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Patient Perspectives: What are infantile hemangiomas? Pediatr Dermatol 2015; 32:e318-9. [PMID: 26584704 DOI: 10.1111/pde.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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[High frequency electrocoagulation for treating noninvoluting congenital hemangioma]. ZHONGHUA ZHENG XING WAI KE ZA ZHI = ZHONGHUA ZHENGXING WAIKE ZAZHI = CHINESE JOURNAL OF PLASTIC SURGERY 2015; 31:437-440. [PMID: 27055323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the clinical efficiency of electrocoagulation for the treatment of noninvoluting congenital hemangioma. METHODS Sixteen infants with noninvoluting congenital hemangioma who were admitted to our hospital from January 2011 to June 2013 were included in this study. Color Doppler ultrasound was used to determine the hemangioma location, as well as its size and depth. High frequency electrocoagulation was adopted for the treatment. The output power was set at 10-20 W. The probes were inserted around the tumor or at the surface of the tumor. After switching on for 1-2 seconds, the direction and position of the probe was modulated until covering the whole tumor. After the treatment, the absorption of tumor was about 3-6 months. The efficiency was evaluated during the follow-up. RESULTS Tumor atrophy was obvious after treatment in all patients. The temperature around the tumor mass was decreased, and the aberrant blood signals were decreased under the ultrasonic examination. Complete or partial atrophy were observed. The efficiency was graded as level I, II, III, IV in 0, 2, 9 and 5 patients, respectively. One patient showed local infection due to improper nursing, which was completely relieved after corresponding treatment. No severe adverse events were observed. CONCLUSIONS High-frequency electrocoagulation is effective for treating noninvoluting congenital hemangioma through coagulating the aberrant blood vessels in the tumor, interrupting the vascular endothelial cell, blocking the aberrant blood flow, as well as leading to atrophy and absorption of tumor mass. Besides, no obvious scar is observed after the surgery.
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[Clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma in children]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2015; 44:495-498. [PMID: 26705041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma (NICH) in children. METHODS The clinical, morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed. RESULTS The mean patients' age at diagnosis was 4.2 years, with a male to female ratio of 1.75:1. The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases). Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes. The center of the lobules was occupied by one or more thin or thick walled vessels, which were surrounded by fibrous and fatty tissue, which contained abnormal arterial and venous structures. At the edge of the lobules there were lymphatic vessels. Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 (22/22), CD31 (22/22), SMA (22/22), vimentin (22/22) and Glut1 (0/22). D2-40 expression was located at the edge of the capillary lobules. CONCLUSIONS NICH is a benign lesion. Clinically and pathologically, it needs to be differentiated from rapidly involuting congenital hemangioma, infantile hemangiomas, tufted angioma, vascular malformation, and others.
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[Congenital vascular malformations]. MMW Fortschr Med 2012; 154:51-56. [PMID: 23156876 DOI: 10.1007/s15006-012-1280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Periocular lesion in an infant. BMJ 2011; 343:d7461. [PMID: 22123913 DOI: 10.1136/bmj.d7461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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[Abortive or minimal-growth hemangiomas. A review of 14 cases]. ACTAS DERMO-SIFILIOGRAFICAS 2011; 103:246-50. [PMID: 22056260 DOI: 10.1016/j.ad.2011.03.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 03/08/2011] [Accepted: 03/14/2011] [Indexed: 11/16/2022] Open
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The use of propranolol in the management of periocular capillary haemangioma--a systematic review. Eye (Lond) 2011; 25:1277-83. [PMID: 21738233 PMCID: PMC3194317 DOI: 10.1038/eye.2011.164] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 05/27/2011] [Accepted: 05/27/2011] [Indexed: 12/11/2022] Open
Abstract
Capillary haemangioma or infantile haemangioma (IH) is the most common congenital vascular tumour in the periocular region. Several treatment modalities have been documented, with variable degree of success. Propranolol has recently been reported to be an effective and safe alternative. The aim of this systematic review is to examine the evidence base for the use of propranolol administered orally in the management of periocular capillary haemangioma, and use this information to guide future research. A systematic review of literature was carried out by two independent reviewers using the search strategies highlighted below. A total of 100 cases of oral propranolol use in periorbital or orbital capillary haemangiomas have been documented in the literature. Of the 85 cases that had details of previous treatment, it was used as first-line treatment in 50 (58.8%). The commonest dose used was 2 mg/kg/day. Adverse events were documented in one-third of cases; in most cases these were minor. Improvement or complete resolution of the lesions occurred in 96% of cases. Recurrence was noted in one-fifth of cases. Propranolol has shown a lot of promise in the therapy of IH and further research in the form of properly designed randomized trials is certainly warranted. Treatment guidelines based on literature available to date is included in this review.
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Biomarkers: important clues to the pathogenesis of infantile haemangioma and their clinical significance. THE CHINESE JOURNAL OF DENTAL RESEARCH : THE OFFICIAL JOURNAL OF THE SCIENTIFIC SECTION OF THE CHINESE STOMATOLOGICAL ASSOCIATION (CSA) 2010; 13:105-108. [PMID: 21264359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Infantile haemangioma is the most common tumour of infancy, yet the pathogensis of this lesion remains unknown and the predictable life cycle is poorly understood. Though much new information on infantile haemangioma has emerged over the past decade, researchers continue to debate the fundamental features; including cells of origin, nonrandom distribution, and mechanisms regulating the sometimes explosive growth and slow involution. The development of biomarkers has shed light on the pathogenesis and management of infantile haemangioma. Several useful biomarkers and their suggestions as to the aetiology of infantile haemangioma are reviewed. In addition, the application in clinical diagnosis and choice of treatment methods of infantile haemangioma is summarised.
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MESH Headings
- AC133 Antigen
- Adjuvants, Immunologic/metabolism
- Aminoquinolines/metabolism
- Antigens, CD/metabolism
- Biomarkers/metabolism
- Calcium-Binding Proteins
- DNA-Binding Proteins/genetics
- Female
- Glucose Transporter Type 1/metabolism
- Glycoproteins/metabolism
- Hemangioma, Capillary/chemistry
- Hemangioma, Capillary/congenital
- Hemangioma, Capillary/etiology
- Hemangioma, Capillary/genetics
- Humans
- Imiquimod
- Infant
- Microfilament Proteins
- Neoplastic Syndromes, Hereditary
- Neovascularization, Pathologic/genetics
- Neovascularization, Pathologic/metabolism
- Peptides/metabolism
- Placenta/chemistry
- Pregnancy
- Receptors, Androgen/genetics
- Skin Neoplasms/chemistry
- Skin Neoplasms/etiology
- Skin Neoplasms/genetics
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Intraosseous noninvoluting congenital hemangioma of the mandible in a neonate. Turk J Pediatr 2009; 51:507-509. [PMID: 20112611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hemangiomas are benign tumors of the capillary endothelium involved in varied clinical and pathologic entities. Congenital hemangioma is quite rare compared to infantile hemangioma. Hemangiomas rarely occur in bone. Intraosseous hemangiomas are most commonly found in the vertebral column and skull. The mandible is the most frequently affected skull bone. Intraosseous hemangiomas commonly present in the second decade of life. Here, we report a neonate with noninvoluting congenital hemangioma of the mandible. To our knowledge, she is the youngest patient reported in the literature.
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Intraoral findings and other developmental conditions in Mexican neonates. JOURNAL OF DENTISTRY FOR CHILDREN (CHICAGO, ILL.) 2008; 75:280-286. [PMID: 19040815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE The objective of this study was to investigate the prevalence of intraoral findings and other minor developmental malformations in newborns from San Luis Potosi, Mexico. METHODS Study subjects were neonates born in San Luis Potosi Morones Prieto Hospital between September 1989 and February 1990. All subjects are examined at this hospital within 20 hours of birth. Premature babies or those requiring intensive care were excluded. Examinations are performed by a team consisting of a geneticist, an oral pathologist, 2 dentists, and an oral surgeon using mirrors, tongue blades, and a flashlight. RESULTS The team examined 2,182 neonates and found a frequency of 99% for congenital oral cysts, 2% for natal teeth, 11% for ankyloglossia, 8% for commissural lip pits, and 54% for congenital vascular malformations. The male/female ratios for ankyloglossia and natal teeth were 1.5:1 and 1:2.3, respectively. CONCLUSIONS Babies born at the same hospital demonstrated a high rate of oral cysts, natal teeth, ankyloglossia, and commissural lip pits.
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Postnatal growth and development of a cerebral arteriovenous malformation on serial magnetic resonance imaging in a child with hemangiomatosis. Case report. J Neurosurg 2007; 106:384-7. [PMID: 17566206 DOI: 10.3171/ped.2007.106.5.384] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report the case of a 3-week-old girl with two enhancing extraaxial masses in the posterior fossa, one in the left cerebellopontine angle (CPA) and the other to the right of the vein of Galen. Serial magnetic resonance images obtained in this patient at 3 months and then at 2.5 years of age documented regression of the enhancing mass in the left CPA and development of a cerebellar brain arteriovenous malformation (AVM) in the same CPA location. Also documented were regression of the pineal region mass and formation of the major draining vein of the AVM. The findings in this case support the theory that cerebral AVMs have early postnatal growth potential.
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Birthmarks and Transient Skin Lesions in Newborns and Their Relationship to Maternal Factors: A Preliminary Report from Northern Italy. Dermatology 2007; 215:53-8. [PMID: 17587840 DOI: 10.1159/000102034] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2006] [Accepted: 12/23/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A total of 620 healthy term neonates, randomly selected among babies born at the San Paolo Hospital in Milan (Italy), were examined to study the relationship between birthmarks and transient cutaneous lesions in newborns of different ethnic groups. METHODS Information on sociodemographic factors and on physiopathological variables of the pregnancy was collected. Multiple logistic analyses were performed to assess associations between diagnosed skin lesions and various factors. Odds ratios (OR) as a measure of association and the corresponding 95% confidence intervals were estimated. RESULTS A positive association was found between reduced hypoderm and pregnancy illness (OR = 2.78), hypertrophy genitalia and use of drugs (OR = 1.86) and illnesses in pregnancy (OR = 1.61). Hyperpigmentation in the genital area and Mongolian spot showed significant positive association with geographical area of origin, being systematically more frequent in non-European neonates, while for melanocytic congenital nevi a positive association was observed only for Asiatic newborns (OR = 4.67); salmon patch on the nape showed a significant OR of 1.81 among mothers aged > or = 35. CONCLUSIONS Significant associations between some sociodemographic factors and cutaneous lesions of the newborn and anamnestic data related to the pregnancy were found. Dermatologic conditions are common in the newborns and may justify dermatologic examination.
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Abstract
A number of infantile tumours, far less frequent than infantile haemangiomas, were long assimilated to them. Today they are clearly individualised, based on distinctive clinical and pathologic features, and this difference has been supported by the discovery of new immunophenotypic markers such as GLUT1. GLUT1 stains 100% of infantile haemangiomas and none of the other infantile vascular tumours. Congenital haemangiomas represent a group of vascular tumours still under evaluation as they have slightly heterogeneous presentation. Their prognosis is better appraised and their therapeutic management has improved. They are all fully grown in utero and they do not experience postnatal proliferation like haemangiomas do. Some of them (RICH--Rapidly Involuting Congenital Haemangioma) undergo spontaneous involution during the first year. Others (NICH--Non Involuting Congenital Haemangioma) persist lifelong. Tufted angioma and kaposiform haemangioendothelioma are histopathologically well characterized; in addition they are now considered as part of a same spectrum of vascular tumours, with the contribution of lymphatic endothelial cells in their proliferation. Both are clearly the tumours able to create platelet trapping, thrombocytopenia and the life-threatening Kasabach-Merritt syndrome. However they may occur as isolated tumours, without thrombocytopenia but with cosmetic, and sometimes function-impairing, consequences.
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Abstract
BACKGROUND Tufted angioma (known in Japanese literature as angioblastoma of Nakagawa) is an uncommon, histologically benign, vascular tumor. Lesions typically present during infancy or early childhood and are most commonly reported to persist and/or expand over time. Congenital presentations are rare, as are reports of spontaneous regression. OBSERVATIONS We present a series of 5 histopathologically confirmed cases of congenital tufted angioma that spontaneously regressed during infancy or early childhood. We also review the literature, focusing on both congenital and early-onset cases in infants. CONCLUSION We recommend that observation for potential regression be considered for otherwise uncomplicated congenital or early infantile cases of tufted angioma.
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Abstract
INTRODUCTION Nasal gliomas or heterotopia are nonhereditary congenital malformations composed of heterotopic neuroglial tissue. They usually present in infancy. Evaluation should include preoperative imaging with CT scan and/or MRI to rule out intracranial extension. There have been several cases reported in which nasal gliomas were misdiagnosed as capillary hemangiomas. The differential diagnosis includes prenasal space developmental impairment, which are nasoethmoidal meningoencephaloceles, nasal dermoid and epidermoid cysts. CASE REPORT We describe the case of a newborn male infant presenting at birth with a paramedial nasal glioma. An embryological and clinical analysis of nasal gliomas is proposed. DISCUSSION Nasal glioma is an uncommon congenital lesion presenting as a large panel of midline craniofacial anomalies. The embryological and anatomical origins of nasal gliomas are reviewed. The most known embryological theory was described by Grünwald in 1910 and is called the "prenasal space" theory. This theory is very attractive because of the embryopathogenic continuum proposed among dermoids, gliomas, and encephaloceles. In this article, we discuss major embryological theories on nasal gliomas pathogenesis and propose that while the prenasal space theory can explain the occurrence and the continuum between basal anterior or prenasal encephaloceles and gliomas, it cannot explain the occurrence of craniofacial demoids of the same topography. Better knowledge of embryological mechanisms implicated in the pathogenesis of nasal gliomas can help clinical management of this kind of malformations.
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[Diagnosis and treatment of congenital hemangioma and vascular malformation]. ZHONGHUA KOU QIANG YI XUE ZA ZHI = ZHONGHUA KOUQIANG YIXUE ZAZHI = CHINESE JOURNAL OF STOMATOLOGY 2005; 40:203-5. [PMID: 15938877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Pathophysiology of capillary haemangioma growth after birth. Med Hypotheses 2005; 64:1093-6. [PMID: 15823691 DOI: 10.1016/j.mehy.2004.12.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Accepted: 12/31/2004] [Indexed: 11/18/2022]
Abstract
Capillary haemangiomas (CHs) are the most common soft tissue tumours of infancy. It is generally believed that the primary defect in CHs is intrinsic to endothelial cells, but their pathogenesis is yet poorly understood. The relatively low oxygen environment, in which the human foeto-placental unit develops, during the first trimester, is necessary to induce vasculo-angiogenesis via embryonic endothelial cells proliferation, since these cells are sensitive to hypoxia and acidosis. In newborn infants with haemangioma, persistent embryonic primitive endothelial cells trapped in the intimae underneath the developing vessels, and representing "leader" endothelial cells, can stabilise the labile vascular endothelial growth factor mRNA (VEGF mRNA), produce other angiogenic factors, degrade the underlying basement membrane and invade into the stroma of the neighbouring tissue. With bearing down, the transition from intra- to extra-uterine life is accompanied by more or less pronounced hypoxia. Consequently, in babies with haemangioma, hypoxia can act as a switch to activate these "leader" endothelial cells and thereby initiate a cascade of reactions leading to CH proliferation. As they are regulated by embryonic cells, the haemangioma growth mechanisms pursue the pathway of embryonic angiogenesis and it will stop at the end of the embryonic endothelial cell cycle. Addressing this mechanism in vivo has partly been done (the angiogenic peptide bFGF varies with haemangioma growth). Thus, early treatment seems necessary in infants with haemangioma, before the endothelial cells achieve their proliferative stage. The use of an antibody to interfere with VEGF receptors provides a particular attractive strategy.
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Abstract
OBJECTIVES To verify the diagnostic value of lumbosacral midline cutaneous lesions in asymptomatic children to detect occult spinal dysraphism (OSD) and to propose a practical approach for clinical investigations with respect to the type of cutaneous lesions observed. DESIGN Retrospective study of 54 children referred to the Department of Pediatric Dermatology between 1990 and 1999 for congenital midline lumbosacral cutaneous lesions. SETTING The private or institutional practices of participating dermatologists and pediatricians. MAIN OUTCOME MEASURES Evaluation of the diagnostic value of midline cutaneous lesions for the detec-tion of OSD. Association of skin examination findings with spinal anomalies detected by magnetic resonance imaging or ultrasound. RESULTS Occult spinal dysraphism was detected in 3 of 36 patients with an isolated congenital midline lesion and 11 of 18 patients with a combination of 2 or more different skin lesions. CONCLUSIONS A combination of 2 or more congenital midline skin lesions is the strongest marker of OSD. Careful dermatologic examination is needed to detect suggestive markers and request a spinal magnetic resonance image, which is the most sensitive radiologic approach to detect an OSD.
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Abstract
OBJECT Historically, cutaneous stigmata representative of occult spinal dysraphism (OSD) have included lumbar hemangiomas. Frequently, this skin change is found in conjunction with other cutaneous alterations such as dermal sinus tracts and subcutaneous lipomas. Debate has recently surrounded the question of whether these skin changes in isolation might indicate underlying spinal disease. The authors reviewed their experience in their most recent 120 cases in which OSD was diagnosed. METHODS The authors retrospectively reviewed records obtained in 120 patients with OSD. They found that many of the patients reviewed harbored only a flat capillary hemangioma as an indicator of OSD. In 21 patients (17.5%) with only midline lumbosacral flat capillary hemangiomas, underlying OSD was present. No single variety of OSD had a higher incidence of association with this single cutaneous stigma. CONCLUSIONS Based on their experience, the authors recommend magnetic resonance (MR) imaging evaluation in cases involving this skin lesion in isolation to discern the potential for surgically significant spinal cord anomalies. Prospective studies are now needed to examine MR images obtained in all children with this lesion in the midline lumbosacral spine and assess for OSD.
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Abstract
Pulmonary capillary hemangiomatosis (PCH) is a rare disease characterized by pulmonary hypertension and excessive neovascularization within the pulmonary interstitium, vasculature, and airways. We describe two unusual cases of congenital PCH. Both cases had concurrent anomalies, including renal and urinary bladder agenesis and hypertropic cardiomyopathy. In one case, capillary proliferation caused significant impingement of the proximal bronchial airways. A review of the current literature is described.
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Abstract
A 45-day-old patient was admitted with dyspnea, hepatomegaly, tachycardia, holosystolic murmur in the precordial region, and continuous murmur at the right hypochondrium. Four cutaneous angiomas were noted. Instrumental examinations revealed congestive heart failure and multiple focal lesions in the liver with typical features of hemangiomas. The therapy with subcutaneous interferon-alfa-2a (IFN-alpha) was administered for 12 months with progressive regression of cutaneous hemangiomas, liver lesions, and cardiological alterations. IFN-alpha therapy was effective without any significant adverse effects.
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[Vascular dysplasia in vascular surgery in an African area: 28 cases at the Dakar teaching hospital]. JOURNAL DES MALADIES VASCULAIRES 2003; 28:24-9. [PMID: 12616223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
This retrospective study was conducted to analyze the anatomic and clinical data concerning vascular dysplasia in vascular surgery patients seen in an African hospital and to assess its role in treatment. Twenty-eight patients (14 women and 14 men) were treated for vascular dysplasia between 1994 and 1998. There were 8 cases of hemangioma and 20 cases of vascular malformation. Average age of patients with hemangioma was 3.23 years, with a sex ratio of 0.33. There were 4 cases of mixed hemangioma, 3 of cutaneous hemangioma, and 1 of subcutaneous hemangioma. Cervicocephalic (n=4) and limb (n=3) localizations were the most frequent. Duplex Doppler did not reveal any signs of muscle disease. Four patients underwent surgery, for an early indication in 3 and a late indication in 1. Resection suture was performed in 3 cases and resection graft in one. Mean follow-up was 85.90 days. There was one case of early suppuration. There were no cases of recurrence or late complications and the operative wounds healed well. Vascular malformations concerned 20 patients (sex ratio 1.5, average age 15.55 years) with 16 cases of venous malformation including 4 patients with Klippel Trenaunay syndrome, three with arteriovenous malformation and one with capillary angioma. CT and arteriography were obtained in all cases. Limb localizations predominated (14 patients). In-depth extension was found in 6 cases of venous malformation. Sixteen patients underwent surgery for functional indications in 7. Resection suture was performed in 11 cases. Mean follow-up was 85.90 days. There were 4 early and 2 late postoperative complications. There has been no recurrence. Anatomic and clinical polymorphism of vascular dysplasia requires multidisciplinary collaboration in which vascular surgery plays an important role in complex or complicated forms of the disease in patients attending facilities with limited resources.
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Congenital vascular lesions of the gastrointestinal tract: blue rubber bleb nevus and Klippel-Trenaunay syndromes. South Med J 2001; 94:405-10. [PMID: 11332907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We present two cases of hemangiomatosis of the gastrointestinal tract. The first case describes a 59-year-old patient with upper gastrointestinal hemorrhage due to the blue rubber bleb nevus syndrome. The second case illustrates a 26-year-old patient with recurrent rectal bleeding due to Klippel-Trenaunay syndrome. These two syndromes are distinct disorders characterized by cavernous hemangiomas of the skin, soft-tissue, bones, and viscera. In addition, we review the available literature on the epidemiology, transmission, clinical features, associated conditions, diagnosis, and treatment of these two disorders.
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MESH Headings
- Adult
- Endoscopy, Digestive System
- Gastrointestinal Hemorrhage/etiology
- Gastrointestinal Neoplasms/congenital
- Gastrointestinal Neoplasms/diagnosis
- Gastrointestinal Neoplasms/genetics
- Gastrointestinal Neoplasms/therapy
- Genes, Dominant
- Hemangioma, Capillary/congenital
- Hemangioma, Capillary/diagnosis
- Hemangioma, Capillary/genetics
- Hemangioma, Capillary/therapy
- Humans
- Klippel-Trenaunay-Weber Syndrome/congenital
- Klippel-Trenaunay-Weber Syndrome/diagnosis
- Klippel-Trenaunay-Weber Syndrome/genetics
- Klippel-Trenaunay-Weber Syndrome/therapy
- Male
- Middle Aged
- Nevus, Blue/congenital
- Nevus, Blue/diagnosis
- Nevus, Blue/genetics
- Nevus, Blue/therapy
- Recurrence
- Sclerotherapy/methods
- Syndrome
- Tomography, X-Ray Computed
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Abstract
We reviewed the histopathology of 13 cases of Kasabach-Merrit Syndrome (KMS). In 4 (31%) cases the predominant morphology was that of a tufted angioma (TA). Six (46%) cases were Kaposiform hemangioendotheliomas (KHE), and 3 (23%) cases showed an infantile (juvenile) hemangioma only. Immunostaining for CD34 and actin (HHF-35) was helpful in defining these types of hemangiomas. The TA was characterized by a proliferation of endothelial cells positive for CD34 with a minimal component of actin-positive cells. KHE showed a paucity of immunoreactive cells; only the luminal endothelial cells were positive for CD34. In three cases with the morphology of infantile hemangiomas, actin-positive cells outnumbered the CD34-positive cells. Our findings confirm the observation that the underlying vascular lesion in KMS is usually not an infantile hemangioma as was originally thought, but variants of hemangiomas such as TA and KHE (77% of 13 KMS cases). Infantile hemangioma was the phenotypic substrate of KMS in only 3 of 13 cases.
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Abstract
BACKGROUND Capillary hemangiomas in young children are difficult to treat. They are a recognized proliferation of benign vascular cells and may be disfiguring because of their predilection for the head and neck. OBJECTIVE In contrast to an earlier "wait and see" approach to treating capillary hemangiomas in young children, we sought to determine whether these vascular lesions would respond to a new method of cryosurgery. METHODS In this trial 19 young patients with 24 hemangiomas were treated with contact cryosurgery at a constant applicator tip temperature of only -32 degrees C. RESULTS Our study demonstrates that this method, used early in the treatment of capillary hemangiomas, in particular capillary and mixed capillary-cavernous hemangiomas, will yield excellent to good response in terms of complete remission and regression without leaving side effects such as scarring or hypopigmentation. CONCLUSION Results of our study suggest that capillary hemangioma has an excellent response to even mild cryosurgery.
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Management of congenital subglottic hemangioma. THE JOURNAL OF OTOLARYNGOLOGY 1999; 28:223-8. [PMID: 10461260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
OBJECTIVE This study was conducted to assess the safety and efficacy of individualized management of congenital subglottic hemangioma (CSH) at the Children's Memorial Hospital in Chicago; describe treatment modalities, including endoscopic excision with the carbon dioxide (CO2) laser, systemic corticosteroids, and intralesional corticosteroid injection with short-term intubation; and determine the success of these various strategies in avoiding tracheotomy. METHODS During the 10-year period between January 1, 1988 and December 31, 1997, 28 infants were diagnosed with CSH. A retrospective review of medical records was undertaken to determine demographics, presenting symptoms, location of the lesion, therapeutic modality, and complications. All patients were contacted at the time of writing. RESULTS Twenty-eight patients met the criteria for this study. Gender distribution was 1.8:1 female to male. Age at diagnosis ranged from 4 weeks to 8 months, with a mean of 78.8 days and a median of 60 days. The location of CSH was most often posterior and on the left. Associated hemangiomas were found in 14 (50%) cases. The most common symptoms were stridor and cough. Management included 1 to 13 operative direct laryngoscopies and bronchoscopies, endoscopic excision with the (CO2) laser, and the use of systemic and intralesional corticosteroids. No patient required tracheotomy. CONCLUSION Morbidity and the need for tracheotomy in CSH patients can be minimized using a combination of therapeutic modalities. Each infant's treatment is individualized based on the severity of the patient's symptoms and the morphology of the lesion.
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[Extensive cavernous capillary hemangioma of the right atrium in a newborn infant]. Z Geburtshilfe Neonatol 1999; 203:120-2. [PMID: 10448704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Cardiac hemangiomas in infancy are very rare. We report on a newborn, in whom a tumor of the right artrium was diagnosed in the prenatal period. After complete surgical resection histologic workup showed a cardiac hemangioma.
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MESH Headings
- Echocardiography
- Female
- Heart Atria/pathology
- Heart Atria/surgery
- Heart Neoplasms/congenital
- Heart Neoplasms/diagnosis
- Heart Neoplasms/pathology
- Heart Neoplasms/surgery
- Hemangioma, Capillary/congenital
- Hemangioma, Capillary/diagnosis
- Hemangioma, Capillary/pathology
- Hemangioma, Capillary/surgery
- Hemangioma, Cavernous/congenital
- Hemangioma, Cavernous/diagnosis
- Hemangioma, Cavernous/pathology
- Hemangioma, Cavernous/surgery
- Humans
- Infant, Newborn
- Magnetic Resonance Imaging
- Male
- Pregnancy
- Ultrasonography, Prenatal
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Congenital capillary hemangioma and its therapeutic approach in infants: a case report. J Dermatol 1998; 25:673-6. [PMID: 9830268 DOI: 10.1111/j.1346-8138.1998.tb02479.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hemangiomas, common congenital lesions in infants and children, are thought to arise when islands of angioblastic tissue fail to connect with the developing vascular system. They are not usually life-threatening. A case of congenital capillary hemangioma in an infant, which was surgically excised, is reported, and therapeutic approaches are discussed.
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[Prevention of amblyopia in acute eyelid closure--a new method for keeping the optical axis open by insertion of a small tube]. Klin Monbl Augenheilkd 1998; 213:55-9. [PMID: 9743941 DOI: 10.1055/s-2008-1034945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Complete eyelid closure by capillary eyelid hemangioma or ptosis in the first months of life is an indication for acute measures to prevent amblyopia. Since it is sometimes not possible to hold up the affected upper eyelids with adhesive tape (mechanical obstacle, danger of skin maceration in involvement of the forehead) or not sufficiently (intense divergence), an alternative method will be presented for emergency treatment of blockade of the optical axis. METHODS The eyelids are kept open mechanically with a cylindrical tube of perspex (scleral immersion shell), which is normally used for echography of the anterior segment and for biometry (immersion technique). After surface anesthesia, it can be readily inserted. Its area of contact to the sclera has the form of a scleral shell. A drop of lubricant is applied into the tube at intervals of about five minutes. PATIENTS AND RESULTS In a six-week-old girl with complete eyelid closure owing to a facial hemangioma, adequate eyelid opening could only be achieved by insertion of the scleral immersion shell. In an eleven-months-old boy with complete ptosis and divergence as well as vertical deviation, the optical axis could only be kept open by insertion of the scleral immersion shell and by simultaneous displacement to the temporal side (adhesive tape). The uncomplicated performance for up to two hours daily was initially carried out in the hospital and later by the parents, and could be terminated after five and three and a half weeks, respectively, thanks to improvement due to therapy or spontaneous improvement. CONCLUSIONS Mechanical eyelid opening by insertion of a scleral immersion shell serves to bridge over the time interval to the onset of spontaneous improvement or the success of a causal therapy. The advantages consist in the good handling, also for parents, the low danger of injury and the ubiquitous and rapid availability (basic equipment of an ophthalmological ultrasonography unit).
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Capillary hemangioma of the neck: prenatal MR findings. AJNR Am J Neuroradiol 1997; 18:1432-4. [PMID: 9296183 PMCID: PMC8338154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Prenatal MR findings of a case of extracranial capillary hemangioma simulating an encephalocele at sonography are reported. MR imaging had an adjunctive diagnostic role in excluding the possibility of an encephalocele. The capillary hemangioma had diffuse T2 hypointensity prenatally, which is atypical of postnatal imaging findings.
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Abstract
OBJECTIVE In 1940 Kasabach and Merritt described an infant with a vascular anomaly, extensive purpura, and thrombocytopenia; they called his lesion "capillary hemangioma." Hemangioma is a benign tumor that grows in infancy and is characterized by proliferation of endothelial cells and regression during childhood. Although Kasabach-Merritt syndrome (KMS) is frequently mentioned as a possible complication of hemangioma, our experience suggests that the anatomic vascular lesion underlying the thrombocytopenia is not a "true," classic, involuting type of hemangioma of infancy and childhood. STUDY DESIGN We reviewed the clinical and hemostasis data and the response to treatment in 22 cases of KMS, and we analyzed the biopsy specimens of 15 of them. RESULTS Clinically none of the 22 patients had classic hemangioma. There was no female preponderance. All patients had severe thrombocytopenia (lowest platelet count = 3000/mm3) and consumption of fibrinogen. Histologically, none had the typical "capillary," involuting type of hemangioma of infancy: they exhibited either a tufted angioma or a kaposiform hemangioendothelioma pattern; all specimens also contained numerous abnormal lymphatic-like vessels; lymphatic malformation was the major component in two patients. The infants exhibited a heterogeneous response to a number of therapeutic regimens, as noted in other reports. Severe morbidity was present; three of our patients died, and one had leg amputation. "Residua" were, in fact, residual vascular neoplasia, variable in duration, and not a stable fibrofatty residuum, as in classic involuted hemangioma; only the hematologic phenomenon was "cured" after a period of years. CONCLUSIONS KMS is a distinctive disease of infancy, but the underlying vascular lesion is not a "true," classic, involuting type of hemangioma of infancy. This is a different vascular tumor with a resemblance pathologically to either tufted angioma or kaposiform hemangioendothelioma in association with lymphatic-like vessels. Whether the underlying lesion in KMS is a single anatomic entity or heterogeneous cannot be definitely concluded from this study. We need a better understanding of the pathogenesis of KMS to improve our therapeutic management.
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Abstract
A rare (arteriolo-)capillomedullary venous anomaly of the cerebellum was examined with CT, MRI, and angiography. Unlike the usual venous angioma, this case had such extraordinary features as: infratentorial location, involvement of the whole left cerebellum, an arteriolocapillary component and a history of progressive vomiting and chronic constipation in a 7-year-old boy. CT and MRI were consistent with an extensive vascular malformation, but the actual diagnosis was reached by angiography.
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Abstract
BACKGROUND Several studies have documented cutaneous findings in neonates of various racial groups. Our purpose was to determine the frequency of birthmarks in Israeli neonates of Jewish and Arabic origin. METHODS A cohort of 1672 newborn infants under 96 hours of age were examined for the presence of birthmarks. Of these 841 (50.3%) were Jewish and 831 (49.7%) were Arab. The Jewish group was further subdivided into various ethnic groups according to parental ancestry. RESULTS Melanocytic brown lesions (Mongolian spots, congenital nevi, and café-au-lait spots), were more common in Arab infants. The vast majority of Jewish infants with Mongolian spots were of Asian or African ancestry. On the other hand, congenital melanocytic nevi were found only in Jewish infants of European ancestry. Vascular lesions (salmon patch and port-wine stain) in Arab neonates exhibited a female preponderance. CONCLUSIONS Our data suggest that the prevalence of birthmarks in Israeli neonates is similar to the prevalence reported by others in white neonates.
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Spontaneous improvement of a port wine stain. Cutis 1995; 56:93-5. [PMID: 8536495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A 3-year-old child had been born with an extensive vascular lesion that was clinically and histologically consistent with a port wine stain. Between the ages of six months and three years the lesion showed a remarkable degree of spontaneous resolution. This degree of improvement is exceptional after the age of six months and is documented photographically in this report.
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Eccrine angiomatous hamartoma. PUERTO RICO HEALTH SCIENCES JOURNAL 1994; 13:159-60. [PMID: 7938403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This is the case of a 13 year-old female evaluated for a congenital skin lesion on the left buttock. Physical examination revealed a well-defined light brown patch with a 4mm papule on the center. A skin biopsy revealed an increased number of eccrine glands associated to a proliferation of vascular channels, particularly capillaries. These findings are consistent with a diagnosis of eccrine angiomatous hamartoma.
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Dermacase. Capillary hemangioma. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 1994; 40:29, 206. [PMID: 8312753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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[Diffuse neonatal hemangiomatosis. A case with tetralogy of Fallot]. ANNALES DE PEDIATRIE 1993; 40:625-7. [PMID: 8129334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In neonatal disseminated hemangiomatosis, multiple immature capillary hemangiomas are widely distributed in the skin, mucous membranes, and internal organs including the liver, lungs, and larynx. In patients with life-threatening visceral involvement, corticosteroids or interferon may be required. A case in a female infant with tetralogy of Fallot is reported.
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[Neonatal gastric necrosis. Two new cases including one with a gastric capillary hemangioma]. ANNALES DE PEDIATRIE 1977; 24:875-80. [PMID: 16218269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
MESH Headings
- Asphyxia Neonatorum/complications
- Asphyxia Neonatorum/pathology
- Female
- Gastrectomy
- Hemangioma, Capillary/congenital
- Hemangioma, Capillary/pathology
- Hemangioma, Capillary/surgery
- Hemorrhage/congenital
- Hemorrhage/pathology
- Hemorrhage/surgery
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/pathology
- Infant, Premature, Diseases/surgery
- Ischemia/congenital
- Ischemia/pathology
- Ischemia/surgery
- Male
- Necrosis
- Splenectomy
- Stomach/blood supply
- Stomach/pathology
- Stomach Neoplasms/congenital
- Stomach Neoplasms/pathology
- Stomach Neoplasms/surgery
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