1/10. Rare benign tumours of oral cavity--capillary haemangioma of palatal mucosa: a case report.Haemangiomas are benign tumours composed of blood vessels, they are probably developmental rather than neoplastic in origin. Haemangiomas are often present at birth but may become more apparent during life. The tumours appear as a flat or raised reddish-blue lesions and are generally solitary. They are occasionally seen on the palatal mucosa. Haemangiomas are classified on the basis of their histological appearance as capillary, mixed, cavernous or a sclerosing variety that tends to undergo fibrosis. Their differential clinical diagnosis is based on appearance. The tumours may be slowly progressive, involving extensive portions of the superficial and deep blood vessels. Function may be affected where development of the lesion is extra-invasive. Colour change on pressure is a common finding with return to the original colour on withdrawal of pressure. The case presented here was referred because of swelling and recurrent periodontal bleeding. The lesion was diagnosed as a capillary haemangioma through histopathology. Although different therapeutic procedures have been reported, in this case surgical excision was carried out under general anaesthesia following hospitalization. Despite their benign origins and behaviour, haemangiomas in the region of oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Dental practitioners and oral surgeons need to be aware of these lesions because they may pose serious bleeding risks.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/10. High injection pressure during intralesional injection of corticosteroids into capillary hemangiomas.BACKGROUND: Intralesional injection of corticosteroids is an effective treatment for tumors of the head and neck. Complications are rare but include permanent loss of vision. We designed a study to investigate the mechanism for this complication. methods: Three fellowship-trained pediatric ophthalmologists participated in the study in a nonmasked fashion. Four patients received 5 separate treatment sessions of an intralesional injection of a 50-50 mixture of triamcinolone diacetate (40 mg/mL) and betamethasone sodium phosphate and betamethasone acetate (6 mg/mL) into capillary hemangiomas. Injection pressure was obtained in real time using a cannula designed for this purpose. Maximum pressure, mean pressure, and volume of corticosteroid were measured from each injection. RESULTS: A total of 71 injections (range, 8-33 injections per patient) was performed. The total volume of corticosteroid ranged from 0.9 to 2.1 mL. In 63 of 71 injections, the maximum pressure exceeded 100 mm Hg (range, 18.65-842.18 mm Hg). Each surgeon produced injection pressures greater than the systemic arterial pressures of each patient. CONCLUSIONS: Injection pressures exceeding the systemic arterial pressures routinely occur during intralesional injections of corticosteroids into capillary hemangiomas. Experienced surgeons participating in a nonmasked protocol were unable to prevent high injection pressures of corticosteroid. A sufficient volume of corticosteroid injected at high injection pressure would account for the embolization of corticosteroid particles into the ocular circulation from retrograde arterial flow. We recommend limiting the volume of corticosteroid and performing indirect ophthalmoscopy on all patients receiving injections of long-acting corticosteroids into the orbit and periorbital soft tissue.- - - - - - - - - - ranking = 7keywords = pressure (Clic here for more details about this article) |
3/10. Pulmonary capillary hemangiomatosis associated with primary pulmonary hypertension: report of 2 new cases and review of 35 cases from the literature.Pulmonary capillary hemangiomatosis (PCH) is a rare cause of primary pulmonary hypertension characterized by thin-walled microvessels infiltrating the peribronchial and perivascular interstitium, the lung parenchyma, and the pleura. These proliferating microvessels are prone to bleeding, resulting in accumulation of hemosiderin-laden macrophages in alveolar spaces. Here we report 2 cases of PCH with pulmonary hypertension, 1 of them associated with mechanical intravascular hemolysis, a feature previously reported in other hemangiomatous diseases, but not in PCH. Case 2 was diagnosed by pulmonary biopsy; to our knowledge the patient is the second adult to be treated with interferon alpha-2a. review of the literature identified 35 patients with PCH and pulmonary hypertension. The prognosis is poor and median survival was 3 years from the first clinical manifestation. dyspnea and right heart failure are the most common findings of the disease. hemoptysis, pleural effusion, acropachy, and signs of pulmonary capillary hypertension are less common. Chest X-ray or computed tomography scan usually shows evidence of interstitial infiltrates, pulmonary nodules, or pleural effusion. Hemodynamic features include normal wedge pressures. Radiologic and hemodynamic findings are undifferentiated from those of pulmonary veno-occlusive disease but differ from other causes of primary pulmonary hypertension. epoprostenol therapy, considered the treatment of choice in patients with primary pulmonary hypertension, may produce pulmonary edema and is contraindicated in patients with PCH. Regression of lesions was reported in 1 patient treated with interferon therapy and 2 other patients stabilized, including our second patient. PCH was treated successfully by lung transplantation in 5 cases. Early recognition of PCH in patients with suspected primary pulmonary hypertension is possible based on clinical and radiologic characteristics. diagnosis by pulmonary biopsy is essential for allowing appropriate treatment.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
4/10. Orbital cavernous hemangioma associated with juxtapapillary exophytic retinal capillary hemangioma.A 32-year-old man presented with coexisting orbital hemangioma and juxtapapillary exophytic capillary hemangioma. fluorescein and indocyanine green angiography revealed exophytic juxtapapillary retinal capillary hemangioma. The orbital cavernous hemangioma was surgically removed, and the retinal capillary hemangioma was observed without treatment. Subretinal hemorrhage gradually absorbed and clinical symptoms improved. Juxtapapillary exophytic capillary hemangioma can cause subretinal bleeding secondary to external pressure from an adjacent orbital cavernous hemangioma. Coexistence of both tumors suggests a common etiology.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
5/10. Capillary hemangioma of the cauda equina presenting with radiculopathy and papilledema.A 42-year-old, non-obese man with a three-month history of headache, pulsatile tinnitus, transient visual obscurations, and scintillations later developed low back pain with right lower extremity radiation. brain MRI and magnetic resonance venography were normal, but spine MRI revealed a mass in the cauda equina. Neuro-ophthalmologic examination disclosed bilateral optic disc edema with normal visual function. During spine surgery, cerebrospinal fluid, released under high pressure despite prior hyperventilation, contained a glucose level of 51 mg/dl and a protein level of 1840 mg/dl. Histologic and immunohistochemical features of the lesion were compatible with a capillary hemangioma. Although spinal cord tumors have been associated with papilledema, this is the first report of a capillary hemangioma of the cauda equina in this context. If papilledema is present, spinal cord imaging should be performed when lumbar puncture discloses unexplained protein elevation and in cases that lack clinical features typical of idiopathic intracranial hypertension.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
6/10. Buphthalmos following systemic steroid treatment.Corticosteroid-induced glaucoma is a well-recognized phenomenon in adults, but not children. We describe an infant who developed juvenile glaucoma with buphthalmos while receiving systemic steroid treatment. The intraocular pressure normalized several months following discontinuation of treatment.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
7/10. Capillary hemangioma in the superior sagittal sinus as a rare cause of intracranial hypertension in a child: case report.OBJECTIVE AND IMPORTANCE: The etiological factors involved in idiopathic intracranial hypertension are not easy to identify. This case of idiopathic intracranial hypertension was associated with a capillary hemangioma growing in the lumen of the superior sagittal sinus. CLINICAL PRESENTATION: A 10-year-old girl had experienced progressive headaches and abdominal pain. Fundoscopic examination disclosed bilateral papilledema and high intrathecal pressure, suggesting idiopathic intracranial hypertension. magnetic resonance imaging, including magnetic resonance angiography as well as digital angiography, revealed a 3-cm mass protruding into the superior sagittal sinus lumen above the torcular. INTERVENTION: A capillary hemangioma attached to the internal dural wall of the sagittal sinus lumen was microsurgically removed. The symptoms resolved in several days and no additional treatment was required. CONCLUSION: A tumor growing into a venous sinus is a rare cause of venous outflow impairment and may generate the clinical signs of idiopathic intracranial hypertension. This case emphasizes the importance of multiple complementary imaging modalities and the efficacy of a direct surgical approach, which allowed resolution of symptoms.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
8/10. Resolution of astigmatism after surgical resection of capillary hemangiomas in infants.OBJECTIVE: The goal of the study was to assess the affect of early surgical resection of capillary hemangiomas on the induced astigmatism of infants. DESIGN: Cohort study. PARTICIPANTS: Three infants younger than 9 months of age are included. INTERVENTION: Total resection of the astigmatism-inducing hemangiomas was performed. MAIN OUTCOME MEASURES: Refractive change in the eye operated on was measured and the cosmetic results were observed. RESULTS: Preoperative and postoperative cylinder reduction in the three patients were 8 diopters (D) to 0 D, 3 D to 0 D, and 4.5 D to 1 D, respectively. All patients had excellent cosmetic results, and there were no postoperative complications. CONCLUSIONS: Surgical resection of adnexal hemangiomas in carefully selected infants can lead to excellent cosmetic results. If the mass-induced pressure on the infant sclera is relieved at a young enough age, anisometropia and resultant amblyopia can be eliminated.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
9/10. Pulmonary capillary haemangiomatosis as a cause of pulmonary hypertension in Takayasu's aortoarteritis.Pulmonary hypertension is known to occur in Takayasu's aortoarteritis. It may be either due to pulmonary arterial involvement or elevated left ventricular end diastolic pressure, or both. In our case, the cause of pulmonary hypertension was a recently described rare lesion termed pulmonary capillary haemangiomatosis. This entity has a very distinct histopathologic picture. Although 19 cases have been reported in the English literature, this is the first report on pulmonary capillary haemangiomatosis producing pulmonary hypertension in Takayasu's aortoarteritis.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
10/10. Pulmonary capillary hemangiomatosis: a unique feature of congestive vasculopathy associated with hypertrophic cardiomyopathy.A 34-year-old man with an 18-year history of hypertrophic cardiomyopathy died of worsening right-sided heart failure. central venous pressure was greatly increased to 25 cm H2O before death. Postmortem examination revealed features of severe congestive vasculopathy, including those of pulmonary capillary hemangiomatosis in the lungs. Marked proliferation of capillaries was seen chiefly in alveolar septa and extending into pulmonary veins and arteries, causing severe luminal occlusion with recanalization. Diffusely distributed intra-alveolar edema and hemorrhage with collections of hemosiderin-laden macrophages were also seen, which suggested that the pulmonary capillary hemangiomatosis was associated with longstanding chronic passive congestion of the lung. It is possible that severe pulmonary passive congestion may be one of the causes of development of idiopathic pulmonary capillary hemangiomatosis.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
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