1
|
Gallo A, D'Alisa R, Foreste V, Saccone G, De Angelis MC, Di Spiezio Sardo A, Zizolfi B. Cavernous haemangioma and mid trimester pregnancy loss leading to severe haemorrhage and hysterectomy: a case report and review of literature. Facts Views Vis Obgyn 2023; 15:339-349. [PMID: 38128092 PMCID: PMC10832656 DOI: 10.52054/fvvo.15.4.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background Cavernous haemangiomas are benign vascular tumours that are known to occasionally involve the female genital tract, including the uterus. They are often underdiagnosed during pregnancy, although they can also lead to severe postpartum or antepartum haemorrhage. Objectives Describe our case of an uncommon second-trimester pregnancy loss in a woman with a diffuse cavernous haemangioma of the uterus and cervix and review the wider literature. Methods The review was conducted using MEDLINE, Scopus and PubMed electronic databases from beginning of the database to May 2023, using the following keywords: arteriovenous malformation; cavernous haemangioma/hemangioma; uterine neoplasms; pregnancy complications; abnormal vaginal bleeding. Main outcome measures Description of the characteristics of cavernous haemangioma during pregnancy as well as diagnostic criteria and treatment options. Results Twenty publications were included in the review, which included English-language case reports over a period from 1959 to 2022. No pathognomonic symptoms for cavernous haemangioma of the uterus in a pregnant woman were noted. Complications including massive secondary postpartum haemorrhage, haemoperitoneum, and severe thrombocytopenia with anaemia after delivery were reported. Conclusions Diagnosis and management during pregnancy can be challenging and requires considerable attention, with a multidisciplinary approach including gynaecologists, radiologists, and pathologists to avoid major complications. What is new? An additional case of diffuse cavernous haemangioma of the uterus and cervix is described, that adds to the little existing literature.
Collapse
|
2
|
A Comprehensive Review of Hepatic Hemangioma Management. J Gastrointest Surg 2022; 26:1998-2007. [PMID: 35705835 DOI: 10.1007/s11605-022-05382-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hepatic hemangiomas (HHs) are benign liver lesions often discovered incidentally on imaging for various unrelated pathologies. We herein review the etiology, classification, diagnostic imaging, and management of HHs. METHODS A comprehensive systematic review was performed utilizing MEDLINE/PubMed and Web of Science databases, with the end of search date being March 1, 2022, regarding HH diagnosis, imaging, and management. RESULTS HHs can be broadly classified as capillary hemangiomas or cavernous hemangiomas. While the exact pathophysiology related to the development of HHs remains largely unknown, hormone exposure has been postulated to cause HH growth. HHs appear homogenously hyperechoic on US with distinct margins and posterior acoustic enhancement. While cavernous hemangiomas appear as well-defined hypodense lesions on pre-contrast CT images with the same density as the vasculature, one of the most reliable imaging features for diagnosing cavernous hemangiomas is high signal intensity on T2 weighted images. While most HHs are asymptomatic, some patients can present with pain or compressive symptoms with bleeding/rupture being very rare. Kasabach-Merritt syndrome is a rare but life-threatening condition associated with thrombocytopenia and microangiopathic hemolytic anemia. When HHs are symptomatic or in the setting of Kasabach Merritt syndrome, surgery is indicated. Enucleation is an attractive surgical option for HH as it spares normal liver tissue. Most patients experience symptom relief following surgical resection. CONCLUSION HHs are very common benign liver lesions. High-quality imaging is imperative to distinguish HHs from other liver lesions. Surgery is generally reserved for patients who present with symptoms such as pain, obstruction, or rarely Kasabach-Merritt syndrome. Surgery can involve either formal resection or, in most instances, simple enucleation. Patients generally have good outcomes following surgery with resolution of their symptoms.
Collapse
|
3
|
Gao J, Fei W, Shen C, Shen X, Sun M, Xu N, Li Q, Huang C, Zhang T, Ko R, Cui Y, Yang C. Dermoscopic Features Summarization and Comparison of Four Types of Cutaneous Vascular Anomalies. Front Med (Lausanne) 2021; 8:692060. [PMID: 34262918 PMCID: PMC8273173 DOI: 10.3389/fmed.2021.692060] [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: 04/07/2021] [Accepted: 06/02/2021] [Indexed: 12/01/2022] Open
Abstract
Objective: Dermoscopic features of cutaneous vascular anomalies have been reported, but the described features currently known are limited and not well-understood. The aim of this study is to comprehensively summarize and compare the dermoscopic features of the four different types of cutaneous vascular anomalies [infantile hemangiomas (IH), cherry angioma (CA), angiokeratomas (AK), and pyogenic granuloma (PG)] in the Chinese Han population. Materials and Methods: Dermoscopic features of 31 IH, 172 CA, 31 AK, and 45 PG were collected based on the contact non-polarized mode of dermoscopy at 20-fold magnification. Dermoscopic features including background, lacunae, vessel morphology and distribution were collected and summarized. Additionally, we compared these features by age stage, gender, and anatomical locations in CA. Results: The dermoscopic features of IH included the red lacunae, red/red-blue/red-white backgrounds, and vessel morphology such as linear curved vessels, serpiginous vessels, coiled vessels. For CA, the lacunae appeared reddish brown to reddish blue or only red. In terms of vascular morphology, serpentine vessels, coiled vessels, looped vessels, and curved vessels could be seen in the lesions. A few lesions were black or presented with a superficial white veil. There were statistical differences in red background (P = 0.021), unspecific vessel distribution (P = 0.030), black area (P = 0.029), and white surface (P = 0.042) among different age groups. Red-brown lacunae (P = 0.039), red-blue (P = 0.013), red-white background (P = 0.015), black area (P = 0.016), and white surface (P = 0.046) were of statistical difference in terms of the locations of lesions. Lacunae were also observed in AK, which presented with red, dark purple, dark blue, black. Global dermoscopic patterns that were characterized by a homogeneous area were obvious in all PG lesions, among which 30 (66.7%) were red-white and 15 (33.3%) were red. As for local features, “white rail” lines were detected in 19 (42.2%) lesions and white collarette was seen in 34 (75.6%) lesions. Conclusions: Dermoscopy is an applicable diagnostic tool for the diagnosis of cutaneous vascular anomalies. It is necessary to take into account the age stage and lesion location when we diagnose CA using dermoscopy.
Collapse
Affiliation(s)
- Jing Gao
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Wenmin Fei
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Institute of Skin Health, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Changbing Shen
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China.,Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Xue Shen
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Minghui Sun
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Ning Xu
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China.,Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Qing Li
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Cong Huang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China.,Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Tingfang Zhang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Randy Ko
- Division of Molecular Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Institute of Skin Health, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Chunjun Yang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| |
Collapse
|
4
|
Kim JH, Lam JM. Paediatrics: how to manage infantile haemangioma. Drugs Context 2021; 10:dic-2020-12-6. [PMID: 33889196 PMCID: PMC8029639 DOI: 10.7573/dic.2020-12-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/21/2022] Open
Abstract
Infantile haemangiomas (IHs) are relatively common benign vascular tumours found in the paediatric population. They have varying sizes and involve different depths in the skin leading to various colours, shapes and textures. Although considered harmless in most cases, they may lead to life-threatening complications or cause permanent disfigurations and organ dysfunction. For problematic IHs, the treatment options include oral and topical beta-blockers, systemic corticosteroids, laser treatment, and surgery. In this narrative review, the treatment options for problematic IH are compared and delivered concisely to facilitate the clinical decisions from practitioners, including those in primary care settings. Oral propranolol is currently considered the first-line intervention for problematic IHs. For superficial lesions, there is robust evidence for the use of topical timolol maleate. Systemic corticosteroids are sometimes used in specific situations such as resistance or contraindications to beta-blockers. Surgical excision can be considered in cases requiring urgent intervention such as airway obstruction; this can be done alongside laser therapies for the removal of residual tissue or when reconstructing areas of deformity. The combination of multiple treatment modalities may lead to a more rapid clinical response.
Collapse
Affiliation(s)
- Jason Hs Kim
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
5
|
Genetic and Environmental Risk Factors for Isolated Hemangiomas in Infants. CHILDREN-BASEL 2020; 7:children7100150. [PMID: 32992757 PMCID: PMC7600327 DOI: 10.3390/children7100150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
The goal of this analysis is to identify risk factors for infantile hemangiomas (IH) to better delineate hemangioma predisposition. We analyzed live birth children with isolated cutaneous hemangioma that were reported to the Polish Registry of Congenital Malformations from across Poland between the years 1998 and 2016. Lower birthweight and gestational age were the most significant risk factors associated with IH. We also observed a trend for a higher risk of IH with a lower level of maternal and paternal education. Moreover, mothers with IH have a higher probability of having a child with IH compared to fathers. However, this association is only present when the child is female. Similarly, a higher risk of hemangioma in a female child is found among mothers having relatives of the first degree with IH, compared to fathers with a similar pedigree. Our results suggest the role of exogenous factors in the etiology of IH. The analysis of familial cases suggests a multifactorial model of inheritance. The study indicates that female gender is an important risk factor for the expression of familial IH. Potential interaction of genetic risk factors with exposure to female sex hormones may play a role in the development of IH.
Collapse
|
6
|
Theofilou NE, Scolozzi P, Lombardi T. Angiolymphoid Hyperplasia with Eosinophilia Located on the Forehead: A Possible Association with Oral Contraceptive Use? Dermatopathology (Basel) 2019; 6:225-230. [PMID: 31828064 DOI: 10.1159/000503743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/29/2019] [Indexed: 11/19/2022] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign vasoproliferative tumor characterized by nodules, papules or plaques localized principally in the head and neck region. Histopathological examination reveals hyperplastic blood vessels lined by large endothelial cells, accompanied by an infiltrate of inflammatory cells including eosinophils. The pathogenetic mechanism remains unclear, although different theories have been proposed. Various treatment strategies have been described, but surgery remains the treatment of choice. We describe the case of a young woman with ALHE taking an oral contraceptive pill suggesting a possible etiopathogenetic relationship.
Collapse
Affiliation(s)
- Nantia-Eleni Theofilou
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Tommaso Lombardi
- Oral Medicine and Oral Maxillo-Facial Pathology Unit, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| |
Collapse
|
7
|
Hou F, Dai Y, Fan CY, Suen JY, Richter GT. Estrogen is involved in hemangioma regression associated with mast cells. Orphanet J Rare Dis 2018; 13:181. [PMID: 30340617 PMCID: PMC6195721 DOI: 10.1186/s13023-018-0928-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 10/05/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Estrogen plays a role in infantile hemangioma (IH) development, but the underlying mechanism remains unclear. This study aimed to assess estrogen and estrogen receptor (ER) localization and expression levels in IH. In addition, the unexpected relationship between mast cells (MCs) and estrogen in human IH was discussed. METHODS IH (n = 29), vascular malformation (VMs, n = 33) and normal skin (n = 15) specimens were assessed. IH was classified into proliferative (n = 9; age, 3.56 ± 1.01 months), early involuting (n = 10; age, 8.90 ± 2.69 months) and late involuting (n = 10; age, 20.10 ± 4.93 months) groups. Estradiol (E2), ER-a, ER-β, and tryptase (MC marker) levels were determined immunohistochemically and/or by double immunofluorescence staining. Quantification and localization of tryptase, ER-a, and E2 were assessed for each specimen. RESULTS ER-a, E2, and tryptase were expressed in the cytoplasm and nucleus of MCs in IH. The IH specimens showed significantly more tryptase, ER-a, and E2 positive MCs (30.6 ± 12.7, 9.7 ± 5.6, and 19.8 ± 8.7 cells/high-power field [HPF], respectively) compared with VM specimens (9.0 ± 9.8, 1.5 ± 2.4, and 2.5 ± 4.1 cells/HPF, respectively) and normal skin (6.1 ± 8.5, 0.5 ± 1.2, and 1.9 ± 3.4 cells/HPF, respectively). Proliferating IH displayed fewer E2 positive MCs (14.0 6.3 cells/HPF) compared with early (22.3 ± 10.2 cells/HPF, P = 0.023) and late (22.4 ± 6.8 cells/HPF, P = 0.006) involuting specimens. In addition, proliferating IH showed fewer tryptase positive MCs (24.7 ± 10.8 cells/HPF) compared with early involuting specimens (35.7 ± 15.3 cells/HPF, P = 0.043). All IH specimens were ER-a positive and ER-β negative. CONCLUSIONS E2 and ER-a are expressed on MCs and not on IH endothelial cells. Furthermore, activated MCs may be involved in IH regression.
Collapse
Affiliation(s)
- Fang Hou
- Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, 610072 China
- School of medicine, University of Electronic Science and Technology of China, Chengdu, 610072 China
- Center for the Investigation of Congenital Aberrancies of Vascular Development, Little Rock, AR USA
| | - Yuemeng Dai
- Center for the Investigation of Congenital Aberrancies of Vascular Development, Little Rock, AR USA
| | - Chun-Yang Fan
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - James Y. Suen
- Department of Otolaryngology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Gresham T. Richter
- Center for the Investigation of Congenital Aberrancies of Vascular Development, Little Rock, AR USA
- Division of Pediatric Otolaryngology, Arkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR 72202 USA
| |
Collapse
|
8
|
Aka KE, Apollinaire Horo G, Fomba M, Kouyate S, Koffi AK, Konan S, Fanny M, Effi B, Kone M. A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature. Pan Afr Med J 2018. [PMID: 29515748 PMCID: PMC5837169 DOI: 10.11604/pamj.2017.28.130.10084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The cavernous hemangioma is a rare benign vascular tumor. About 50 cases of this disease were found in the literature over the last century and only 9 cases of cavernous hemangioma on the pregnant uterus were published it comes into cavernous or capillary form. The symptomatology is not unequivocal and when it occurs during pregnancy or postpartum, it causes life-threatening cataclysmic hemorrhage. Antenatal diagnosis is difficult and requires a multidisciplinary approach with pathologists, radiologists and gynecologists to avoid these complications or unnecessary hysterectomies. The diagnosis is histological. Hysterectomy is possible after failure of conservative treatment means. We report a rare case, a novel mixed cavernous hemangioma of the body associated with a capillary hemangioma of the cervix in a patient of 28 years 5th visors with recurrent genital bleeding in the postpartum period leading to a hysterectomy.
Collapse
Affiliation(s)
- Kacou Edele Aka
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| | | | - Minata Fomba
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| | - Salif Kouyate
- Department of Pathological Anatomy, University Hospital of Treichville, Abidjan, Ivory Coast
| | - Abdoul Koffi Koffi
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| | - Seni Konan
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| | - Mohamed Fanny
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| | - Benjamin Effi
- Department of Pathological Anatomy, University Hospital of Treichville, Abidjan, Ivory Coast
| | - Mamourou Kone
- Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast
| |
Collapse
|
9
|
Busca A, Parra-Herran C. Hemangiomas of the uterine cervix: Association with abnormal bleeding and pain in young women and hormone receptor expression. Report of four cases and review of the literature. Pathol Res Pract 2016; 212:532-8. [PMID: 27067810 DOI: 10.1016/j.prp.2016.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/09/2016] [Accepted: 03/15/2016] [Indexed: 11/29/2022]
Abstract
Hemangiomas of the uterine cervix are rare with only about 55 cases reported in the literature. Increased awareness of this unusual cervical lesion can lead to early diagnosis and conservative therapeutic approaches. We present a series of four patients with cervical hemangioma with an extensive review of the existing literature on the subject. All four cervical hemangiomas were diagnosed incidentally in hysterectomy specimens performed for persistent menorrhagia or pain. The mean age at presentation was 34 years. The mean lesion size was 2.1cm and the dominant location was posterior cervix (3 cases). Immunohistochemistry for estrogen and progesterone receptors showed expression of both markers in endothelial cells and stroma, the latter marker showing a stronger and more diffuse pattern. No other significant uterine abnormality was identified in two cases. The vast majority of cervical hemangiomas reported are in reproductive age women. In addition, these lesions express hormone receptors, indicating that their growth is at least in part due to sex hormone stimulation. Although most lesions are symptomatic (mostly bleeding), the diagnosis is frequently unsuspected. Cervical hemangiomas are benign with no recurrences or adverse outcomes reported to date. Conservative treatments are usually successful, and spontaneous remission has been observed. This entity should be included in the differential diagnosis of patients with abnormal vaginal bleeding, particularly in patients of reproductive age with no other clinical and radiologic findings that would explain the symptoms.
Collapse
Affiliation(s)
- Aurelia Busca
- Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Carlos Parra-Herran
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
| |
Collapse
|
10
|
Knight P, Robertson M, Paoletti D. Uterine cavernous haemangioma in pregnancy. Australas J Ultrasound Med 2016; 19:37-41. [DOI: 10.1002/ajum.12003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Paul Knight
- Department of Obstetrics and Gynaecology; Australian National University Medical School; Canberra Australian Capital Territory Australia
- Fetal Medicine Unit; Women and Children's Health Services; The Canberra Hospital; Garran Australian Capital Territory Australia
| | - Meiri Robertson
- Department of Obstetrics and Gynaecology; Australian National University Medical School; Canberra Australian Capital Territory Australia
- Fetal Medicine Unit; Women and Children's Health Services; The Canberra Hospital; Garran Australian Capital Territory Australia
| | - Debra Paoletti
- Department of Obstetrics and Gynaecology; Australian National University Medical School; Canberra Australian Capital Territory Australia
- Fetal Medicine Unit; Women and Children's Health Services; The Canberra Hospital; Garran Australian Capital Territory Australia
| |
Collapse
|
11
|
Slominski AT, Zmijewski MA, Semak I, Zbytek B, Pisarchik A, Li W, Zjawiony J, Tuckey RC. Cytochromes p450 and skin cancer: role of local endocrine pathways. Anticancer Agents Med Chem 2014; 14:77-96. [PMID: 23869782 DOI: 10.2174/18715206113139990308] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/30/2013] [Accepted: 04/10/2013] [Indexed: 12/19/2022]
Abstract
Skin is the largest body organ forming a metabolically active barrier between external and internal environments. The metabolic barrier is composed of cytochromes P450 (CYPs) that regulate its homeostasis through activation or inactivation of biologically relevant molecules. In this review we focus our attention on local steroidogenic and secosteroidogenic systems in relation to skin cancer, e.g., prevention, attenuation of tumor progression and therapy. The local steroidogenic system is composed of locally expressed CYPs involved in local production of androgens, estrogens, gluco- and mineralo-corticosteroids from cholesterol (initiated by CYP11A1) or from steroid precursors delivered to the skin, and of their metabolism and/or inactivation. Cutaneous 7-hydroxylases (CYP7A1, CYP7B1 and CYP39) potentially can produce 7-hydroxy/oxy-steroids/sterols with modifying effects on local tumorigenesis. CYP11A1 also transforms 7-dehydrocholesterol (7DHC)→22(OH)7DHC→20,22(OH)2-7DHC→7-dehydropregnenolone, which can be further metabolized to other 5,7- steroidal dienes. These 5,7-dienal intermediates are converted by ultraviolet radiation B (UVB) into secosteroids which show pro-differentiation and anti-cancer properties. Finally, the skin is the site of activation of vitamin D3 through two alternative pathways. The classical one involves sequential hydroxylation at positions 25 and 1 to produce active 1,25(OH)2D3, which is further inactivated through hydroxylation at C24. The novel pathway is initiated by CYP11A1 with predominant production of 20(OH)D3 which is further metabolized to biologically active but non-calcemic D3-hydroxyderivatives. Classical and non-classical (novel) vitamin D analogs show pro-differentiation, anti-proliferative and anticancer properties. In addition, melatonin is metabolized by local CYPs. In conclusion cutaneously expressed CYPs have significant effects on skin physiology and pathology trough regulation of its chemical milieu.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Robert C Tuckey
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, 930 Madison Avenue, RM525, Memphis, TN 38163, USA.
| |
Collapse
|
12
|
Ma'ayeh M, Purandare N, Harrison M, Geary MP. A rapidly enlarging cutaneous hemangioma in pregnancy. Clin Pract 2014; 4:644. [PMID: 25332760 PMCID: PMC4202182 DOI: 10.4081/cp.2014.644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 07/08/2014] [Indexed: 11/25/2022] Open
Abstract
This is a case of a rapidly enlarging cutaneous pedunculated tumor on a patient’s thumb during her pregnancy. This was excised and identified as a hemangioma. A literature search identified a possible hormonal factor in causing an accelerated growth of this tumor.
Collapse
|
13
|
Abstract
Uterine hemangioma is a rare benign tumor usually presenting with menorrhagia or pregnancy-associated complications. Although the current literature identifies fewer than 50 cases, we in our institution identified 5 similar cases among 3700 patients undergoing total hysterectomy from January 2006 to December 2010. Adenomyosis was the most common preoperative diagnosis among our patients. Vaginal examination, uterine curettage specimens, ultrasonography, and hysterography are usually uninformative, and the definitive diagnosis relies on the final histologic examination. The differential diagnosis includes adenomatoid tumor, lymphangioma, and arteriovenous malformation. Uterine hemangiomas are classified into congenital and acquired. The former is believed to be associated with some hereditary diseases, while the latter is associated with both physical changes and hormone alteration, especially high estrogen level. The best treatment for hemangiomas is unclear. However, it is very important to obtain an accurate diagnosis to prevent overtreatment among reproductive-age women. The prognosis is excellent after hysterectomy.
Collapse
Affiliation(s)
- Wan-Yi Chou
- Department of Pathology, China Medical University Hospital, 2 Yuh-Der Road, Taichung City, Taiwan.
| | | |
Collapse
|
14
|
Liu C, Qin ZP, Fan ZN, Zhao WJ, Wang YM, Wei FC, Li KL, Liu SH. New treatment strategy for granulomatous epulis: Intralesional injection of propranolol. Med Hypotheses 2012; 78:327-9. [DOI: 10.1016/j.mehy.2011.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 11/09/2011] [Accepted: 11/10/2011] [Indexed: 12/19/2022]
|
15
|
Jacobs BJ, Anzarut A, Imbriglia JE, Gordillo G, Imbriglia JE. Vascular anomalies of the upper extremity. J Hand Surg Am 2010; 35:1703-9; quiz 1709. [PMID: 20888510 PMCID: PMC4643689 DOI: 10.1016/j.jhsa.2010.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 08/03/2010] [Indexed: 02/02/2023]
Abstract
The topic of vascular anomalies is uncommon in the hand surgery literature, but hand surgeons do diagnose and treat patients with hemangiomas and vascular malformations. These are separate entities and require different treatment strategies. Proper diagnosis will lead to timely and appropriate treatment.
Collapse
|
16
|
Buckmiller LM, Richter GT, Suen JY. Diagnosis and management of hemangiomas and vascular malformations of the head and neck. Oral Dis 2010; 16:405-18. [DOI: 10.1111/j.1601-0825.2010.01661.x] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
17
|
A potential role for notch signaling in the pathogenesis and regulation of hemangiomas. J Craniofac Surg 2009; 20 Suppl 1:698-702. [PMID: 19169152 DOI: 10.1097/scs.0b013e318193d898] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hemangiomas are the most common benign tumor of infancy, yet its pathogenesis and the mechanisms governing proliferation and involution are not well understood. It is believed that hemangiomas arise out of clonal, abnormal hemangioma endothelial cells (HemECs). The underlying anomaly of the HemEC is not known, although studies have shown that vascular endothelial growth factor (VEGF) and VEGF signaling may influence HemECs. Moreover, there are numerous subtypes of hemangiomas, with differences in natural history, potential for morbidity, and prognosis, and little is known how this relates to HemEC. The Notch signaling pathway is a highly conserved pathway across species from worms to mammals. Notch signaling has been shown to play a role during embryogenesis in directing vascular patterning and development and arterial and venous cell fate determination. Postnatally, it has been implicated in tumor angiogenesis in multiple malignancies. Notch signaling triggers tumor angiogenesis at least in part to stimulation by VEGF, thus establishing that there is a cross talk between the VEGF and Notch pathways. Given the presence of VEGF and its receptors in hemangiomas and known VEGF-Notch cross talk in tumor angiogenesis, the authors hypothesize that Notch signaling may contribute to hemangioma proliferation and involution. Preliminary studies of resected hemangioma specimens by reverse transcription polymerase chain reaction (RT-PCR) show that all 4 Notch receptors and 2 Notch ligands, Jagged1 and Delta-like ligand 4, are expressed by hemangiomas. These findings support a role for Notch in hemangiomas, meriting further analysis of the functional relevance of Notch signaling in hemangiomas.
Collapse
|
18
|
Reggiani Bonetti L, Boselli F, Lupi M, Bettelli S, Schirosi L, Bigiani N, Sartori G, Rivasi F. Expression of estrogen receptor in hemangioma of the uterine cervix: reports of three cases and review of the literature. Arch Gynecol Obstet 2009; 280:469-72. [PMID: 19148658 DOI: 10.1007/s00404-009-0928-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 01/03/2009] [Indexed: 12/21/2022]
Abstract
The occurrence of hemangioma in the female genital tract, particularly in uterine cervix, is rare. The majority of them show asymptomatic behavior. Surgical excision remains curative in most of the cases. Conservative therapies such as sclerosing agents, cryotherapy, and CO(2) laser excision may be alternatively applied. We present three cases of hemangiomas of the cervix in asymptomatic women, diagnosed as cavernous hemangioma in two cases and capillary hemangioma in one. All tumors were immunoreactive for CD31, CD34, factor-VIII-related antigen. Focal expression of estrogen receptors was detected. No positivity was obtained with progesterone receptor antibodies. The presence of estrogen receptor in the endothelial cells of the hemangioma of the cervix suggests a direct role of this hormone in the hemangioma development. A possible target therapy is discussed.
Collapse
Affiliation(s)
- Luca Reggiani Bonetti
- Dipartimento Integrato Servizi Diagnostici e di Laboratorio e di Medicina Legale, Sezione di Anatomia Patologica, Università degli studi di Modena e Reggio Emilia, Modena, Italy.
| | | | | | | | | | | | | | | |
Collapse
|