1/33. Metastatic cardiac angiosarcoma of the cervical spine. Case report.STUDY DESIGN: A case report of metastatic cardiac angiosarcoma of the cervical spine. OBJECTIVES: To show that this rare spine tumor behaves in the same manner as an arteriovenous malformation and embolization, which can allow for successful spine surgery, and to discuss the natural history and rarity of this tumor. SUMMARY OF BACKGROUND DATA: Primary angiosarcoma of the heart is a very rare tumor, with fewer than 200 reports in the English literature and nothing reported in the spine literature. RESULTS: The patient in this study initially sought treatment for neck pain, left arm pain, and weakness 17 months after cardiac surgery and subsequent chemotherapy. A cervical computed tomography scan demonstrated a C5 lytic vertebral body tumor with intracannilicular extension and cord compression. An anterior cervical approach was made, but the tumor was too vascular to resect, and surgery was aborted. The C5 vascular vertebral body metastasis subsequently was embolized successfully by an interventional neuroradiologist. reoperation via an anterior approach with corpectomy, cadaveric fibula, and anterior locking plate internal fixation was successful, producing marked improvement in the patients' symptoms. CONCLUSION: Spinal involvement by primary cardiac angiosarcoma is very rare, and this is only the second operative case ever reported. The vascular nature of this tumor makes it behave in a manner similar to that of a high-flow arteriovenous malformation. Surgery should not be undertaken before preoperative angiography and embolization. The dismal prognosis for this rare malignancy is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/33. Unusual vascular dysplasia presenting as an intra-abdominal catastrophe.A case of severe, generalised vascular dysplasia presenting as an intra-abdominal catastrophe is reported. Associated clinical features included cutis marmorata telangiectatica congenita, congenital glaucoma, hypertension, and focal fits. The case has been reported in view of its rarity and nature of presentation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/33. Congenital arteriovenous malformations of the face. Report of a case.Arteriovenous malformations (AVM) are uncommon vascular abnormalities which can be either developmental defects present from birth, or acquired ones, secondary to trauma. They may cause local swelling and discomfort, and also may present a potential for severe bleeding. Traumatic AVM are usually single fistulous channels, whereas congenital lesions are most often multiple interconnections of vessels of varying caliber that result in a diffuseness which renders clini-al delineation and treatment difficult. The nature of the lesion is determined by the stage of development of the vascular system during which it develops. Congenital lesions range from finely channelled capillary hemangiomas to large-bore, high-flow A-V fistulas. Most lesions are not observed at birth, but become manifest later in life; minor trauma and endocrine change are implicated as the stimuli for the initiation of hemodynamic activity. The diagnosis is clinical, with confirmation by arteriography. The treatment has not been completely satisfactory in all cases. Surgical intervention has been used most often, but newer techniques include cryotherapy and muscle embolization.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/33. Osler-Weber-Rendu syndrome--pathological manifestations and autopsy considerations.An 18-year-old university student with Osler-Weber-Rendu disease collapsed in the bathroom. Attempted resuscitation was unsuccessful. Her past history included recurrent epistaxes, mucosal telangiectasias, intracranial arteriovenous malformations with previous hemorrhage, a single pulmonary arteriovenous malformation, recent onset of grand mal seizures, and depression. There was a positive paternal family history. At autopsy the pulmonary arteriovenous malformation was confirmed. In addition, within the brain there were widespread areas of gliosis with hemosiderin deposition and small vascular malformations. No other significant abnormalities were detected and toxicological screening revealed only moderately elevated levels of carbemazepine. death was attributed to epilepsy associated with glial scarring from previous microhemorrhages. The detection of vascular malformations in the lung or brain at autopsy should prompt careful examination of all tissues for similar lesions. Given the possibility of Osler-Weber-Rendu disease in such cases, fibroblast cultures should be undertaken to enable molecular studies to proceed. The heritable nature of this disorder necessitates accuracy of diagnosis at autopsy; once the diagnosis is confirmed family screening should be recommended.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/33. Intra-rachidian disorders: two unusual cases of recurrent abdominal pain in children.Recurrent abdominal pain (RAP) is generally thought to be of psychological origin but organic aetiologies are increasingly being identified. The cases of two children with vertebral disorders revealed by recurrent abdominal pain are reported. A 14-y-old girl presented with RAP associated with scoliosis, due to a T8-T9 intra-dural extra-medullary tumour. A 7-y-old girl who suffered from nocturnal RAP located in the right iliac fossa for 1 y had decreased muscular strength, pyramidal signs, and a 10 degree Lassegue sign in the right lower limb, revealing a vascular malformation extending from T12 to L2. Conclusion: Atypical pain and associated neurological signs or scoliosis must raise the possibility of intra-rachidian disorders. Magnetic resonance examination will then precisely state the location and nature of the pathological process, avoiding excessive delay in therapeutic management.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/33. Intraosseous arteriovenous malformation in a pediatric patient.An isolated tibial intraosseous arteriovenous malformation was diagnosed in a seven-year-old boy. This malformation was not associated with any major clinical symptomatology except pain. It had a paucity of physical findings and was not well visualized with conventional radiography. It was not associated with any soft-tissue or cutaneous manifestations and it was entirely intramedullary, with minimal cortical involvement. This case illustrates the value of magnetic resonance imaging in the localization of these lesions. The absence of radiation exposure, coupled with the noninvasive nature, makes magnetic resonance imaging important in evaluating an intramedullary process in a pediatric patient.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/33. Inadvertent embolization of a persistent sciatic artery in pelvis trauma.We describe a case of unilateral persistent sciatic artery (PSA), a rare vascular anomaly, in a 43-year-old woman with severe multiple trauma. A small amount of diluted embolization particles went into this vessel during emergent endovascular therapy under fluoroscopic monitoring. The procedure was immediately stopped when the true nature of the anatomic variant was recognized. Fortunately, an ischemic event of the lower leg did not occur. The imaging findings of computed tomography and digital subtraction angiography are presented and the relevant literature is reviewed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/33. Arteriovenous malformation of the nasopharynx: a case report.Arteriovenous malformation (AVM) of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent itself truly as a lethal benign disease. We present here an unusual case of an AVM with the size of 1.5 cm x 0.8 cm at the adenoid tissue found in an 8-year-old boy, which is not previously reported in the literature where we treated the patient with surgery alone. Although bleeding is a common presentation with vascular malformations, we have not seen any bleeding in our case. After the surgery, paranasal sinus and neck CT were undertaken. They showed no other AVM.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/33. Intradural spinal arteriovenous malformation of the glomus type: a case report.Spinal arteriovenous malformations (AVMs) being even rarer than cranial ones, constitute 3 - 4% of all spinal tumours, with an overall male:female ratio of 4:1. We report the case of a 24-year old female Youth Corps member who presented with an apoplectic onset of a left hemiparesis, progressively deteriorating to an incomplete quadriplegia with motor power of 2 and 0 in the right and left lower limb muscle groups, respectively. magnetic resonance imaging (MRI) showed a vascular malformation whose precise nature was indeterminate; the definitive diagnosis of a Glomus AVM was only made intra-operatively. laminectomy with complete surgical excision was done and she gradually improved to ambulate with minimal support. The experience in our unit tends to support the observation in literature that spinal arteriovenous malformations could be very rare, and depending on the location, could be amenable to complete surgical excision and recovery of neurological function.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/33. Management of mandibular vascular malformation with sclerotherapy. Report of two cases.BACKGROUND: Management of vascular anomalies is extremely challenging and varies according to the nature of the lesion. Traditionally, embolization with the resection of the lesion and autologous immediate reconstruction has been used. The purpose of this report is to present cases successfully using sclerosing solution injections alone. methods: This paper describes the management of two cases of the mandibular vascular malformations using trans-osseous injection of the sodium tetradecyl sulfate to the periphery of the lesion. The procedure was performed four or five times at two weeks intervals respectively. Imaging was performed using subtraction arteriography and sequential panoramic dental radiographs. RESULTS: Radiological and histological evaluation of the cases showed resolution of the lesions following sclerotherapy alone. CONCLUSIONS: Conservative interventional management using trans-osseous injection of sclerosing solution was successful in treating mandibular vascular anomalies.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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