1
|
Orly J, Bisdorff A, Fraissenon A, Joly A, Boulouis G, Guibaud L, Tavernier E, Mallet S, Marcelin C, Miquel J, Martin L, Droitcourt C, Gusdorf L, Abasq C, Dadban A, Chiaverini C, Vabres P, Herbreteau D, Boccara O, Wassef M, Maruani A. Intramuscular capillary-type hemangioma: Diagnosis, treatment, and outcomes. A French multicentric retrospective study of 66 cases. Eur J Radiol 2023; 165:110962. [PMID: 37423018 DOI: 10.1016/j.ejrad.2023.110962] [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: 03/09/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Intramuscular capillary-type hemangiomas (ICTHs) are rare entities, belonging to the group of intramuscular "hemangiomas." The diagnosis remains challenging. We aimed to assess the diagnostic criteria, treatments and outcomes of ICTHs. METHODS This retrospective study collected all cases of ICTH followed up in 9 French hospital centers, reviewed by an adjudication expert group. RESULTS Among 133 patients screened, 66 with ICTH were included. The median age of patients at diagnosis was 28.0 years, interquartile range (21.0---36.0). The lesion, mainly presenting as a gradually increasing mass (83.9%), was painless (88.9%) and was located in the head and neck (42.4%). MRI (available in all cases) mainly revealed a well-delineated lesion, isointense to the muscle on T1-weighted images, with enhancement after contrast injection; hyperintense on T2-weighted images; and containing flow voids. Among the 66 cases, 59 exhibited typical ICTH features and 7 shared some imaging features with arteriovenous malformations. These latter were larger than typical ICTHs and more painful and appeared on imaging as less well delimited and more heterogeneous tissue masses, with larger tortuous afferent arteries, earlier draining vein opacification and mild arteriovenous shunting. We propose to name these lesions arteriovenous malformation (AVM)-like ICTH. Pathological reports were similar in typical and AVM-like ICTH, showing capillary proliferation with mainly small-size vessels, negative for GLUT-1 and positive for ERG, AML, CD31 and CD34, with low Ki67 proliferation index (<10%), and adipose tissue. The most frequent treatment for ICTH was complete surgical resection (17/47, 36.2%), preceded in some cases by embolization, which led to complete remission. CONCLUSIONS ICTH can be diagnosed on MRI when it is typical. Biopsy or angiography are required for atypical forms.
Collapse
Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | - Annouk Bisdorff
- Reference Center for Vascular Anomalies FAVA-multi, University Hospital of Lariboisière, Coordinator of the Constitutive Center for Superficial Arteriovenous Malformations in Children and Adults, AP-HP, Department of Neuroradiology, Paris, France
| | - Antoine Fraissenon
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France; Service de Radiologie Mère-Enfant, Hôpital Nord, Saint-Etienne, France; CREATIS, UMR 5220, U1294 Lyon, France
| | - Aline Joly
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Maxillo-facial Surgery, Tours, France
| | - Grégoire Boulouis
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Laurent Guibaud
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | - Stéphanie Mallet
- University Hospital Center of Marseille, Department of Dermatology, Marseille, France
| | - Clément Marcelin
- University Hospital Center of Bordeaux, Department of Radiology, Bordeaux, France
| | - Juliette Miquel
- University Hospital Center of La Réunion, Department of Pediatric Dermatology, Saint-Pierre, La Réunion, France
| | - Ludovic Martin
- University Hospital Center of Angers, Department of Dermatology, Angers, France
| | | | - Laurence Gusdorf
- University Hospital Center of Reims, Department of Dermatology, Reims, France
| | - Claire Abasq
- University Hospital Center of Brest, Department of Dermatology, Brest, France
| | - Ali Dadban
- University Hospital Center of Amiens, Department of Dermatology, Amiens, France
| | | | - Pierre Vabres
- University of Bourgogne, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Dijon, France
| | - Denis Herbreteau
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- University Hospital of Lariboisière, AP-HP, Department of Pathology, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France.
| |
Collapse
|
2
|
DeGiovanni JC, Simmonds J, Lang-Orsini M, Lee A. Recurrent Intramuscular Hemangioma (Infiltrating Angiolipoma) of the Lower Lip: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2020; 101:306-311. [PMID: 32921186 DOI: 10.1177/0145561320957759] [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: 11/17/2022] Open
Abstract
OBJECTIVE To report a case of a recurrent intramuscular hemangioma (IMH) of the lower lip of a 68-year-old female and review the published literature to provide an overview of the presentation, diagnostic strategy, pathological classification, and management of these lesions within the oral cavity. METHODS A case report was conducted by reviewing the documentation at a single institution. A systematic literature review on OVID MEDLINE and PubMed was performed using the MESH terms "intramuscular hemangioma" and "oral cavity," "tongue," "cheek," "buccal," "gingiva," and "lip." RESULTS A 62-year-old female presented to our institution with a 2 × 2 × 1 cm IMH of the lower lip involving the surrounding orbicularis oris muscle. She underwent a submucosal resection and did well postoperatively. Six and a half years later, she represented to our institution with a new lower lip lesion in the area of her previous resection. Preoperative magnetic resonance imaging showed a new 10 × 11 mm lesion with a well circumscribed central component surrounded by ill-defined tissue. Preoperative angiography showed that the lesion was supplied by vessels branching off the left facial artery, which were embolized. She underwent wide-local excision (WLE) with bilateral advancement flaps and at her 2-month postoperative visit has not had recurrence. CONCLUSION Only 39 cases of IMH in the oral cavity have been reported, with only 3 others occurring in the lower lip. Here we add the first case of an IMH of the oral cavity that recurred after primary WLE. The patient was successfully retreated with WLE. At a 3-month follow-up visit, she noted some incompetence with oral secretions and occasional tingling along the incision site but no evidence of recurrence.
Collapse
Affiliation(s)
| | | | | | - Arnold Lee
- Tufts University School of Medicine, Boston, MA, USA.,1867Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
3
|
Lidang Jensen M, Nielsen VT. Intramuscular (Subfascial) Vascular Spindle Cell Lipoma. A Case Report. TUMORI JOURNAL 2018; 76:616-9. [PMID: 2284703 DOI: 10.1177/030089169007600624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spindle cell lipoma is a distinct type of lipoma characterized by replacement of mature fat by collagen forming spindle cells. It is a benign lesion occurring chiefly in males older than 45 years and affects the subcutaneous tissues in the regions of the shoulder and posterior neck. Deep-seated (intramuscular) spindle cell lipomas are probably uncommon tumors and to date only two cases have been reported in the literature. A new case of a vascular variant of spindle cell lipoma in an intramuscular (subfascial) location is presented and the differential diagnosis is discussed.
Collapse
|
4
|
Shin YS, Kim YJ, Park IS, Chu YC, Kim JH, Lee HY, Lee KH, Kang YH. Sonographic Differentiation Between Angiolipomas and Superficial Lipomas. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2421-2429. [PMID: 27738296 DOI: 10.7863/ultra.15.08050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the sonographic findings of angio lipomas with those of superficial lipomas. METHODS Preoperative sonograms of 26 angiolipomas from 18 patients and 47 superficial lipomas from 43 patients that were confirmed by biopsy were reviewed retrospectively. The echo texture, echogenicity, internal echogenic stranding, vascularity, visualization of lateral and superficial-deep tumor capsules, shape, and tumor length, width, and length-to-width ratio were evaluated and compared between angiolipomas and superficial lipomas. RESULTS Angiolipomas frequently appeared as heterogeneous (19 of 26 [73.1%]), hyperechoic (23 of 26 [88.5%]), and ovoid (17 of 26 [65.4%]) masses with lesser visualized lateral tumor capsules (6 of 26 [23.1%]), whereas superficial lipomas appeared as homogeneous (36 of 47 [76.6%]), isoechoic (35 of 47 [74.5%]), and spindle-shaped (23 of 47 [48.9%]) masses with well-visualized lateral capsules (33 of 47 [70.2%]), and the differences were statistically significant (P < .001). Vascularity was seen in 4 angiolipomas (16.7%) and in no superficial lipomas (0%). The mean length and width ± SD of angiolipomas (2.2 ± 1.02 and 0.6 ± 0.27 cm, respectively) were smaller than those of superficial lipomas (4.2 ± 1.52 and 1.1 ± 0.51 cm), with statistical significance (P< .001). The other sonographic findings did not reveal statistically significant differences between the tumor types. CONCLUSIONS Sonography might help differentiate angiolipomas from superficial lipomas.
Collapse
Affiliation(s)
- Yoon Sang Shin
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Yeo Ju Kim
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - In Suh Park
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Young Chae Chu
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Jun Ho Kim
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Ha Young Lee
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Kyung Hee Lee
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Young Hye Kang
- Department of Radiology, Inha University Hospital, Incheon, Korea
| |
Collapse
|
5
|
Angiolipoma in head and neck: report of two cases and review of the literature. Int J Oral Maxillofac Surg 2010; 39:610-5. [PMID: 20197228 DOI: 10.1016/j.ijom.2009.12.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Revised: 12/16/2009] [Accepted: 12/22/2009] [Indexed: 12/21/2022]
Abstract
Angiolipomas are either encapsulated or non-encapsulated fatty tumours. They are distinguished from other lipomas by the excessive degree of vascular proliferation and because they are mixed with mature adipocytes. They commonly occur in the trunk and extremities and are rare in the maxillofacial area. Only 36 cases in the head and neck have been reported in the literature. The authors report the first non-infiltrating intramasseterine angiolipoma, and a case of non-infiltrating angiolipoma of the cheek. These tumours appear as homogenous low-density areas on CT with no contrast enhancement. MRI gives better tumour delineation and clear definition of the location and longitudinal extent of the mass. Histopathology demonstrates mature adipose tissue and the proliferation of numerous small branching blood vessels. Management of angiolipomas requires complete surgical excision.
Collapse
|
6
|
Rao SS, Panda NK, Saikia UN, Saravanan K. Angiolipoma Presenting as a Nasal Mass: How Rare a Presentation? EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808700710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Angiolipomas are benign adipose tumors. There are two types: infiltrating and noninfiltrating. An angiolipoma presenting as a nasal mass is rare. To our knowledge, this is only the second documented case of angiolipoma presenting in the nasal dorsum. Total surgical excision by an external rhinoplasty technique with close follow-up is advised. Recurrence is not common.
Collapse
Affiliation(s)
- Sridhara Suryanarayan Rao
- From the Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh K. Panda
- From the Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Karuppiah Saravanan
- From the Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
7
|
Goodwin RW, O'Donnell P, Saifuddin A. MRI appearances of common benign soft-tissue tumours. Clin Radiol 2007; 62:843-53. [PMID: 17662731 DOI: 10.1016/j.crad.2007.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Revised: 03/05/2007] [Accepted: 04/27/2007] [Indexed: 02/07/2023]
Abstract
Benign soft-tissue tumours are many times more common than their malignant counterparts, and magnetic resonance imaging (MRI) is the technique of choice for imaging the lesions. This review illustrates the MRI appearances of the most common benign soft-tissue tumours, based on consecutive referrals to our institution. The imaging signs that are useful for diagnosis are described.
Collapse
Affiliation(s)
- R W Goodwin
- Department of Radiology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | | | | |
Collapse
|
8
|
Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2005; 24:1433-66. [PMID: 15371618 DOI: 10.1148/rg.245045120] [Citation(s) in RCA: 452] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. These lesions are identical to subcutaneous fat on computed tomographic (CT) and magnetic resonance (MR) images and may contain thin septa. Lipomatosis represents a diffuse overgrowth of mature fat affecting either subcutaneous tissue, muscle or nerve, and imaging is needed to evaluate lesion extent. Lipoblastoma is a tumor of immature fat occurring in young children, and imaging features may reveal a mixture of fat and nonadipose tissue. Angiolipoma, myolipoma, and chondroid lipoma are rare lipomatous lesions that are infrequently imaged. Spindle cell and pleomorphic lipoma appear as a subcutaneous lipomatous mass in the posterior neck or shoulder, with frequent nonadipose components. Hibernoma appears as a lipomatous mass with serpentine vascular elements. Benign lipomatous lesions affecting bone, joint, or tendon sheath include intraosseous lipoma, parosteal lipoma, liposclerosing myxofibrous tumor, discrete lipoma of joint or tendon sheath, and lipoma arborescens. Intraosseous and parosteal lipoma have a pathognomonic CT or MR appearance, with fat in the marrow space or on the bone surface, respectively. Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.
Collapse
Affiliation(s)
- Mark D Murphey
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-133A, Washington, DC 20306, USA.
| | | | | | | | | | | |
Collapse
|
9
|
Christensen SR, Børgesen SE, Heegaard S, Prause JU. Orbital intramuscular haemangioma. ACTA OPHTHALMOLOGICA SCANDINAVICA 2002; 80:336-9. [PMID: 12059877 DOI: 10.1034/j.1600-0420.2002.800320.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To present the clinical and histopathological characteristics of an intramuscular haemangioma in the extraocular muscles. METHODS In 1989, an otherwise healthy 21-year-old female developed proptosis of the left eye. Clinical examination revealed a painless, non-compressible, retrobulbar lesion. No discoloration of skin or conjunctiva could be observed. The patient had no history of head injury. She underwent surgery three times over a period of 9 years, without reaching a diagnosis. The tumour increased slowly in size despite the operations and MR imaging suggested a tumour of angiomatous origin. Finally, radical surgery was performed with enucleation of the left eye and excision of affected extraocular muscles. RESULTS Histopathological examination of the removed orbital tumour showed a mixed type intramuscular haemangioma involving four extraocular muscles. CONCLUSION We report the first case of an intramuscular haemangioma of the orbit.
Collapse
|
10
|
Yonehara Y, Nakatsuka T, Ichioka I, Takato T, Matsumoto S, Yamada A. Intramuscular haemangioma of the anterior chest wall. BRITISH JOURNAL OF PLASTIC SURGERY 2000; 53:257-9. [PMID: 10738339 DOI: 10.1054/bjps.1999.3275] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intramuscular haemangiomas of the chest wall are rare. We present the case of a 33-year-old man with an intramuscular haemangioma of the left side of the anterior chest wall located in the left sixth intercostal space. We resected the tumour and surrounding tissue. Histopathological examination of the tumour demonstrated an intramuscular haemangioma of small-vessel type. The patient has been free of recurrence for 5 years after surgery.
Collapse
Affiliation(s)
- Y Yonehara
- Department of Plastic and Reconstructive Surgery, Saitama Medical School, Saitama, Japan
| | | | | | | | | | | |
Collapse
|
11
|
Shohet JA, Simpson B, Coleman JR, Geiger XJ. Angiolipoma presenting as a nasal mass. Otolaryngol Head Neck Surg 1998; 118:848-9. [PMID: 9627247 DOI: 10.1016/s0194-5998(98)70279-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J A Shohet
- Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, USA
| | | | | | | |
Collapse
|
12
|
Abstract
We report the features of a hibernoma on magnetic resonance (MR) imaging. The MR characteristics of this lesion were consistent with a complex lipid-containing mass. The mass did not suppress on short tau inversion recovery (STIR) imaging and was clearly not a simple lipoma. Hibernoma should be considered in the differential diagnosis of complex fatty masses.
Collapse
Affiliation(s)
- S Atilla
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | |
Collapse
|
13
|
Affiliation(s)
- J L Chang
- Department of Orthopedics, University of Virginia Health Sciences Center, Charlottesville
| | | | | |
Collapse
|
14
|
Shajrawi I, Dreyfuss UY, Stahl S, Boss JH. Intramuscular Haemangioma of the Forearm. JOURNAL OF HAND SURGERY 1990; 15:362-5. [PMID: 2230508 DOI: 10.1016/0266-7681_90_90021-u] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intramuscular haemangioma, though benign, may be a serious disorder, because its large size can cause functional impairment, pain and disfigurement, which may require surgical excision. These, as well as the baffling histopathological aspects, are exemplified by this report of an intramuscular haemangioma of the forearm in an adolescent girl. Clinical recognition of a cutaneous angioma overlying a deeply-situated soft tissue tumour may aid the diagnosis of an intramuscular haemangioma.
Collapse
Affiliation(s)
- I Shajrawi
- Bnai Zion Medical Center, Technion, Haifa, Israel
| | | | | | | |
Collapse
|
15
|
Abstract
Angiolipomas are uncommon benign soft tissue tumors with both fatty and vascular components; they may be encapsulated or locally invasive. Three cases are reported in which phleboliths were present within infiltrating angiolipomas. The demonstration of phleboliths in a lipoma suggests the diagnosis of infiltrating angiolipoma rather than the usual encapsulated lipoma.
Collapse
|