; England, Ryan W.; Edwards, Andrew K.; Kitajewski, Alison A.; Tan, Qian Kun; Weinstein, Andrew; Kung, Justin E.; Wilcox, Maya; Kitajewski, Jan K.; Shawber, Carrie J.

    2016-01-01

    Infantile hemangiomas (IHs) are the most common vascular tumor and arise from a hemangioma stem cell (HemSC). Propranolol has proved efficacious for problematic IHs. Propranolol is a nonselective β-adrenergic receptor (βAR) antagonist that can lower cAMP levels and activate the mitogen-activated protein kinase (MAPK) pathway downstream of βARs. We found that HemSCs express β1AR and β2AR in proliferating IHs and determined the role of these βARs and the downstream pathways in mediating propranolol’s effects. In isolated HemSCs, propranolol suppressed cAMP levels and activated extracellular signal-regulated kinase (ERK)1/2 in a dose-dependent fashion. Propranolol, used at doses of <10−4 M, reduced cAMP levels and decreased HemSC proliferation and viability. Propranolol at ≥10−5 M reduced cAMP levels and activated ERK1/2, and this correlated with HemSC apoptosis and cytotoxicity at ≥10−4 M. Stimulation with a βAR agonist, isoprenaline, promoted HemSC proliferation and rescued the antiproliferative effects of propranolol, suggesting that propranolol inhibits βAR signaling in HemSCs. Treatment with a cAMP analog or a MAPK inhibitor partially rescued the HemSC cell viability suppressed by propranolol. A selective β2AR antagonist mirrored propranolol’s effects on HemSCs in a dose-dependent fashion, and a selective β1AR antagonist had no effect, supporting a role for β2AR signaling in IH pathobiology. In a mouse model of IH, propranolol reduced the vessel caliber and blood flow assessed by ultrasound Doppler and increased activation of ERK1/2 in IH cells. We have thus demonstrated that propranolol acts on HemSCs in IH to suppress proliferation and promote apoptosis in a dose-dependent fashion via β2AR perturbation, resulting in reduced cAMP and MAPK activation. Significance The present study investigated the action of propranolol in infantile hemangiomas (IHs). IHs are the most common vascular tumor in children and have been proposed to arise from

  15. Propranolol Targets Hemangioma Stem Cells via cAMP and Mitogen-Activated Protein Kinase Regulation.

    PubMed

    Munabi, Naikhoba C O; England, Ryan W; Edwards, Andrew K; Kitajewski, Alison A; Tan, Qian Kun; Weinstein, Andrew; Kung, Justin E; Wilcox, Maya; Kitajewski, Jan K; Shawber, Carrie J; Wu, June K

    2016-01-01

    Infantile hemangiomas (IHs) are the most common vascular tumor and arise from a hemangioma stem cell (HemSC). Propranolol has proved efficacious for problematic IHs. Propranolol is a nonselective β-adrenergic receptor (βAR) antagonist that can lower cAMP levels and activate the mitogen-activated protein kinase (MAPK) pathway downstream of βARs. We found that HemSCs express β1AR and β2AR in proliferating IHs and determined the role of these βARs and the downstream pathways in mediating propranolol's effects. In isolated HemSCs, propranolol suppressed cAMP levels and activated extracellular signal-regulated kinase (ERK)1/2 in a dose-dependent fashion. Propranolol, used at doses of <10(-4) M, reduced cAMP levels and decreased HemSC proliferation and viability. Propranolol at ≥10(-5) M reduced cAMP levels and activated ERK1/2, and this correlated with HemSC apoptosis and cytotoxicity at ≥10(-4) M. Stimulation with a βAR agonist, isoprenaline, promoted HemSC proliferation and rescued the antiproliferative effects of propranolol, suggesting that propranolol inhibits βAR signaling in HemSCs. Treatment with a cAMP analog or a MAPK inhibitor partially rescued the HemSC cell viability suppressed by propranolol. A selective β2AR antagonist mirrored propranolol's effects on HemSCs in a dose-dependent fashion, and a selective β1AR antagonist had no effect, supporting a role for β2AR signaling in IH pathobiology. In a mouse model of IH, propranolol reduced the vessel caliber and blood flow assessed by ultrasound Doppler and increased activation of ERK1/2 in IH cells. We have thus demonstrated that propranolol acts on HemSCs in IH to suppress proliferation and promote apoptosis in a dose-dependent fashion via β2AR perturbation, resulting in reduced cAMP and MAPK activation. The present study investigated the action of propranolol in infantile hemangiomas (IHs). IHs are the most common vascular tumor in children and have been proposed to arise from a hemangioma

  16. Estimates of absorbed dose in different organs in children treated with radium for skin hemangiomas

    SciTech Connect

    Lundell, M.

    1994-12-01

    Between 1930 and 1959, more than 10,000 infants were treated at Radiumhemmet, Stockholm, with radium ({sup 226}Ra) needles and/or tubes for hemangioma of the skin. Absorbed dose to the brain, eye lenses, parotid glands, thyroid gland, breast enlarge, lungs, stomach, intestine, ovaries, testicles and bone marrow were calculated for each individual. The mean absorbed dose to the different organs ranged from 0.06 to 0.48 Gy. The highest absorbed dose was given to the breast (maximum 47.7 Gy). There was a wide dose range for each organ which was due mainly to differences in the distance between the applicator and the organ. The absorbed dose to all organs decreased on average by 32% during the study period. This was due to a 25% decrease in the treatment time and a change in the distribution of the treatment sites. 17 refs., 4 figs., 4 tabs.

  17. Radiotherapy of Painful Vertebral Hemangiomas: The Single Center Retrospective Analysis of 137 Cases

    SciTech Connect

    Miszczyk, Leszek; Tukiendorf, Andrzej

    2012-02-01

    Purpose: An evaluation of dose-response relationship and an attempt to define predictive factors. Methods and Materials: A total of 137 cases of painful vertebral hemangioma irradiations (101 patients). Fraction dose (fd) varied from 2 to 15 Gy (123 fractionated and 14 radiosurgical treatments), and total dose (TD) from 8 to 30 Gy (111 cases irradiated with fd of 2 GY to TD of 24 Gy). We evaluated pain relief, changes in analgesic requirements, and reossification. Results: Means of pain relief 1, 6, 12, and 18 months after radiotherapy (defined as a decrease of primary pain level expressed in percent) were 60.5%, 65.4%, 68.3%, and 78.4%, respectively. Proportion of patients with no need for analgesics and patients using tramadol were 39%, 40%, 44%, 57%, and 20%, 17%, 22%, and 11% in these times. The proportion of patients experiencing complete/partial pain relief changed from 36/48% 1 month, to 64/22% 1.5 years after radiotherapy. No impact of radiotherapy on reossification was found. The positive impact of fd and TD increase for analgesics uptake reduction and pain relief was found. An increase of the fd by 1 Gy results in 27% chance of analgesics uptake reduction and 3.8% reduction of pain, whereas 14% analgesics uptake reduction and 2.2% of pain reduction in case of the TD. The predictive factors improving results were found: female gender, older age, better performance states (the chance of the lower analgesic treatment decreases over 2.5 times in comparison to the higher Zubrod degree), bigger Hb concentration, shorter symptoms duration and lower analgesics uptake before radiotherapy. Conclusions: The obtained data support the efficacy of radiotherapy in improving pain secondary to vertebral hemangioma, with the degree of pain amelioration being related to increasing fd and TD. The positive predictive factors were defined: female gender, older age, better performance status, increased Hb concentration, shorter symptoms duration, and lower analgesics uptake

  18. The Role of the Pharmacist in the Treatment of Patients with Infantile Hemangioma Using Propranolol.

    PubMed

    Castaneda, Saul; Melendez-Lopez, Samuel; Garcia, Esbeydy; De la Cruz, Hermelinda; Sanchez-Palacio, Jose

    2016-10-01

    Infantile hemangiomas (IH) are the most common benign vascular tumors of childhood, with an incidence of 5-10% during the first year of age. Propranolol is considered the first-line treatment for this condition. Potentially there is a high probability of negative results to therapy, because in many countries there are no treatment protocols or propranolol formulations appropriate for the pediatric population. The objective of the present study was to evaluate the impact of pharmacist interventions such as detecting, analyzing, and solving problems presented during treatment with propranolol in patients with IH. An open observational prospective study was performed over 25 months in a group of pediatric patients diagnosed with infantile hemangioma treated with propranolol. Pharmacist participation consisted of development of an extemporaneous formulation and counseling the child's parents. At each visit to the pharmacy service, family members were interviewed, detecting and classifying problems related to treatment. Sixty-three children with IH were treated during the period under review. Patient ages ranged from 3 to 11 months old; 64% were female and 36% were male. Forty-nine problems in 30 patients were detected, principally inadequate dose (18.4%), non-adherence to treatment (16.3%), side effects (14.3%), and wrong administration (14.3%). Of the problems detected, 81.6% were resolved. Interventions by the pharmacist in 27 patients were intensive counseling on adherence to therapy (20%), detection of adverse effects (11.4%), and adjustment of the dose (22.9%). In 95.2% of patients a good response to treatment was obtained compared with 77.2% reported in European studies without pharmacist intervention. It seems that pharmacist participation increases adherence to treatment and reduces the likelihood of adverse effects, allowing for safe and effective therapy in patients with IH.

  19. Atenolol Versus Propranolol for Treatment of Infantile Hemangiomas During the Proliferative Phase: A Retrospective Noninferiority Study.

    PubMed

    Bayart, Cheryl B; Tamburro, Joan E; Vidimos, Allison T; Wang, Lu; Golden, Alex B

    2017-07-01

    The nonselective beta-blocker propranolol is the current criterion standard for treatment of infantile hemangiomas (IHs) and the first therapy that the U.S. Food and Drug Administration has approved for the condition, but concern about adverse effects, such as bronchospasm, hypoglycemia, and sleep disturbances, has sparked interest in the use of alternative agents such as the selective β1 antagonist atenolol. Our aim was to compare the efficacy and adverse effect profiles of atenolol with those of propranolol in the treatment of IHs in a retrospective noninferiority trial. Twenty-seven children with IHs treated with atenolol according to the Cleveland Clinic foundation's standardized clinical assessment and management plan (SCAMP) met inclusion criteria and were compared with a matched group of 53 children with IHs treated with propranolol. Three reviewers assessed response to therapy using a modified version of the previously validated Hemangioma Activity Score (HAS). The mean change in HAS was -2.94 ± 1.20 for patients treated with atenolol and -2.96 ± 1.42 for those treated with propranolol. There was no statistically significant difference in pre- and posttreatment modified HAS scores between the two groups (p = 0.60). There was no significant difference in the overall rate of adverse effects (p = 0.10), although 11% of patients treated with propranolol experienced reactive airway symptoms, whereas this was not seen in any of the patients treated with atenolol. Our study supports previous findings that atenolol is at least as effective as propranolol for treatment of IHs and poses less risk of bronchospasm. Our SCAMP proposes guidelines for dosing and monitoring parameters. © 2017 Wiley Periodicals, Inc.

  20. PHACES syndrome: Diode laser photocoagulation of intraoral hemangiomas in six young patients

    PubMed Central

    Favia, Gianfranco; Limongelli, Luisa; Tempesta, Angela; Favia, Matteo; Maiorano, Eugenio

    2015-01-01

    Introduction The acronym PHACES describes the association of posterior fossa malformations, facial hemangiomas, arterial anomalies (cardiovascular or cerebrovascular), coarctation of the aorta and cardiac defects, eye abnormalities, and sternal or ventral defects. In this study we report on 6 patients affected by the PHACES syndrome and showing 34 intraoral hemangiomas (IH), treated by diode laser photocoagulation (DLP). Case presentation IH appeared as red-bluish soft masses, smooth or lobulated, from a few millimetre to several centimetres in size, covered by intact mucosa and blanching on pressure. IHs were treated by DLP with 320 μm fibres at a wavelength of 800 ± 10 nm. The diode laser techniques applied were: Transmucosal DLP (DLTP), a no-contact technique in which laser energy is delivered by a flexible optic quartz fiber, which is kept 2–3 mm apart from the lesion, and Intralesional DLP (DLIP), in which the fibre is introduced into the lesion through a transmucosal access. DLTP was used for 20 flat, superficial IHs and, after a variable number of laser sessions (average = 3) depending on the size of the lesion, 65% completely regressed, while in the remaining 35% shrinkage of the lesion was achieved with minor and few complications. The remaining 14 deep/multi-lobulated IHs were treated by DLIP, resulting in complete regression of 79% of them. Conclusions DLP techniques are an effective and minimally invasive procedure for IH in patients with PHACES, in consideration of the multiple lesions to treat, of the necessity of multiple interventions and the higher compliance of the patients. PMID:25974260

  1. Effectiveness and Safety of Oral Propranolol versus Other Treatments for Infantile Hemangiomas: A Meta-Analysis

    PubMed Central

    Liu, Xiaohan; Qu, Xinhua; Zheng, Jiawei; Zhang, Ling

    2015-01-01

    Background Epidemiological studies evaluating treatments for infantile hemangiomas have produced inconsistent results. A meta-analysis of published data was conducted to investigate the effectiveness and safety of oral propranolol versus other treatments for infantile hemangiomas. Methods A meta-analysis was conducted based on literature (published from 1960 to December 1, 2014) found on the PubMed, EMBASE, and OVID search engines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the outcome measures. Heterogeneity, publication bias and subgroup analysis were performed. Results A total of 61 studies involving 5,130 participants met the inclusion criteria. Propranolol was found to be a more effective modality in treating IHs (ORs = 0.92; 95%CI, 0.89–0.95) and had fewer complications compared to the other treatments including systemic steroids (ORs = 0.68; 95% CI, 0.59–0.76); laser ablation (ORs = 0.55; 95% CI, 0.43–0.67); other beta-adrenergic blockers (ORs = 0.56; 95% CI, 0.50–0.61) and surgery (ORs = 0.55; 95% CI, 0.28–0.81). A subgroup analysis of propranolol showed that a dose of 2 mg/kg/day or more yielded better outcomes (ORs = 0.92; 95% CI, 0.88–0.95; ORs = 0.95; 95% CI, 0.89–1.00), and IHs that had not been previously treated had better responses to propranolol treatment (ORs = 0.95; 95% CI, 0.91–0.98). Conclusions The meta-analysis demonstrated that propranolol was more effective and safer than other therapies in treating IHs. It provides strong evidence for supporting the use of propranolol as a first-line therapy for IHs. PMID:26375455

  2. Surgery in extensive vertebral hemangioma: case report, literature review and a new algorithm proposal.

    PubMed

    Tarantino, Roberto; Donnarumma, Pasquale; Nigro, Lorenzo; Delfini, Roberto

    2015-07-01

    Hemangiomas are benign dysplasias or vascular tumors consisting of vascular spaces lined with endothelium. Nowadays, radiotherapy for vertebral hemangiomas (VHs) is widely accepted as primary treatment for painful lesions. Nevertheless, the role of surgery is still unclear. The purpose of this study is to propose a novel algorithm of treatment about VHs. This is a case report of an extensive VH and a review of the literature. A case of vertebral fracture during radiotherapy at a total dose of 30 Gy given in 10 fractions (treatment time 2 weeks) using a linear accelerator at 15 MV high-energy photons for extensive VH is reported. Using PubMed database, a review of the literature is done. The authors have no study funding sources. The authors have no conflicting financial interests. In the literature, good results in terms of pain and neurological deficits are reported. No cases of vertebral fractures are described. However, there is no consensus regarding the treatment for VHs. Radiotherapy is widely utilized in VHs determining pain. Surgery for VHs determining neurological deficit is also widely accepted. Perhaps, regarding the width of the lesion, no indications are given. We consider it important to make an evaluation before initiating the treatment for the risk of pathologic vertebral fracture, since in radiotherapy, there is no convention regarding structural changes determined in VHs. We propose a new algorithm of treatment. We recommend radiotherapy only for small lesions in which vertebral stability is not concerned. Kyphoplasty can be proposed for asymptomatic patients in which VHs are small and in patients affected by VHs determining pain without spinal canal invasion in which the VH is small. In patients affected by pain without spinal canal invasion but in which the VH is wide or presented with spinal canal invasion and in patients affected by neurological deficits, we propose surgery.

  3. Cardiovascular and blood glucose parameters in infants during propranolol initiation for treatment of symptomatic infantile hemangiomas.

    PubMed

    Puttgen, Katherine B; Summerer, Barbara; Schneider, Jeremy; Cohen, Bernard A; Boss, Emily F; Bauman, Nancy M

    2013-09-01

    We sought to determine the effect of propranolol on cardiovascular and blood glucose parameters in infants with symptomatic infantile hemangiomas who were hospitalized for initiation of treatment, and to analyze adverse effects of propranolol throughout the course of inpatient and outpatient treatment. A retrospective cohort analysis was performed on 50 infants (age less than 12 months) with symptomatic infantile hemangiomas who were hospitalized for propranolol initiation between 2008 and 2012. Demographic data and disease characteristics were recorded. Systolic and diastolic blood pressures, heart rate, blood glucose values, and adverse events recorded during hospitalization were analyzed. An additional cohort of 200 consecutively treated children was also assessed for adverse events associated with outpatient propranolol use. The median age among the inpatient cohort was 3.4 months (range, 0.8 to 12.0 months). Infants older than 6 months were more likely to exhibit bradycardia than were younger infants (p < 0.001). Hypotensive and/or bradycardic periods were infrequent and were not associated with observable clinical symptoms. The mean systolic and diastolic blood pressures and the mean heart rate decreased significantly from day 1 of hospitalization to day 2 (p = 0.004; p = 0.008; p < 0.001), but not from day 2 to day 3, when the propranolol dose was increased to target. Hypoglycemia was rare (0.3% incidence.) Among the 250 outpatients, 2 infants developed lethargy and hypoglycemia during a viral illness and recovered without sequelae. One infant experienced recurrent bronchospasm with viral illnesses and required concomitant bronchodilator therapy. Frequent deviations from normal ranges of blood pressure and heart rate occur upon initiation of propranolol, but are clinically asymptomatic. These findings support that outpatient initiation of propranolol in healthy, normotensive infants appears to be a relatively safe alternative to inpatient initiation

  4. Nasal Reconstruction and Repair of Secondary Nasal Deformities Following Treatment of Nasal Hemangiomas.

    PubMed

    Lu, Xiaona; Fan, Fei; Wang, Huan; You, Jianjun

    2017-03-01

    Secondary nasal deformities and retardation of development due to treatment of nasal hemangioma during infancy are a challenge when it comes to nasal reconstruction. In order to evaluate nasal repair and reconstruction in these patients, the authors compared the ease and outcomes of using expanded forehead, nasolabial sulcus, and medial upper arm tube flaps. According to the deformities and patients' wishes, flaps were selected; using autogeneic rib cartilage, auricle cartilage, or silica gel as a scaffold or without framework; the inner lining were made by the residual scar tissue or the distal end of transferred flap. The esthetical and functional scores were recorded by the Nasal Appearance and Function Evaluation Questionnaire score to evaluate the effectiveness of the methods. From January 2010 to December 2015, 34 patients were included. Postoperative follow-up went for 12 to 36 months. The expanded forehead flap was used in 28 patients, the nasolabial sulcus flap in 5 patients, and the medial upper arm tube flap in 1 patient. Regarding framework, 20 patients used rib cartilage, 8 patients used auricle cartilage, 1 patient used silicone, and 5 patients did not use any framework. All patients reported the increasing nasal appearance and function evaluation. Repair of secondary nasal defects following treatment of hemangiomas in infants and young children using an expanded frontal flap and autogenous cartilage framework is a reliable method with great long-term esthetic results. The nasolabial sulcus flap is a relatively simple method, especially for patients with a unilateral nasal alar defect. Supporting structure is needed and appropriate overcorrection is necessary.

  5. α6-Integrin is required for the adhesion and vasculogenic potential of hemangioma stem cells.

    PubMed

    Smadja, David M; Guerin, Coralie L; Boscolo, Elisa; Bieche, Ivan; Mulliken, John B; Bischoff, Joyce

    2014-03-01

    Infantile hemangioma (IH) is the most common tumor of infancy. Hemangioma stem cells (HemSC) are a mesenchymal subpopulation isolated from IH CD133+ cells. HemSC can differentiate into endothelial and pericyte/smooth muscle cells and form vascular networks when injected in immune-deficient mice. α6-Integrin subunit has been implicated in the tumorgenicity of glioblastoma stem cells and the homing properties of hematopoietic, endothelial, and mesenchymal progenitor cells. Therefore, we investigated the possible function(s) of α6-integrin in HemSC. We documented α6-integrin expression in IH tumor specimens and HemSC by RT-qPCR and flow cytometry. We examined the effect of blocking or silencing α6-integrin on the adhesive and proliferative properties of HemSC in vitro and the vasculogenic and homing properties of HemSC in vivo. Targeting α6-integrin in cultured HemSC inhibited adhesion to laminin but had no effect on proliferation. Vessel-forming ability in Matrigel implants and hepatic homing after i.v. delivery were significantly decreased in α6-integrin siRNA-transfected HemSC. In conclusion, α6-integrin is required for HemSC adherence to laminin, vessel formation in vivo, and for homing to the liver. Thus, we uncovered an important role for α6 integrin in the vasculogenic properties of HemSC. Our results suggest that α6-integrin expression on HemSC could be a new target for antihemangioma therapy. © AlphaMed Press.

  6. Periodic appearance and disappearance of a chest wall (serratus anterior development) cavernous hemangioma that was finally resected in a child.

    PubMed

    Nakagawa, Tomoki; Watanabe, Hajime; Nakazato, Kenei; Masuda, Daisuke; Ogura, Go; Masuda, Ryota; Nakamura, Naoya; Iwazaki, Masayuki

    2013-08-01

    Primary chest wall tumors occur infrequently; in particular, cavernous hemangioma of the chest wall is an extremely rare disease. We report a case of child with cavernous hemangioma of the chest wall, which was successfully resected. Obvious enlargement of the tumor and the appearance of pain were observed during a 2-year follow-up. In the present case, transcutaneous ultrasonography showed the appearance and disappearance of the mass. This was considered to be caused by the transfer of contents between the shallow and deep parts of the tumor. This may have resulted from serratus anterior muscle movement between the two-layered tumor. Transcutaneous ultrasonography, as well as magnetic resonance imaging, was therefore extremely effective for preoperative diagnosis. Transcutaneous ultrasonography is easily performed, even in children, such as in the present case. Because of its simplicity and usefulness, transcutaneous ultrasonography may be considered as the first-line imaging modality for diagnosis.

  7. Renal cavernous hemangioma: robot-assisted partial nephrectomy with selective warm ischemia. Case report and review of the literature.

    PubMed

    Ceccarelli, G; Codacci Pisanelli, M; Patriti, A; Biancafarina, A

    2015-01-01

    Renal hemangioma is a relatively rare benign tumor with a wide range of clinical and radiological presentation, not easy to differentiate preoperatively from a renal cancer. Due to its benign nature complete surgical resection is the recommended therapy and is considered curative. A 73-year old male patient followed-up for a lung carcinoma and a chronic renal failure underwent a CT scan showing a 35-mm mass of the inferior pole of the left kidney. The patient underwent robot-assisted partial nephrectomy with left inferior pole selective warm ischemia. The outcome was favorable and no repercussions on the renal reserve were observed postoperatively. Histopathological characteristics of the surgical specimen were consistent with renal cavernous hemangioma. A robot-assisted operation allows the fine dissection required to carry out a bloodless nephron-sparing surgery without a complete warm ischemia. The use of robot could be noteworthy for nephron-sparing surgery in cases of concomitant chronic renal failure.

  8. Cryogen spray cooling for spatially selective photocoagulation: a feasibility study with potential application for treatment of hemangiomas

    NASA Astrophysics Data System (ADS)

    Anvari, Bahman; Tanenbaum, B. S.; Milner, Thomas E.; Hoffman, Wendy; Said, Samireh; Chang, Cheng-Jen; Liaw, Lih-Huei L.; Kimel, Sol; Nelson, J. Stuart

    1996-12-01

    The clinical objective in laser treatment of hemangiomas is to photocoagulate the dilated cutaneous blood vessels, while at the same time minimizing nonspecific thermal injury to the overlying epidermis. We present an in-vivo experimental procedure, using a chicken comb animal model, and an infrared feedback system to deliver repetitive cryogen spurts during continuous Nd:YAG laser irradiation. Gross and histologic observations are consistent with calculated thicknesses of protected and damaged tissues, and demonstrate the feasibility of inducing spatially selective photocoagulation when using cryogen spray cooling in conjunction with laser irradiation. Experimental observation of epidermal protection in the chicken comb model suggests selective photocoagulation of subsurface targeted blood vessels for successful treatment of hemangiomas can be achieved by repetitive applications of a cryogen spurt during continuous Nd:YAG laser irradiation.

  9. Intractable hiccup as the presenting symptom of cavernous hemangioma in the medulla oblongata: a case report and literature review.

    PubMed

    Lee, Kyung-Hwa; Moon, Kyung-Sub; Jung, Min-Young; Jung, Shin

    2014-06-01

    A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem.

  10. Application of the laser diode with central wavelength 975 nm for the therapy of neurofibroma and hemangiomas

    NASA Astrophysics Data System (ADS)

    Szymańczyk, Jacek; Sawczak, Mirosław; Cenian, Witold; Karpienko, Katarzyna; Jędrzejewska-Szczerska, Małgorzata; Cenian, Adam

    2017-01-01

    This paper presents a newly developed dermatological laser (with a central wavelength 975 nm) for application in therapies requiring deep penetration of tissue, e.g., cutaneous (dermal) neurofibroma (von Recklinghausen disease) and hemangiomas. This laser can work either in pulses or continues wave mode. Laser radiation is transmitted toward the application region by optical fiber with a diameter of 0.6 mm. The compact design of the laser facilitates its transport and increases the comfort of use.

  11. Growing skull hemangioma: first and unique description in a patient with Klippel-Trénaunay-Weber syndrome.

    PubMed

    van der Loo, Lars E; Beckervordersandforth, Jan; Colon, Albert J; Schijns, Olaf E M G

    2017-02-01

    We present the first and unique case of a rapid-growing skull hemangioma in a patient with Klippel-Trénaunay-Weber syndrome. This case report provides evidence that not all rapid-growing, osteolytic skull lesions need to have a malignant character but certainly need a histopathological verification. This material offers insight into the list of rare pathological diagnoses in an infrequent syndrome.

  12. Clinical observation on the treatment of hemangioma by CO2 laser supplemented with He-Ne laser

    NASA Astrophysics Data System (ADS)

    Zhao, Zhigui

    1993-03-01

    Sixty-six cases of hemangioma were treated with CO2 laser alone (22 cases as a control group), or CO2 laser supplemented with He-Ne laser (44 cases of the treated group). Optimum power dosage was first sought on normal volunteers. Arteriolar vasculature and lymphatics were blocked 3 - 5 times with procaine hydrochloride (5:1) to minimize local blood congestion. Results show that the healing rate of the treated group was significantly higher than that of the control group (X3 equals 3.92, P < 0.05). Eleven cases (50%) were complicated with exudation in the control as compared with 3 cases (6.8%) in the treated group (P < 0.01). Of the 18 cases completely cured in the control group, the number of treatments averaged at 11.4 times, while of the 39 cases completely cured in the treated group, the average number of treatments was 5.9 times, which is also statistically significant (P < 0.01). It is considered that CO2 laser supplemented with He-Ne laser is superior than CO2 laser alone for the treatment of hemangioma. Furthermore, it is also proposed that the supplement of copper and Chinese herbal medicines may prevent the incidence of recurrence. Laser was used for the treatment of hemangioma in our country during the 1980s. In foreign literature, there were several reports using Nd:YAG and copper vapor laser for the treatment of agniomasimplex and nevus flammeus. Ar+ laser agglomeration was commonly used for the treatment of angioma conjunctive in our country, but the use of CO2 laser for the treatment of angioma epiderma is not well documented. We wish to report the use of CO2 laser supplemented with He-Ne laser for the treatment of hemangioma in our hospital from April 1988 to December 1989.

  13. Early Surgical Management of Large Scalp Infantile Hemangioma Using the TopClosure® Tension-Relief System

    PubMed Central

    Zhu, Zhanyong; Yang, Xilin; Zhao, Yueqiang; Fan, Huajun; Yu, Mosheng; Topaz, Moris

    2015-01-01

    Abstract Infantile hemangiomas (IHs) are the most common benign vascular neoplasms of infancy and childhood. The majority do not need medical intervention. However, large ulcerated scalp IHs may lead to fatal bleeding as well as severe cosmetic disfigurement that indicate early surgical excision, inflicting substantial surgical risks, with short- and long-term morbidity. The TopClosure Tension-Relief System (TRS) is an innovative skin stretching and wound closure-secure system that facilitates primary closure of relatively large skin defects. This system has been shown as a substitute for skin grafts, flaps, or tissue expanders. We describe a case of a giant IH of the scalp usually requiring a complex surgical approach, which was immediately primarily closed applying the TRS. A 3-day-old female infant presented with a giant scalp hemangioma at birth that rapidly grew in the neonatal period with early signs of ulceration. The patient underwent surgical resection of the giant scalp hemangioma with immediate primary closure of the defect using the TRS. Surgical procedure and postoperative period were uneventful. Early surgical resections of IHs at infancy carry substantial surgical risks and morbidity. This is the first reported case of early resection of a scalp hemangioma in the neonatal period, with successful immediate primary closure by application of stress-relaxation technique through the TRS. The application of the TopClosure TRS in this age group has significant advantages. It reduces the complexity and length of surgery, reducing blood loss, eliminating donor site morbidity, improving wound aesthetics, and minimizing the need for future reconstructive procedures. PMID:26632734

  14. Early Surgical Management of Large Scalp Infantile Hemangioma Using the TopClosure® Tension-Relief System.

    PubMed

    Zhu, Zhanyong; Yang, Xilin; Zhao, Yueqiang; Fan, Huajun; Yu, Mosheng; Topaz, Moris

    2015-11-01

    Infantile hemangiomas (IHs) are the most common benign vascular neoplasms of infancy and childhood. The majority do not need medical intervention. However, large ulcerated scalp IHs may lead to fatal bleeding as well as severe cosmetic disfigurement that indicate early surgical excision, inflicting substantial surgical risks, with short- and long-term morbidity.The TopClosure Tension-Relief System (TRS) is an innovative skin stretching and wound closure-secure system that facilitates primary closure of relatively large skin defects. This system has been shown as a substitute for skin grafts, flaps, or tissue expanders.We describe a case of a giant IH of the scalp usually requiring a complex surgical approach, which was immediately primarily closed applying the TRS.A 3-day-old female infant presented with a giant scalp hemangioma at birth that rapidly grew in the neonatal period with early signs of ulceration. The patient underwent surgical resection of the giant scalp hemangioma with immediate primary closure of the defect using the TRS. Surgical procedure and postoperative period were uneventful.Early surgical resections of IHs at infancy carry substantial surgical risks and morbidity. This is the first reported case of early resection of a scalp hemangioma in the neonatal period, with successful immediate primary closure by application of stress-relaxation technique through the TRS. The application of the TopClosure TRS in this age group has significant advantages. It reduces the complexity and length of surgery, reducing blood loss, eliminating donor site morbidity, improving wound aesthetics, and minimizing the need for future reconstructive procedures.

  15. Treatment of hemangioma of the head and neck with diode laser and forced dehydration with induced photocoagulation.

    PubMed

    Angiero, Francesca; Benedicenti, Stefano; Romanos, Georgios E; Crippa, Rolando

    2008-04-01

    The aim of this study was to investigate the efficacy of treating oral hemangiomas using forced dehydration with induced photocoagulation (FDIP) via diode laser. One-hundred sixty patients were treated between 1999 and 2006 (76 men, 46%; 84 women, 54%). In 136 cases we used FDIP to treat hemangioma, and in 24 cases complete surgical excision was performed. One-hundred thirty-four lesions had a surface area <2 x 2 cm2, whereas only two had large lesions measuring 2.5 x 2 cm2. In 136 patients with hemangiomas treated with FDIP, 134 cases (98.53%) showed complete remission, one case (0.735%) did not show complete remission, and one case (0.735%) displayed tumor growth. There were no adverse effects and all patients were carefully followed-up until complete healing was documented, along with any complications. Our findings suggest that FDIP is a useful and effective treatment for benign oral vascular lesions. FDIP treatment of these oral lesions is clinically significant because it provides effective management, avoids recurrence, and shortens healing time. We believe that the use of this method by medical and dental specialists should be supported.

  16. [Changes in ambulatory electrocardiographic findings after oral administration of low-dose propranolol in infants with hemangioma].

    PubMed

    Yi, Lan-Fen; Wen, Hong-Xia; Huang, Sui; Qiu, Mei; Zhang, Jing-Yang; Cao, Xiao-Xiao

    2016-04-01

    To investigate the effects of oral administration of low-dose propranolol on heart rate variability (HRV), acceleration capacity (AC), deceleration capacity (DC), and cardiac conduction in the treatment of infantile hemangioma. A total of 118 infants with hemangioma (≤1 year) were enrolled, and 24-hour ambulatory electrocardiography was performed before oral administration of low-dose propranolol and after one month of administration. The changes in time-domain indices [standard deviation of all normal sinus RR intervals (SDNN), standard deviation of all mean 5-minute RR intervals (SDANN), root mean squared successive difference (RMSSD), and percentage of successive normal sinus RR intervals >50 ms (PNN50)] and frequency-domain indices [low frequency (LF) and high frequency (HF)] for HRV, AC, and DC were observed, as well as abnormalities in cardiac conduction and other aspects after administration of propranolol. After administration of propranolol, the infants had significantly increased SDNN, RMSSD, LF, HF, and PNN50 (P<0.01), and significantly reduced AC, mean heart rate (HR) and minimum HR (P<0.01). The 24-hour ambulatory electrocardiographic findings showed a nonsignificantly higher abnormal rate after administration of propranolol. In the treatment of infantile hemangioma, propranolol can inhibit the activity of sympathetic nerve and block cardiac conduction, but without any serious adverse effect.

  17. Physicochemical stability of a new topical timolol 0.5% gel formulation for the treatment of infant hemangioma.

    PubMed

    Merino-Bohórquez, V; Casas, M; Caracuel, F; Cameán, M; Fernández-Anguita, M J; Ramírez-Soto, G; Lucero, M J

    2015-01-01

    Infant hemangioma (IH) is the most common tumor in infants, which affects 5-10% of white children. It is a tumor of vascular origin that appears in the first months of life. The indication for the treatment of the IH is not approved in the datasheet of the product, however it has been used in the infant hemangioma by topical administration as an alternative to oral propranolol, avoiding the main problems of the oral route (bradycardia and hypotension). The objective of this work is to study the physical and chemical (HPLC stability indicating method) stability of a 0.5% timolol gel for topical application during 60 days (considering the stability limit as 90% of initial concentration of timolol maleate). The gel was prepared with a polyacrylic acid derivative and the physical stability of the system was studied by visual control, rheological and mechanical characterization. The studied formulation guarantees the correct dose administering and stability after 60 days stored at 25 ± 2 °C and light protected (tube of aluminum). We have developed an easy topical gel for the treatment of infant hemangioma with physical and chemical stability higher than those provided by the majority of hospitals.

  18. Facial nerve hemangiomas at geniculate ganglion: preservation of nerve integrity is correlated with duration of facial palsy.

    PubMed

    Wang, Kai; Chou, Haiyan; Li, Yefeng

    2015-01-01

    To study preservation of nerve integrity in 16 cases with facial nerve hemangiomas at geniculate ganglion (GG). 16 cases with facial nerve hemangiomas at GG, who presented with facial palsy, were included in the study. Preservation of nerve integrity was attempted by the same surgeon during surgical removal, and those who failed to preserve nerve integrity underwent nerve grafting. The patients were divided into longer duration group (>12months) and shorter duration group (≤12months) according to duration of facial palsy, and preservation of nerve integrity in the couple of groups was compared. Nerve integrity was preserved in 2 of 10 cases (20%) among longer duration group, while it was preserved in 5 of 6 cases (83.3%) among shorter duration group (p<0.05). All the cases with nerve integrity preserved recovered to grade III or better, among which 3 cases recovered to grade I or grade II, while only 3 of 9 cases (33.3%) with nerve grafting recovered to grade III at the best. Preservation of nerve integrity was correlated with duration of facial palsy in cases with hemangiomas at GG. Patients with nerve integrity preserved showed better outcomes of facial nerve. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Lower gastrointestinal bleeding, hematuria and splenic hemangiomas in Klippel-Trenaunay syndrome: a case report and literature review.

    PubMed

    Kocaman, Orhan; Alponat, Ahmet; Aygün, Cem; Gürbüz, Yeşim; Sarisoy, H Tahsin; Celebi, Altay; Sentürk, Omer; Hülagü, Sadettin

    2009-03-01

    Klippel-Trenaunay syndrome is a congenital vascular anomaly characterized by a triad of varicose veins, cutaneous capillary malformation, and hypertrophy of bone and soft tissue. Gastrointestinal and genitourinary vascular malformations in Klippel- Trenaunay syndrome may present with lower gastrointestinal bleeding and hematuria. The majority of patients with splenic hemangiomatosis are asymptomatic. We herein report a case admitted to the Gastroenterology Clinic with life-threatening hematochezia and symptomatic iron deficiency anemia. The patient's history was remarkable for subtotal cystectomy and enterocystoplasty in December 2002 for vascular malformation, located in the bladder, which presented with hematuria. Although the patient was also diagnosed with colonic varices and splenic hemangiomas at that time, due to the asymptomatic mild intermittent hematochezia and splenic hemangiomas, the patient did not seek any help for rectal bleeding until her admittance to our department for evaluation of massive lower gastrointestinal bleeding. Endoscopy revealed vascular malformations starting from the transitional zone in the rectum extending up to the descending colon. Due to this extensive involvement of the rectum and sigmoid colon, no interventional endoscopic procedure was attempted and she was referred to surgery. A very low anterior resection with double stapling technique was done. Postoperative follow-up has been uneventful for six months since the operation. To the best of our knowledge, this is the first Klippel-Trenaunay syndrome case presenting with lower gastrointestinal bleeding, hematuria and splenic hemangiomas. The literature on the evaluation and management of lower gastrointestinal and genitourinary bleeding in Klippel-Trenaunay syndrome is reviewed.

  20. Technetium-99m labeled red blood cells for the detection and localization of cavernous hemangiomas of the bone

    SciTech Connect

    Lenane, P.

    1986-09-01

    Labeled red blood cells (RBCs) have already been proven useful in the detection and localization of many vascular abnormalities. One such abnormality is that of a cavernous hemangioma. Cavernous hemangiomas have a distinct circulation and have been found in many areas of the body. The ability to utilize this unique circulation is important to consider when choosing a diagnostic exam. This paper reports a case demonstrating the usefulness of labeled red blood cells for the detection and localization of cavernous hemangioma of the bone. A 31-yr-old female present with a history of persistent generalized headaches for many years. About 1 yr prior to the exam, she noticed that her headaches had become more localized to the right side of her head. Physical examination revealed a palpable lump developing on the right side of her head which was sensitive to the touch. The patient was then scheduled for a CT scan to be followed by both a bone scan and a /sup 99m/Tc blood-pool scan. A flow study using 15 mCi /sup 99m/Tc labeled RBCs was performed in the right lateral position at 1.5 sec/frame for 32 frames. Immediate blood-pool images 30-min, and 1-hr delayed images were recorded.