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Ranjan A, Agarwal R, Singh D. Capillary haemangioma of the tricuspid valve annulus: A rare presentation. Int J Surg Case Rep 2023; 106:108171. [PMID: 37087932 PMCID: PMC10149200 DOI: 10.1016/j.ijscr.2023.108171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE To the best of our knowledge, very few tricuspid valves (TV) haemangiomas have been reported to date in the literature due to the avascular nature of the cardiac valve. We report the case of an otherwise healthy male presented with unexplained shortness of breath who was found to have tricuspid valvular haemangioma. CASE PRESENTATION 52-year-old male who presented with progressive dyspnoea on exertion for 6 months. Echocardiography revealed an echo-dense mass attached to the heart's anterior leaflet of the tricuspid valve. A cardiac MRI suggested it as pulmonary fibroelastoma, but a surgical excision biopsy revealed it to be a capillary haemangioma. Patient symptoms improved after surgery. CLINICAL DISCUSSION Cardiac valve tumour-like haemangiomas are rare, with the involvement of the tricuspid valve even rarer. Most TV haemangiomas are detected incidentally, however, they may present with a range of symptoms. Echocardiography is the mainstay of diagnosis however definitive diagnosis is by histopathology. Surgical excision is the treatment of choice, though surgery in asymptomatic patients is still controversial. CONCLUSION Cardiac haemangiomas are rare, with the involvement of the tricuspid valve even rarer. They should undergo surgical excision due to the risks of embolism, rupture, and sudden death.
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Affiliation(s)
- Ashis Ranjan
- Department of Cardiology, Govt TD Medical College, Alappuzha, India; All India Institute of Medical Sciences, Deoghar, India.
| | - Rajat Agarwal
- All India Institute of Medical Sciences, Deoghar, India
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2
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Drevet G, Chalabreysse L, Gamondes D, Tronc F, Maury JM. Epicardial carvernous hemangioma: The diagnostic challenge of a middle mediastinal mass. Thorac Cancer 2021; 12:2404-2406. [PMID: 34288503 PMCID: PMC8410526 DOI: 10.1111/1759-7714.14074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/28/2022] Open
Abstract
Primary tumors in the middle mediastinum are rare and pose diagnostic challenges. Lymphomas, mediastinal cysts and thymomas most frequently affect this anatomic area. Primary cardiac tumors are rare and constitute a differential diagnosis for the inferior middle mediastinum. Surgical exploration and resection is often mandatory in order to make a definitive diagnosis. Here, we report the case of a 69 year-old women who presented with persistent dyspnea. A complete preoperative workup revealed a large tissular mass adjacent to the right atrium. A diagnosis of a typical epicardial cavernous hemangioma was made following surgical resection.
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Affiliation(s)
- Gabrielle Drevet
- Department of Thoracic Surgery and Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Delphine Gamondes
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | - François Tronc
- Department of Thoracic Surgery and Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jean-Michel Maury
- Department of Thoracic Surgery and Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
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3
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Hirota M, Suezawa T, Kobayashi Y, Kawabata T, Kuroko Y, Kotani Y, Ito H, Kasahara S. Endocardial Hemangioma of the Right Ventricle: Complete Excision With Right Ventricular Restoration. Ann Thorac Surg 2020; 111:e411-e413. [PMID: 33359506 DOI: 10.1016/j.athoracsur.2020.09.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 10/22/2022]
Abstract
Primary cardiac tumor can arise from any location in the right and left cardiac chamber. Complete excision is generally recommended because of uncertainty regarding malignancy; however it is important to minimize the resultant functional deterioration after surgery. We report a case of endocardial hemangioma (4 × 3 × 3 cm) on the free wall of the right ventricle, located between the anterior and posterior papillary muscles. We describe details of the procedure to preserve the right ventricular volume and competence of the tricuspid valve.
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Affiliation(s)
- Masanori Hirota
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
| | - Takanori Suezawa
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
| | - Yasuyuki Kobayashi
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
| | - Takuya Kawabata
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
| | - Yosuke Kuroko
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
| | - Yasuhiro Kotani
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Hospital, Okayama, Japan
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan
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4
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Hemangioma of the Atherosclerotic Changed Aortic Valve. Case Rep Cardiol 2019; 2019:7916298. [PMID: 31016051 PMCID: PMC6446087 DOI: 10.1155/2019/7916298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/21/2019] [Indexed: 11/22/2022] Open
Abstract
The incidence of heart valve hemangioma is very low and is mostly observed in the mitral and tricuspid valve. In 2006, two cases of aortic valve hemangioma were reported for the first time, including one with calcifying aortic valve stenosis. We now present a case of aortic valve hemangioma in a patient suffering from aortic valve insufficiency combined with atherosclerotic thickening.
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Akikwala T, Trivedi D, Kochamba G, Kansagra K, Sridhar S, Rudikoff AG, Hernandez Conte A. Perioperative Evaluation and Surgical Management of a Patient With a Pericardial Hemangioma Abutting the Right Ventricular Outflow Tract and Main Pulmonary Artery. J Cardiothorac Vasc Anesth 2018; 33:1362-1366. [PMID: 29807714 DOI: 10.1053/j.jvca.2018.04.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Tulsi Akikwala
- Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Dhaval Trivedi
- Department of Cardiac Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Gary Kochamba
- Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Kartik Kansagra
- Department of Radiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Sreevathsan Sridhar
- Department of Radiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Andrew G Rudikoff
- Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Antonio Hernandez Conte
- Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.
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6
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Yamamoto H, Beppu S. Left ventricular cardiac hemangioma in a patient with chronic heart failure. J Med Ultrason (2001) 2017; 45:509-513. [PMID: 29280024 DOI: 10.1007/s10396-017-0852-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022]
Abstract
Cardiac hemangiomas are rare benign tumors. Here, we report the case of a man in his 30s who had a cardiac hemangioma with no symptoms. He was being treated with β-blockers for chronic heart failure with hypertensive heart disease at Osaka Minato Central Hospital. Routine echocardiography revealed a mobile spherical mass in the left ventricle that had not been detected on echocardiography performed 4 months previously. Subsequently, the tumor was excised to prevent potential embolic events and was pathologically diagnosed as a cardiac hemangioma. This case demonstrates the relatively rapid progress of a cardiac hemangioma regardless of β-blocker administration, which is occasionally used for the treatment of hemangiomas. The efficacy of β-blockers in treating cardiac hemangiomas may vary according to the type of β-blocker. Echocardiography is useful in screening and follow-up of cardiac hemangiomas; however, additional imaging modalities are needed for differential diagnosis.
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Affiliation(s)
- Hiroyoshi Yamamoto
- Department of Internal Medicine, Osaka Minato Central Hospital, 8-31 Chikko, Minato-ku, Osaka, 552-0021, Japan.
| | - Shintaro Beppu
- Department of Internal Medicine, Osaka Minato Central Hospital, 8-31 Chikko, Minato-ku, Osaka, 552-0021, Japan
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7
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Unger E, Costic J, Laub G. Giant Cardiac Cavernous Hemangioma. Ann Thorac Surg 2015; 100:322-5. [PMID: 26140782 DOI: 10.1016/j.athoracsur.2014.08.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 07/27/2014] [Accepted: 08/15/2014] [Indexed: 11/16/2022]
Abstract
We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor.
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Affiliation(s)
- Eric Unger
- Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
| | - Joseph Costic
- Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Glenn Laub
- Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
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Li W, Teng P, Xu H, Ma L, Ni Y. Cardiac Hemangioma: A Comprehensive Analysis of 200 Cases. Ann Thorac Surg 2015; 99:2246-52. [DOI: 10.1016/j.athoracsur.2015.02.064] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 11/28/2022]
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Angiosarcoma arising in a patient with a 10-year-old hemangioma. Case Rep Oncol Med 2014; 2014:185323. [PMID: 25692058 PMCID: PMC4322827 DOI: 10.1155/2014/185323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/17/2014] [Accepted: 12/17/2014] [Indexed: 11/18/2022] Open
Abstract
The transformation of a benign hemangioma into a malignant angiosarcoma has been rarely reported, with only 11 cases reported in the literature. There have been no reports of malignant transformation of hemangioma into angiosarcoma in association with epithelioid hemangioendothelioma, to our knowledge. The existence of precursor malignancies in the tumorigenesis of sarcomas is still not clearly defined. We describe the case of a 40-year-old woman with a preceding history of a suspected hemangioma for ten years, who upon resection was found on histology to have evidence of a hemangioma with an associated area of epithelioid hemangioendothelioma as well as areas of overt high grade epithelioid angiosarcoma. These findings raise the possibility of the evolution of hemangioma to epithelioid hemangioendothelioma, and the latter to overt angiosarcoma. The patient was managed as having a high grade sarcoma with wide resection and radiation. She declined systemic adjuvant chemotherapy after a thorough discussion about the risks and benefits of chemotherapy, and she currently remains disease free one year after the surgery.
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Affiliation(s)
- Shinichi Taguchi
- Department of Cardiovascular Surgery; Keio University Hospital; Tokyo Japan
| | - Ryohei Yozu
- Department of Cardiovascular Surgery; Keio University Hospital; Tokyo Japan
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Abstract
We report an adolescent with a benign cardiac haemangioma with attachments exclusively to the anterior leaflet of the mitral valve. On the basis of our review of the literature, this study has not been reported previously.
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12
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An unusual case of a large cavernous hemangioma invading the left ventricular apex. Ann Thorac Surg 2011; 91:602-3. [PMID: 21256327 DOI: 10.1016/j.athoracsur.2010.07.087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Revised: 07/07/2010] [Accepted: 07/23/2010] [Indexed: 11/21/2022]
Abstract
Cardiac hemangiomas are extremely rare benign vascular tumors of the heart. We present the unusual case of a 60-year-old man with a large cavernous hemangioma involving the left ventricular apex. The tumor was completely excised under cardiopulmonary bypass. The pertinent literature is reviewed and the technical steps, clinical presentation, and histopathologic findings are discussed.
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13
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Omura K, Onishi T, Yamawaki K, Salem Omar AM, Kanzawa M, Ishida T, Shite J, Kawai H, Itoh T, Okita Y, Hirata KI. A rare case of pericardial hemangioma with bloody pericardial effusion. J Cardiol Cases 2010; 2:e15-e19. [PMID: 30524585 DOI: 10.1016/j.jccase.2010.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 12/28/2009] [Accepted: 01/14/2010] [Indexed: 11/25/2022] Open
Abstract
A 78-year-old woman presented with leg edema and exertional dyspnea. Echocardiography revealed a smooth-surfaced mass adjacent to the left atrium in the pericardial cavity with a massive pericardial effusion. Pericardiocentesis resulted in the drainage of a bloody effusion. Magnetic resonance imaging documented a mass having isointensity on T1- and hyperintensity on T2-weighted images. In addition, the mass was evenly enhanced with gadolinium 10 min after administration. By surgical resection, a 25 × 30 mm in diameter tumor was excised together with a left atrial wall portion. The pathological examination made a final diagnosis as hemangioma. Based on these findings, we report the rare case of pericardial hemangioma with a bloody pericardial effusion, which presented with heart failure symptoms. Although bloody pericardial effusion is considered a supportive characteristic for malignant tumors, we could preoperatively make a precise diagnosis of benign hemangioma by means of several imaging modalities.
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Affiliation(s)
- Kazuya Omura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Tetsuari Onishi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Kohei Yamawaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Alaa Marbrouk Salem Omar
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Maki Kanzawa
- Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Junya Shite
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Hiroya Kawai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
| | - Tomoo Itoh
- Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Okita
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
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14
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Abstract
Cardiac angiosarcoma usually arises from the right atrium. We report an extremely rare case of primary angiosarcoma originating from the left atrium in a 70-year-old woman. This represents the ninth reported case of left-sided cardiac angiosarcoma in the English literature. Analysis of all nine cases shows that this malignant neoplasm occurs more in female patients with a mean age of 60 years, unlike the right-sided one which typically affects male patients in their early 40s. The prognosis of this tumor is extremely poor with life expectancy lying between 3 to 34 months despite early diagnosis by imaging and multimodality treatment.
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Affiliation(s)
- Cally K L Ho
- Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong.
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Abstract
Cardiac hemangiomas are rare benign tumors of the heart typically diagnosed incidentally. We report a case of a 70-year-old man with a right atrial cavernous hemangioma and a concomitant pulmonary embolism. The possible association, clinical features, operative procedure, and pathologic findings are described.
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Yaganti V, Patel S, Yaganti S, Victor M. Cavernous hemangioma of the mitral valve: a case report and review of literature. J Cardiovasc Med (Hagerstown) 2009; 10:420-2. [DOI: 10.2459/jcm.0b013e32832915a6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Vivirito M, Boldorini R, Rossi L, Caimmi PP, Bernardi M, Teodori G. Capillary hemangioma of the aortic valve: False preoperative diagnosis of endocarditis. J Thorac Cardiovasc Surg 2006; 132:690-1. [PMID: 16935132 DOI: 10.1016/j.jtcvs.2006.05.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2006] [Accepted: 05/03/2006] [Indexed: 10/24/2022]
Affiliation(s)
- Mario Vivirito
- Department of Cardiac Surgery, Maggiore della Carità Hospital, Novara, Italy.
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Uğraş S, Bayram I. Cavernous haemangioma of the mitral valve in a child: report of a case and review of the literature. Pathology 2005; 37:396-8. [PMID: 16194857 DOI: 10.1080/00313020500254545] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rossi S, Fletcher CDM. Angiosarcoma arising in hemangioma/vascular malformation: report of four cases and review of the literature. Am J Surg Pathol 2002; 26:1319-29. [PMID: 12360047 DOI: 10.1097/00000478-200210000-00009] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Malignant change in a benign vascular tumor is exceedingly rare, and there have been only five previously reported convincing cases. Four new cases of angiosarcoma (AS) arising in a hemangioma/vascular malformation (HVM) are described. All patients were in the 6th or 7th decade of life (two female, two male). Development of an enlarging deep-seated mass was the main presenting symptom. MRI disclosed the presence of two separate soft tissue masses in both thighs in one patient. No patient had a history of prior radiotherapy at the same site. Preoperative duration, known in three cases, ranged from 1 to 24 months (median 12 months). Three tumors were located in the lower extremities (thigh and buttock), one in the retroperitoneum, and one in the parotid region. Three patients were treated by marginal excision; in one case only a biopsy was performed. Radiotherapy/chemotherapy was given in all cases. Two patients were disease free 2 and 14 months after surgery and two developed metastases. Grossly, the tumors were described as frankly hemorrhagic masses or as firm, whitish areas with hemorrhagic nodules and were centered in skeletal muscle in three cases. Size ranged between 2.2 cm and 8 cm (median 4.3 cm). Histologically, all the tumors had two distinct components. In three cases the benign and the malignant components were variably intermixed, whereas in one case the HVM was mainly located at the edge of the malignant tumor. The benign component showed features of an arteriovenous hemangioma (three cases) or intramuscular capillary hemangioma. AS showed epithelioid morphology in three cases and a well-differentiated dissecting pattern in one case. An imperceptible transition between the two components was noted in two cases. The two anatomically separate masses excised from one patient appeared almost identical. All cases were positive for at least two endothelial markers (CD31, CD34, VWF) and negative for the epithelial markers (EMA, AE1/AE3, Pan-keratin). Possible mechanisms for this exceptional phenomenon are discussed.
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Affiliation(s)
- Sabrina Rossi
- Department of Pathology, Brigham & Women's Hospital and Harvard medical School, Boston, Massachussetts 02115, USA
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Abstract
Hemangioma of the heart is a rare lesion, representing 5% to 10% of benign cardiac tumors. Hemangioma of the mitral valve has been reported previously in one autopsy case report. We describe the excision and repair of a hemangioma of the mitral valve in a 33-year-old African-American woman.
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Affiliation(s)
- S W Nye
- Department of Surgery, The Ohio State University College of Medicine, Columbus, USA
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