Cases reported "Hemangioma"

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1/39. A rare case of intramuscular haemangioma in a six-year-old boy--a diagnostic dilemma.

    Intramuscular haemangiomas are uncommon tumours of the head and neck, occurring mainly in adults and usually located in the region of the masseter muscle and parotid gland. We report the case of a child with an intramuscular haemangioma over the left maxilla, which caused some diagnostic confusion in view of its atypical location combined with the unusual age and inflammatory mode of presentation.
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2/39. Tufted angioma of adult onset, revealing abundant eccrine glands and central regression.

    Tufted angioma (angioblastoma) usually occurs in infancy. Some lesions reveal proliferation of eccrine glands and some undergo spontaneous regression. We report a lesion from the left lateral chest of a 58-year-old male, which had appeared 5 years ago and gradually increased in size. Its color had faded out centrally. Histological examination showed many angiomatous lobules on the border of the lesion but few in the central portion. Abundant eccrine sweat glands, small venules and dense connective tissue were seen in both areas. The histology and the clinical course suggested that central regression occurred in the lesion. Out of 211 reported cases, we found 4 cases that had annular lesions spreading centrifugally. Though these lesions were not examined histologically, they were suspected to regress in the central portions. We suggest that central regression can rarely occur in tufted angioma.
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3/39. Fine needle aspiration cytology of cellular hemangioma of infancy. A case report.

    BACKGROUND: Cellular hemangioma is a common benign vascular neoplasm of infants and children. The lesion typically occurs within the superficial dermis, where it is recognized as a strawberry nevus. Occasionally, this neoplasm is situated within deep soft tissues of the head or neck, with a particular predilection for the parotid gland region. Fine needle aspiration cytology (FNAC) of cellular hemangioma involving the parotid gland has been reported previously, but never confirmed by cytologic findings alone. We report the first case of infantile cellular hemangioma with sufficient characteristic cytologic features to be diagnosed by FNAC. CASE: A 3-month-old male presented with a rapidly enlarging, sensitive, solid, supraparotid mass. Ultrasound and computed tomography were performed but were nondiagnostic. Subsequent FNAC of the mass demonstrated a highly cellular specimen composed predominantly of elongated spindled cells arranged in three-dimensional coils and arcades. immunohistochemistry demonstrated the endothelial origin of the spindled cells and confirmed the diagnosis of cellular hemangioma. CONCLUSION: Deeply situated cellular hemangiomas may pose a difficult diagnostic challenge to the clinician as well as to the radiologist. The infantile variant of this tumor enlarges rapidly, simulating an aggressive malignant tumor, and is occasionally accompanied by substantial compressive symptoms. Radiographic presentation of the lesion may be that of a solid tumor mass, unlike most other hemangiomas. Precise cytologic diagnosis of infantile cellular hemangioma can be rendered on aspirated material and is crucial in planning conservative medical treatment.
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4/39. hemangioma of the salivary gland: a study of ten cases of a rarely biopsied/excised lesion.

    hemangioma is a common soft tissue tumor that frequently occurs in the oral and maxillofacial region including salivary glands, but is rarely biopsied and is therefore often unfamiliar to the surgical pathologist. Our study examined the subclassification and histologic features of salivary gland hemangioma (SGH). Consultative cases coded as hemangioma and located in salivary gland from 1970 to 2000 were retrieved from the Registry of Oral and Maxillofacial pathology of the Armed Forces Institute of pathology (washington, DC). Only cases with histologic evidence of salivary gland involvement were included. Slide material and patient history for all cases were reviewed, subclassification assigned, and histologic features were noted. Ten cases coded as hemangioma with slides and history met our inclusion criteria. Seven cases were the "juvenile hemangioma" subtype in the parotid of infants, ranging in age from 3 to 10 months (mean age, 5.3 months) with a male predominance. These SGH had a distinctive histologic appearance of a cellular proliferation of capillary sized vessels around retained salivary gland ducts. Mitoses were easily identified. Three additional cases in females included an arteriovenous hemangioma of a lip minor salivary gland since birth in a 15-month-old infant and two parotid gland lesions: a lobular capillary hemangioma of a 10-year-old and a cavernous hemangioma in a 51-year-old. The latter three cases grew as replacing masses and lacked retained salivary gland ducts within the lesion, despite glandular tissue at the periphery of the tumor. No SGH cases in our series were identified in the submandibular or sublingual glands. Despite its common occurrence, SGH is relatively rare in our surgical pathology files. The parotid gland is the most common location (90%). Salivary gland hemangioma includes usual hemangioma subtypes, mainly in females, and a distinctive infantile subtype of capillary hemangioma (juvenile hemangioma), displaying distinctive histology and found predominately in males. The cellularity, mitotic activity, and retained salivary gland ducts in the latter lesion should not make one consider malignancy.
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5/39. von hippel-lindau disease type 2A in a family with a duplicated 21-base-pair in-frame insertion mutation in the VHL gene.

    BACKGROUND: von hippel-lindau disease (VHL), also called angiomatosis retinae, is inherited as an autosomal dominant trait. It is frequently associated with other tumors in the central nervous system, kidneys, or adrenal glands. In order to investigate the relationship between genotype and corresponding phenotypes, we performed molecular genetic analysis in a Japanese patient with VHL type 2A. methods: After informed consent had been obtained, the three exons of the VHL gene were PCR-amplified and sequenced either directly or after subcloning. Clinical features were also examined. RESULTS: A novel in-frame duplication of the 21 base pairs at nucleotide 806 (the position of codon 198) of the VHL gene was found in our patient. The clinical phenotype of the patient included retinal hemangiomas associated with vitreous hemorrhage and traction retinal detachment, pheochromocytoma, and hemangioma-like lesions in the cerebellum which corresponded to those of VHL type 2A. Abnormal diffuse vascular leakage was observed in the apparently intact retina by fluorescein angiography. CONCLUSION: An insertion mutation of the VHL gene is a rare association with VHL type 2. This insertion mutation may interfere the binding between the VHL gene and elongins. Abnormal retinal vascular leakage suggests the possible effects of overexpressed vascular permeability factors such as vascular endothelial growth factor from hemangiomas associated with defective VHL gene.
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6/39. hemangioma with phleboliths in the sublingual gland: as a cause of submental opacity.

    Hemangiomas are the most common lesions of the major salivary glands during infancy and early childhood. Changes in blood flow dynamic within hemangioma results in thrombus and phleboliths. There have been a number of reports of hemangiomas with phleboliths in parotid and submandibular glands. We present the first case of a hemangioma with multiple phleboliths in the subligual gland as a cause of submental opacity, and discussed the diagnosis of radiopaque masses in the sublingual and submental regions.
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7/39. Primary angiosarcoma of the parotid gland arising from benign congenital hemangioma.

    A case of malignant transformation of a benign congenital hemangioma of the parotid gland is presented. The malignant tumor occurred in a woman with a history of congenital hemangioma surgically removed 8 years previously. No radiotherapy had been administered at the time of primary excision. The recurrent tumor consisted of a large lesion occupying nearly all the parotid gland and infiltrating the surrounding soft tissues and overlying skin. Its histopathologic features were typical of epithelioid angiosarcoma. The vast majority of vascular lesions of major salivary glands are benign. However, pathologists should be aware of the remote possibility of malignant transformation in these lesions.
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8/39. Intramuscular hemangioma in the digastric muscle.

    Intramuscular hemangioma is a distinctly rare neoplasm originating within normal muscle. In the head and neck region, it occurs most frequently in the masseter muscle. diagnosis of intramuscular hemangioma is extremely difficult because it is not encountered frequently and is often confused with salivary gland stone, parotid neoplasm or other tumors. In this report, a second case of intramuscular hemangioma of the digastric muscle and the diagnosis of this type of tumor in the early stage and the importance of its treatment are described.
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9/39. Sonographic appearance of a congenital parotid gland hemangiolymphangioma simulating malignancy in an infant.

    Congenital hemangiolymphangioma, also called mixed angioma, is a benign tumor that very rarely occurs in the parotid gland. We present a rare case of hemangiolymphangioma of the parotid gland in a 4-month-old boy whose clinical and radiologic presentation simulated malignancy. Gray-scale and color Doppler sonography revealed an enlarged left parotid gland and inhomogeneous hypoechoic and hyperechoic areas scattered throughout the gland. Mild internal vascularity was noted on color Doppler sonographic examination. CT revealed a predominantly fatty mass involving the superficial lobe of the parotid gland. The results of fine-needle aspiration cytology were inconclusive, and total parotidectomy was performed. Histopathologic examination of surgical specimens confirmed a diagnosis of hemangio lymphangioma. The patient recovered well and was free of recurrence at the 6-month follow-up visit. To our knowledge, this case report is the first to describe the findings of congenital hemangiolymphangioma of the parotid gland on sonography and CT. This rare diagnosis should be considered in neonates and infants presenting with a rapidly growing parotid gland tumor suggesting malignancy. Histopathologic examination is necessary to confirm the diagnosis.
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10/39. Treatment for postoperative liver failure after major hepatectomy under hepatic total vascular exclusion.

    Hepatic total vascular exclusion (HTVE) with clamping of the portal triad and the inferior vena cava below and above the liver is a useful technique in the resection of major hepatic lesions situated close to the hepatic veins and inferior vena cava. From 1996 to 2000, five patients underwent major hepatectomy under HTVE; among these, liver failure occurred in two patients because of liver cirrhosis or hepatic artery interruption. In the former case, apheresis therapy (plasma exchange: 9 times), continuous prostaglandin E, (PGE,) infusion via the hepatic artery(0.01 tg/kg/min) for 7 days, and hyperbaric oxygen therapy (3 times: 2 ATA, 60 min) were applied. In the latter case, apheresis therapy (plasma exchange: 9 times, continuous hemodiafiltration: 12 days) and continuous PGE, infusion via the superior mesenteric artery for 7 days were applied. With these treatment modalities, both cases were cured of postoperative liver failure.
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