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Dong A, Nian S, Bai Y, Zuo C. Hemangioma of the Ilium Simulating Bone Metastasis on 18 F-PSMA-1007 PET/CT. Clin Nucl Med 2024; 49:e304-e306. [PMID: 38377381 DOI: 10.1097/rlu.0000000000005076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT A 64-year-old man was referred for 18 F-PSMA-1007 PET/CT scan for initial staging of biopsy-proved prostate adenocarcinoma. 18 F-PSMA-1007 PET/CT showed focal intense 18 F-PSMA-1007 of the prostate adenocarcinoma and a focal intense activity with SUV max of 10.5 in the left ilium. The 18 F-PSMA-1007-avid iliac bone lesion corresponded to a hemangioma, which was initially detected on pelvic MRI 13 months ago and remained stable in size. This case indicates that hemangioma should be included in the differential diagnosis of PSMA-avid iliac bone lesions.
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Affiliation(s)
| | - Shensheng Nian
- Orthopedics, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yushu Bai
- Orthopedics, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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2
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Alsaleh MH, Alkhars AS, Albensaad M, Alsharif A. Incidental Detection of Synchronous Benign Hepatic and Splenic Hemangiomas on 18 F-PSMA PET/CT. Clin Nucl Med 2024; 49:e298-e300. [PMID: 38537220 DOI: 10.1097/rlu.0000000000005185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT A 51-year-old man with biochemical failure after brachytherapy for prostatic adenocarcinoma (PSA 5 μg/L rising to 6.45 μg/L) underwent a PSMA PET/CT scan. The scan revealed focal 18 F-PSMA activity at the right apex suggestive of local residual or recurrent disease. In addition, 18 F-PSMA images demonstrated 2 focal 18 F-PSMA-avid liver and spleen lesions; both lesions were further evaluated by abdominal MRI, and the final radiological diagnosis was synchronous hepatic and splenic hemangiomas.
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3
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Tabatabaei S, Paknahad M, Garmabi J, Ghorbani F. Central giant cell granuloma in the posterior region of mandible mimicking a fibro-osseous lesion and hemangioma: a case report. J Med Case Rep 2024; 18:255. [PMID: 38769587 DOI: 10.1186/s13256-024-04571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/03/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND A central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion occurring primarily in children and young adults. On the histological level, it is characterized by numerous multinucleated giant cells scattered randomly throughout a sea of spindle-shaped mesenchymal stromal cells which are dispersed throughout the fibrovascular connective tissue stroma containing areas of haemorrhage. When it comes to radiographic features, CGCG can have an array of variations, ranging from well-defined expansile lesions to ill-defined and destructive lesions, with or without expansion. CASE PRESENTATION This case report reviews an 11-year-old Caucasian patient with a chief complaint of slow-growing swelling involving the right posterior mandibular region. The cone beam computed tomography (CBCT) revealed an ill-defined mixed lesion mimicking both fibro-osseous lesion and hemangioma. However, microscopic examination revealed multinucleated giant cells in a fibrous stroma suggestive of central giant cell granuloma. CONCLUSION Our intent in reporting this case is to highlight the importance of thorough clinical, radiographical and histopathological examination for accurate diagnosis and therapeutic interventions as well as to emphasize the importance of taking different possibilities into consideration when examining bony swellings in the head and neck region.
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Affiliation(s)
- Salma Tabatabaei
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Paknahad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Garmabi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farhad Ghorbani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Ghasrodasht Street, Shiraz, 7144833586, Iran.
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Yang W, Gu B, Li D, Wang J, Zhang J. Endoscopic Resection for Colonic Angiomas. Dig Dis Sci 2024; 69:1520-1521. [PMID: 38448763 DOI: 10.1007/s10620-024-08329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/31/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Wei Yang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Binbin Gu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Dan Li
- Endoscopy Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jiahui Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jinshun Zhang
- Health Management Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
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Archer S, Ferreira AT, Rocha M, Pedroto I. Extremely giant liver hemangioma: a case beyond the norms. Rev Esp Enferm Dig 2024; 116:274-275. [PMID: 37539532 DOI: 10.17235/reed.2023.9877/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
A 68-year-old overweight woman with no history of oral contraceptive use presented a large liver mass of 40 cm on abdominal ultrasound without associated symptoms. Complete blood count, coagulation study, and liver biochemistry were unremarkable. Abdominal contrast-enhanced CT revealed a 33x24 cm lesion with discontinuous peripheral globular uptake and centripetal fill-in, consistent with an extremely giant hemangioma. It affected all segments of the right lobe, compressing the right suprahepatic vein and displacing all intra-abdominal structures, with a deviation of the midline structures (stomach and pancreas) to the left. Given the hemangioma size and its significant mass effect, surgery was discussed but declined by the patient, who remains asymptomatic 3 years later. Extremely giant liver hemangiomas (>10 cm) are rare, and the approach to asymptomatic patients is debated. Some advocate for prophylactic excision due to the potential for internal bleeding, growth, or rupture, while others suggest intervention for hemangiomas near major vascular structures. The American College of Gastroenterology recommends surgical intervention in such cases, but the European Association for the Study of the Liver suggests a conservative approach for most patients. This case highlights a successful "watch-and-wait" strategy, bringing attention to this unusual condition and its controversial management.
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Affiliation(s)
- Sara Archer
- Gastroenterology, Centro Hospitalar Universitário de Santo António, Portugal
| | | | - Marta Rocha
- Gastroenterology, Centro Hospitalar Universitário de Santo António
| | - Isabel Pedroto
- Gastroenterology, Centro Hospitalar Universitário de Santo António, Portugal
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Hu Y, Dong H. Rare Presentation of Rapidly Involuting Congenital Hemangioma of the Skull: A Case Report. Am J Case Rep 2024; 25:e943370. [PMID: 38679897 PMCID: PMC11068070 DOI: 10.12659/ajcr.943370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/17/2024] [Accepted: 03/07/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Rapidly involuting congenital hemangioma (RICH) of the fetal skull is an extremely rare vascular disease which undergoes proliferation only in utero and progresses with maximal size at birth. RICH can be detected by prenatal imaging but is easily misdiagnosed. CASE REPORT A 28-year-old nulliparous woman was referred at 38 weeks of gestation for routine screening with obstetric ultrasonography. The ultrasonography revealed a female fetus with a previously undetected head tumor (32×22 mm). Certain unusual sonographic features were observed: the lesion was fusiform, with a wide base adjacent to the frontal bone. Tumor growth appeared to be toward the brain parenchyma rather than outwards (ie, toward the skull), which suggested that the mass may have been derived from the skull. The mass may have remained undiagnosed due to its small size or due to the superimposition of the skull in poor quality ultrasound images. On the basis of ultrasound findings, the lesion was diagnosed as an intracranial tumor, but fetal MRI findings led to the suspicion of RICH of the fetal skull. Finally, the patient was followed up until 1 year after birth, by which time the lesion had completely disappeared. CONCLUSIONS Careful evaluation of prenatal ultrasound is necessary to ensure detection of any mass adjacent to the skull, and the ultrasonography technician should carefully examine the features of any suspected mass to diagnose it correctly to avoid affecting the treatment strategy.
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Affiliation(s)
- Yanli Hu
- Department of Ultrasound Diagnosis, Women and Children’s Hospital of Chongqing Medical University, Chongqing, PR China
- Department of Ultrasound Diagnosis, Chongqing Health Center for Women and Children, Chongqing, PR China
| | - Hongmei Dong
- Department of Ultrasound Diagnosis, Women and Children’s Hospital of Chongqing Medical University, Chongqing, PR China
- Department of Ultrasound Diagnosis, Chongqing Health Center for Women and Children, Chongqing, PR China
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Roy A, Yadav RR, Naranje K, Singh A. Successful interventional treatment of huge hepatic haemangioma in a neonate following failed medical approach. BMJ Case Rep 2024; 17:e258909. [PMID: 38569730 PMCID: PMC10989169 DOI: 10.1136/bcr-2023-258909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
An outborn male term neonate presented with a complaint of respiratory distress since birth on day 9 of life. On examination, baby was having tachypnoea, tachycardia and hepatomegaly. The baby was delivered at term gestation and cried immediately after birth. The chest X-ray showed cardiomegaly. The abdomen ultrasound showed a complex cystic vascular lesion suggestive of hepatic haemangioma. The echocardiography showed an atrial septal defect. The baby was initially treated conservatively along with specific treatment (steroids and propranolol) for haemangioma for 6 weeks. However, the symptoms persisted and there was non-resolution, therefore, particle embolisation of the right hepatic artery was performed. Subsequently, it resulted in complete resolution of the lesion.
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Affiliation(s)
- Abhijeet Roy
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rajanikant R Yadav
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kirti Naranje
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anita Singh
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Xu F, Liu F. Intense 18 F-Prostate-Specific Membrane Antigen Uptake and Mild 18 F-FDG Uptake in a Biopsy-Proven Pulmonary Hemangioma. Clin Nucl Med 2024; 49:375-376. [PMID: 38377395 DOI: 10.1097/rlu.0000000000005117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT We present intense radiotracer activity in a soft tissue density abutting the aortic arch of the left lung on 18 F-prostate-specific membrane antigen PET/CT scan in a patient with prostate cancer, mimicking metastatic disease from prostate cancer versus primary lung malignancy. 18 F-FDG PET/CT scan, however, shows no elevated FDG activity. The results of pathology examination from resected specimen are consistent with pulmonary hemangioma.
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Affiliation(s)
- Feng Xu
- From the Department of Radiology, Washington DC VA Medical Center, Washington, DC
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9
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Lu X, Li Z, Chen D, Luo X. Evaluation of breast mixed hemangioma by multimodality ultrasound with a literature review. Asian J Surg 2024; 47:1923-1924. [PMID: 38212219 DOI: 10.1016/j.asjsur.2023.12.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024] Open
Affiliation(s)
- Xiaokai Lu
- Department of Ultrasonography, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming, 650118-123, Yunnan, People's Republic of China.
| | - Zhiyao Li
- Department of Ultrasonography, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming, 650118-123, Yunnan, People's Republic of China.
| | - Dong Chen
- Department of Ultrasonography, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming, 650118-123, Yunnan, People's Republic of China.
| | - Xiaomao Luo
- Department of Ultrasonography, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming, 650118-123, Yunnan, People's Republic of China.
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10
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Di Nora A, Pizzo F, Testaì M, Gulizia C, Pavone P. Beard neonatal hemangioma: report of a PHACE syndrome. Acta Neurol Belg 2024; 124:727-728. [PMID: 38104298 DOI: 10.1007/s13760-023-02450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Alessandra Di Nora
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
| | - Francesco Pizzo
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Martina Testaì
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Carmela Gulizia
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Piero Pavone
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, AOU "Policlinico", PO "G. Rodolico", Via S. Sofia, 87, 95128, Catania, Italy
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11
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Kitami M, Saito M, Aoki H. Diffusion-weighted Imaging as a "Gatekeeper" Sequence in the Evaluation of Clinically Diagnosed "Infantile Hemangioma". Radiographics 2024; 44:e240041. [PMID: 38547033 DOI: 10.1148/rg.240041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Masahiro Kitami
- Department of Diagnostic Radiology, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai 989-3126, Japan
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mioko Saito
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidekazu Aoki
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
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12
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Velusamy S, Dutta S, Naik D, Nelamangala Ramakrishnaiah VP. Surgery for a symptomatic massive liver haemangioma. BMJ Case Rep 2024; 17:e257370. [PMID: 38508598 PMCID: PMC10952885 DOI: 10.1136/bcr-2023-257370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Liver haemangiomas are the most common benign hepatic tumours, but secondary portal hypertension resulting from haemangiomas is exceedingly uncommon. We present a case of a man in his 50s who presented with a progressively enlarging mass in the right upper abdomen. CT of the liver revealed a large hypodense lesion involving the right lobe, with two smaller lesions in the left lobe. The portal vein was compressed by the tumour, causing portal hypertension. The patient underwent right hepatectomy. Postoperatively, the patient had an uneventful course, and a 3-month follow-up demonstrated resolution of the oesophageal varices, portal gastropathy, with hypertrophy of the left lobe. This case report highlights the successful surgical management of a rare massive hepatic haemangioma causing portal hypertension with surgical resection, emphasising the potential benefits of surgical intervention with minimal complications.
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Affiliation(s)
- Sowmiya Velusamy
- Surgery, Division of HPB Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India
| | - Souradeep Dutta
- Surgery, Division of HPB Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India
| | - Debasis Naik
- Surgery, Division of HPB Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India
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Li X, Wen X, Yang L. Intercostal hemangiomas coexisting with multiple hepatic hemangiomas: Clinical and imaging findings in a single case report with a review of the literature. Medicine (Baltimore) 2024; 103:e37261. [PMID: 38394533 DOI: 10.1097/md.0000000000037261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
RATIONALE Intercostal hemangioma (IH) is an extremely rare disease, with only 18 cases reported in the past 30 years. Herein, we report the first case of IH coexisting with multiple hepatic hemangiomas, which recurred 32 months after surgery with rib erosion. IHs are invasive and difficult to distinguish from other intercostal tumors on imaging. To date, there have been no review articles on the imaging findings of IHs. We hope that this article will help clinicians improve their ability to diagnose and treat IH. PATIENTS CONCERNS A 58-year-old male came to our hospital with gastrointestinal disease. Chest tumors were accidentally discovered on routine chest computed tomography (CT). The patient had no chest symptoms. The patient also had multiple liver tumors that had been present for 2 years but with no remarkable changes. DIAGNOSIS Plain chest CT revealed 2 adjacent masses protruding from the left chest wall into the thoracic cavity. Neurogenic tumors or hamartomas were suspected on enhanced CT scans. Abdominal contrast-enhanced computed tomography scan indicated multiple liver tumors as MMHs, which was consistent with the 2 previous Doppler ultrasound findings. INTERVENTIONS Surgeons removed the chest tumors by video-assisted thoracoscopic surgery. No treatment was provided for the MMHs. OUTCOMES Two tumors of the chest wall were diagnosed as the IHs. There were no significant changes in the hepatic tumors after 32 months of follow-up. Unfortunately, the IH recurred, and the left 5th rib was slightly eroded. LESSONS It is necessary to include IHs as a potential differential diagnosis for chest wall tumors because early clinical intervention can prevent tumor growth and damage to adjacent structures. The imaging findings of IH show special characteristics. Preoperative imaging evaluation and diagnosis of IH are helpful for safe and effective surgery. Because of the high recurrence rate, complete surgical resection of IH with a sufficient tumor-free margin is recommended. It should be noted that the ribs should also be removed when the surrounding ribs are suspected to have been violated.
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Affiliation(s)
- Xiangui Li
- Department of Radiology, Ziyang People's Hospital, Ziyang, Sichuan, China
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14
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Cukman M, Luzaic K, Krstanovic K, Stevanovic S. Management of a rapidly enlarging supraclavicular mass of unknown aetiology. BMJ Case Rep 2024; 17:e255774. [PMID: 38383129 PMCID: PMC10882406 DOI: 10.1136/bcr-2023-255774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Intramuscular haemangiomas are benign tumours showing an extremely rare occurrence and making up less than 1% of all haemangiomas. The goal of this case report is to share our experience in treating a patient with an extremely rare intramuscular haemangioma, which occurred in the supraclavicular region VB level of the neck and extended towards the infraclavicular space, localised within and inferior to the trapezius muscle. The lesion was diagnosed by using multimodal imaging and a wide excision was performed with intraoperative feeding vessel ligation and a good postoperative result. The main difficulties regarding diagnosis and treatment include a lack of evidence-based guidelines, due to limited publications on this topic, the nature of the lesion frequently showing obscure anatomic localisation deep within muscles and unclear delineation, various anatomic origin requiring an individual treatment approach, inconclusive radiologic signs as well as non-specific symptoms.
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Affiliation(s)
- Mateo Cukman
- University of Zagreb School of Medicine, Zagreb, Croatia
- Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Karla Luzaic
- University of Zagreb School of Medicine, Zagreb, Croatia
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15
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Oh J, Han SI, Lim SC. Intraosseous hemangioma with aneurysmal bone cyst-like changes of the hyoid bone: Case report and literature review. Medicine (Baltimore) 2024; 103:e37137. [PMID: 38335421 PMCID: PMC10860961 DOI: 10.1097/md.0000000000037137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
RATIONALE Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones. PATIENT CONCERNS We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body. DIAGNOSIS Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone. INTERVENTIONS The mass was completely removed without significant problems. OUTCOMES Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. LESSONS The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.
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Affiliation(s)
- Jeonghyun Oh
- Department of Otorhinolaryngology, Chosun University, Gwangju, Korea
| | - Song Iy Han
- Division of Premedical Science, Chosun University, Gwangju, Korea
| | - Sung-Chul Lim
- Department of Pathology, College of Medicine, Chosun University, Gwangju, Korea
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Machado PAB, Pereira CDO, de Bortolo JL, Martins ALCL, Campos HG, de Aguiar AJ, Postai RPTA, Wiederkehr JC, Wiederkehr HDA. Littoral cell angioma of the spleen: case report and literature review. Einstein (Sao Paulo) 2024; 22:eRC0267. [PMID: 38324846 PMCID: PMC10948099 DOI: 10.31744/einstein_journal/2024rc0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/19/2023] [Indexed: 02/09/2024] Open
Abstract
Littoral cell angioma is an extremely rare splenic vascular tumor originating from the cells lining the splenic red pulp sinuses. Approximately 150 cases of littoral cell angioma have been reported since 1991. Its clinical manifestation is usually asymptomatic and is mostly diagnosed as an incidental finding through abdominal imaging. Herein, we present a case of littoral cell angioma in a 41-year-old woman with no previous comorbidities, which initially presented as a nonspecific splenic lesion diagnosed on imaging in the emergency room. The patient was treated through laparoscopic intervention.
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Affiliation(s)
- Paulo André Bispo Machado
- General and Trauma Surgery ServiceHospital do TrabalhadorUniversidade Federal do ParanáCuritibaPRBrazil General and Trauma Surgery Service , Hospital do Trabalhador , Universidade Federal do Paraná , Curitiba , PR , Brazil .
- Escola de MedicinaPontifícia Universidade Católica do ParanáCuritibaPRBrazil Escola de Medicina , Pontifícia Universidade Católica do Paraná , Curitiba , PR , Brazil .
| | - Caroline de Oliveira Pereira
- General and Trauma Surgery ServiceHospital do TrabalhadorUniversidade Federal do ParanáCuritibaPRBrazil General and Trauma Surgery Service , Hospital do Trabalhador , Universidade Federal do Paraná , Curitiba , PR , Brazil .
| | - Julia Letícia de Bortolo
- Escola de MedicinaPontifícia Universidade Católica do ParanáCuritibaPRBrazil Escola de Medicina , Pontifícia Universidade Católica do Paraná , Curitiba , PR , Brazil .
| | - Ana Luísa Caetano Lopes Martins
- Escola de MedicinaPontifícia Universidade Católica do ParanáCuritibaPRBrazil Escola de Medicina , Pontifícia Universidade Católica do Paraná , Curitiba , PR , Brazil .
| | - Helder Groenwold Campos
- General and Trauma Surgery ServiceHospital do TrabalhadorUniversidade Federal do ParanáCuritibaPRBrazil General and Trauma Surgery Service , Hospital do Trabalhador , Universidade Federal do Paraná , Curitiba , PR , Brazil .
| | - Alan Junior de Aguiar
- Digestive System Surgery ServiceHospital Vita BatelCuritibaPRBrazil Digestive System Surgery Service , Hospital Vita Batel , Curitiba , PR , Brazil .
| | - Rayana Pecharki Teixeira Alves Postai
- Digestive System Surgery ServiceHospital Vita BatelCuritibaPRBrazil Digestive System Surgery Service , Hospital Vita Batel , Curitiba , PR , Brazil .
| | - Julio Cesar Wiederkehr
- Digestive System Surgery ServiceHospital Vita BatelCuritibaPRBrazil Digestive System Surgery Service , Hospital Vita Batel , Curitiba , PR , Brazil .
| | - Henrique de Aguiar Wiederkehr
- General and Trauma Surgery ServiceHospital do TrabalhadorUniversidade Federal do ParanáCuritibaPRBrazil General and Trauma Surgery Service , Hospital do Trabalhador , Universidade Federal do Paraná , Curitiba , PR , Brazil .
- Digestive System Surgery ServiceHospital Vita BatelCuritibaPRBrazil Digestive System Surgery Service , Hospital Vita Batel , Curitiba , PR , Brazil .
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17
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Namikawa T, Araki K, Utsunomiya M, Yokota K, Munekage M, Maeda H, Kitagawa H, Kobayashi M, Hanazaki K, Seo S. Laparoscopic partial splenectomy in a patient with splenic hemangioma after distal gastrectomy for a neuroendocrine tumor. Clin J Gastroenterol 2024; 17:29-33. [PMID: 37805948 DOI: 10.1007/s12328-023-01868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023]
Abstract
Herein, we report the case of a patient with splenic hemangioma after distal gastrectomy who was treated with laparoscopic partial splenectomy. A 64-year-old woman previously underwent laparoscopic distal gastrectomy with regional lymph-node dissection for a gastric neuroendocrine tumor (G3) with venous infiltration and no lymph-node metastases. Periodic follow-up abdominal computed tomography revealed a well-defined, heterogeneous mass in the lower pole of the spleen 5 years after the operation, which grew from 12 to 19 mm 1 year later. A laparoscopic partial splenectomy was planned. During surgery, a smooth-surfaced mass with a lighter color than that of the surrounding area was observed at the lower pole of the spleen. The inferior polar branch of the splenic artery was transected, and the ischemic area of the lower pole of the spleen, where the tumor was present, was confirmed. First, the line used to perform splenic transection was determined using soft coagulation. The splenic parenchyma was then gradually transected using a vessel-sealing device system, and partial splenectomy was possible with almost no bleeding. The patient was discharged on postoperative day 8 without any complications. Pathological examination revealed a hemangioma without any malignant findings. Laparoscopic partial splenectomy is a safe and useful procedure that can be performed, considering the tumor size and location.
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Affiliation(s)
- Tsutomu Namikawa
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan.
| | - Kohei Araki
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
| | - Masato Utsunomiya
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
| | - Keiichiro Yokota
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
| | - Masaya Munekage
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
| | - Hiromichi Maeda
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
| | - Hiroyuki Kitagawa
- Department of Operating Room Management, Kochi Medical School Hospital, Nankoku, Kochi, Japan
| | - Michiya Kobayashi
- Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi, Japan
| | - Kazuhiro Hanazaki
- Integrated Center for Advanced Medical Technologies, Kochi Medical School Hospital, Nankoku, Kochi, Japan
| | - Satoru Seo
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Oko-Cho, 783-8505, Japan
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18
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Jia G, Dong A, Cheng C, Zuo C. Intense 18 F-PSMA-1007 Uptake of Splenic Hemangioma. Clin Nucl Med 2024; 49:e90-e92. [PMID: 38048527 DOI: 10.1097/rlu.0000000000004995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
ABSTRACT A 77-year-old man was referred for 18 F-PSMA-1007 PET/CT scan for initial staging of biopsy-proved prostate adenocarcinoma. 18 F-PSMA-1007 PET/CT showed focal intense 18 F-PSMA-1007 of the prostate adenocarcinoma and a focal intense activity (SUV max , 27) in the spleen. The 18 F-PSMA-1007-avid splenic lesion corresponded to a splenic hemangioma, which was initially detected on contrast-enhanced CT 7 months ago and unchanged in size and enhancement pattern on follow-up contrast-enhanced CT. This case indicates that splenic hemangioma should be included in the differential diagnosis of PSMA-avid splenic lesions.
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Affiliation(s)
- Guorong Jia
- From the Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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19
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Caldwell NJ, Ackman JB, Chebib I, Mino-Kenudson M, Nielsen GP, Hung YP. Anastomosing haemangioma of the mediastinum: Clinicopathological series with radiological and genetic characterisation. Histopathology 2024; 84:463-472. [PMID: 37936489 DOI: 10.1111/his.15085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 11/09/2023]
Abstract
AIMS Anastomosing haemangiomas are benign tumours with anastomosing vascular channels that may mimic angiosarcoma. While anastomosing haemangiomas have been described in diverse locations, particularly the abdominal/paraspinal region, data on anastomosing haemangiomas in the mediastinum remain limited. We report the clinicopathological, radiological and molecular characteristics of the largest single-institutional series of mediastinal anastomosing haemangiomas. METHODS AND RESULTS In our pathology archives in 2011-23, we reviewed all vascular lesions involving the mediastinum and identified seven anastomosing haemangiomas. Clinical information was abstracted from medical charts; available radiological imaging was reviewed. Targeted DNA-based next-generation sequencing (447 genes, including GNAQ and GNA11) was performed on five cases. The seven patients included five women and two men, with an age range of 55-77 (median = 72) years. Of the six tumours with available radiology, two each were in the prevascular, visceral and paravertebral mediastinum, with lobulated peripheral enhancement in all tumours examined with contrast enhancement. Six patients underwent tumour resection; one patient received proton radiotherapy. Microscopically, each tumour was solitary and characterised by anastomosing capillary-sized vessels lined by hobnail endothelial cells. Fibrin microthrombi, hyaline globules and extramedullary haematopoiesis were common. In the five tumours analysed by next-generation sequencing, GNAQ p.Q209P was identified in one tumour; no additional reportable alterations were identified in the remaining cases. No recurrence was noted in the four patients with available follow-up of 3-58 (median = 9.5) months after resection. CONCLUSION While mediastinal anastomosing haemangiomas can microscopically mimic angiosarcoma, awareness of this entity and radiological correlation may help to circumvent this diagnostic pitfall.
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Affiliation(s)
- Nicholas J Caldwell
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeanne B Ackman
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ivan Chebib
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yin P Hung
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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20
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Ethunandan M. Management of Midfacial and Skull Vault Osseous Vascular Lesions. Oral Maxillofac Surg Clin North Am 2024; 36:61-72. [PMID: 37821289 DOI: 10.1016/j.coms.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
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Affiliation(s)
- Madan Ethunandan
- Oral & Maxillofacial Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK; Oral & Maxillofacial Surgery, Sri Ramchandra Institute of Higher Education and Research, Prour, Chennai, 600116, India.
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21
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Perkov S, Vorobev V, Kurochkin MA, Gorodkov S, Gorin D. Rapid low-cost hyperspectral imaging system for quantitative assessment of infantile hemangioma. J Biophotonics 2024; 17:e202300375. [PMID: 38009761 DOI: 10.1002/jbio.202300375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
Hemangioma, the predominant benign tumor occurring in infancy, exhibits a wide range of prognoses and associated outcomes. The accurate determination of prognosis through noninvasive imaging modalities holds essential importance in enabling effective personalized treatment strategies and minimizing unnecessary surgical interventions for individual patients. The present study focuses on advancing the personalized prognosis of hemangioma by leveraging noninvasive optical sensing technologies by the development of a novel rapid hyperspectral sensor (image collection in 5 s, lateral resolution of 10 μm) that is capable of quantifying hemoglobin oxygenation and vascularization dynamics during the course of tumor evolution. We have developed a quantitative parameter for hemangioma assessment, that demonstrated agreement with the clinician's conclusion in 90% among all cases during clinical studies on six patients, who visited clinician from two to four times. The presented methodology has potential to be implemented as a supportive tool for accurate hemangioma diagnostics in clinics.
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Affiliation(s)
- Sergei Perkov
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Viktor Vorobev
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Maxim A Kurochkin
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Sergey Gorodkov
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
- Faculty of Pediatrics, Saratov State Medical University, Saratov, Russia
| | - Dmitry Gorin
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
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22
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Rybczynska DN, Markiet KE, Pienkowska JM, Szurowska E, Frydrychowski A. To assess the quantitative features of focal liver lesions in gadoxetic acid enhanced MRI and to determine whether these features can accurately differentiate benign form malignant lesions. Eur J Radiol 2024; 171:111288. [PMID: 38194844 DOI: 10.1016/j.ejrad.2024.111288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/07/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
PURPOSE The study aims at assessing the quantitative features which distinguish focal liver lesions (FLLs) in gadoxetic acid (GA) enhanced liver MRI and at determining whether these features can accurately differentiate benign from malignant lesions. MATERIAL AND METHODS 107 patients with 180 unequivocal FLLs in previous examinations were included in a single-center retrospective study. All patients underwent a MRI test of the liver with GA. 99 benign and 74 malignant lesions were included. The group of benign lesions consisted of 60 focal nodular hyperplasias (FNH), 22 hemangiomas (HMG), 6 hepatic adenomas (HA), and 11 other benign lesions (1 angiomyolipioma, 6 lesions histopathology diagnoses as benign without further specification, or ones lacking features of malignancy, and 4 lesions radiologically diagnosed as benign which remained stable in the follow-up studies). The group of malignant lesions consisted of primary 51 hepatocellular carcinomas, 12 metastases, and 11 metastases from melanoma malignum (MM meta). 7 FLLs were excluded (4 cases of uncertain histopathological diagnosis, 2 cholangiocarcinomas, and 1 regenerative nodule). For the included lesions ROI (region of interest) measurements were taken by two observers in the T2-w, ADC (apparent diffusion coefficient) and in the T1-w sequence in the hepatobiliary phase (HBP). The interobserver agreement was evaluated with the Wilcoxon test. The Kruskal - Wallis, Mann - Whitney U and post hoc Dunn's tests were applied to assess if there were any significant differences in the ROI values between individual lesions. The variables with the p values of < 0.05 were considered statistically significant. RESULTS We found significant differences in the ROI values between lesions with p < 0.0001. Strikingly high ROI values in the T2-w sequence were found for HMG. The lowest ADC values were encountered for metastases and MM metastases. The highest ROI values in the HBP were found for FNH, and the lowest for metastases. We also found statistically significant differences in the ROI values between benign and malignant lesions with benign lesions presenting statistically higher ROI values compared to malignant lesions. CONCLUSIONS There were significant differences in the ROI values among different types of FLLs. The predominant quantitative feature in the T2-w sequence was a strikingly high ROI value for HMG. Benign lesions presented statistically higher ROI values in the T2-w, ADC, and HBP sequences compared to malignant lesions. This was true for all lesions except for HA.
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Affiliation(s)
- Dorota N Rybczynska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland; Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland.
| | - Karolina E Markiet
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
| | - Joanna M Pienkowska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
| | - Edyta Szurowska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
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23
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Cai Q, Qian TG, Zhao QY, Feng SY, Yang Q, Luo YC, Dai YQ, Liang P, Yu XL, Liu FY, Han ZY, Du QW, Li X, Yu J. Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study. Int J Hyperthermia 2024; 41:2285705. [PMID: 38269491 DOI: 10.1080/02656736.2023.2285705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/15/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH). METHODS This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR. RESULTS During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006). CONCLUSIONS Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.
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Affiliation(s)
- Qian Cai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Tong-Gang Qian
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qi-Yu Zhao
- Department of Ultrasound, Zhejiang University School of Medicine & the First Hospital of Zhejiang Province, Hangzhou, China
| | - Shun-You Feng
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qiao Yang
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Yu-Qing Dai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Qiao-Wei Du
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
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24
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Wang X, Xu X, An F, Ren Z, Li Y, Wang K, Hua Y. Infantile hemangioma in a subadult Chinese pangolin: a case report. BMC Vet Res 2024; 20:31. [PMID: 38267947 PMCID: PMC10807128 DOI: 10.1186/s12917-023-03832-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/29/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Hemangiomas are a relatively common type of tumor in humans and animals. Various subtypes of hemangiomas have been described in the literature. The classification methods for hemangiomas differ between human and veterinary medicine, and the basis for tumor classification can be found in the literature. CASE PRESENTATION This study describes a tumor in the subcutaneous tissue of the right dorsum of an artificially rescued juvenile Chinese pangolin. Computed tomography (CT) examination yielded the preliminary diagnosis of a vascular malformation, and surgery was performed to resect the tumor. Histopathological examination showed that the tumor mainly was consisted of adipose tissue, capillaries, and spindle cells in the fibrous stroma. Immunohistochemistry showed the positive expression of CD31, CD34, α-SMA, GLUT1 and WT-1 in the tumor tissue, and the tumor was eventually diagnosed as an infantile haemangioma. CONCLUSION The final diagnosis of infantile hemangioma was depended on the histopathological immunohistochemical and CT examination of the neoplastic tissue. This is the first report of infantile hemangioma in a critically endangered species Chinese pangolin.
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Affiliation(s)
- Xianghe Wang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, 510550, China
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China
| | - Xuelin Xu
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China
| | - Fuyu An
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China
| | - Zhengyu Ren
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China
| | - Yongzheng Li
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China
- College of Life Sciences and Technology, Central South University of Forestry and Technology, Changsha, 410004, China
| | - Kai Wang
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China.
| | - Yan Hua
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, 510520, China.
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25
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Kalinic N, Cvjetkovic Tomanic T, Redzek A, Sobot N, Skrbic R, Radomir B, Bjeljac I, Jonjev Z, Maric S, Bosic Miljevic I, Zdravkovic R. Pericardial hemangioma: An extremely rare cardiac tumor. Kardiol Pol 2024; 82:105-106. [PMID: 38230478 DOI: 10.33963/v.kp.98422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Novica Kalinic
- Clinic for Cardiac Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Tanja Cvjetkovic Tomanic
- Clinic for Cardiac Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Aleksandar Redzek
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nikola Sobot
- Clinic for Cardiac Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Ranko Skrbic
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Bosko Radomir
- Clinic for Cardiac Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Ilija Bjeljac
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Zivojin Jonjev
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Stefan Maric
- Clinic for Cardiac Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Iva Bosic Miljevic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ranko Zdravkovic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
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26
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Alexandre AM, Romi A, Gaudino S, Gessi M, Frassanito P, Camilli A, Luca S, Pedicelli A. Giant Congenital Hemangioma of the Skull: Prenatal Diagnosis and Multimodal Endovascular and Surgical Management. Medicina (Kaunas) 2024; 60:145. [PMID: 38256405 PMCID: PMC10821461 DOI: 10.3390/medicina60010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Introduction: calvarial capillary hemangiomas are vascular tumors rarely seen in newborns. Differential diagnosis may be not straightforward on imaging studies and the management depends on patient and lesion characteristics. Case report: we present the case of a large congenital intracranial extra-axial lesion detected by routine prenatal US screening, a giant calvarial congenital hemangioma, treated with a multimodal strategy. Neonatal MR showed a hemorrhagic solid lesion, causing compression of brain tissue. Conservative treatment was attempted, but a one-month follow-up MR showed growth of the lesion with increased mass effect. Pre-operative endovascular embolization and surgical resection were performed. The pathology was consistent with intraosseous capillary hemangioma. The post-operative course was uneventful. At the 8-month follow-up, the patient had no clinical deficits and MR showed complete resection of the lesion. At the 13-month follow-up, the patient was asymptomatic, showing normal neurological examination and psychophysical development. Conclusions: although wait-and-see policy is feasible for small and asymptomatic lesions, radical resection is indicated when the mass is large, thus causing severe mass effect on the brain. Hypervascularization of the tumor may be responsible for hemorrhagic complications and severe anemia. On these grounds, endovascular treatment is feasible and effective to reduce hemorrhagic complications.
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Affiliation(s)
- Andrea M. Alexandre
- UOSA Interventional Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.M.A.); (A.P.)
| | - Andrea Romi
- Neuroradiology Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Simona Gaudino
- Neuroradiology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Marco Gessi
- Neuropathology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Paolo Frassanito
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | | | - Scarcia Luca
- Department of Neuroradiology, Henri Mondor Hospital, 94000 Creteil, France
| | - Alessandro Pedicelli
- UOSA Interventional Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.M.A.); (A.P.)
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27
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Suzuki M, Hojo M, Sugiyama H. Idiopathic multiple bronchial artery aneurysms and racemose haemangioma without symptoms. BMJ Case Rep 2024; 17:e258606. [PMID: 38176756 PMCID: PMC10773295 DOI: 10.1136/bcr-2023-258606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Affiliation(s)
- Manabu Suzuki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Haruhito Sugiyama
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
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Xie LL, Huang YB, Dong KR, Yang SB, Shen C, Ma YY. Postnatal treatment and evolution patterns of giant fetal hepatic hemangioma: a case series of 29 patients. BMC Pediatr 2024; 24:8. [PMID: 38172842 PMCID: PMC10765870 DOI: 10.1186/s12887-023-04476-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To explore the clinical characteristics, postnatal treatment and prognosis of giant fetal hepatic hemangioma (GFHH). METHOD Retrospective analysis was performed on children with giant fetal hepatic hemangioma (maximum tumor diameter > 40 mm) diagnosed by prenatal ultrasound and MRI from December 2016 to December 2020. These patients were observed and treated at the Children's Hospital of Fudan University after birth. The clinical data were collected to analyze the clinical characteristics, treatment, and prognosis of GFHH using independent sample t tests or Fisher's exact tests. RESULTS Twenty-nine patients who were detected by routine ultrasound in the second and third trimester of pregnancy with giant fetal hepatic hemangiomas were included. The first prenatal ultrasound diagnosis of gestational age was 34.0 ± 4.3 weeks, ranging from 22 to 39 weeks. Of the patients, 28 had focal GFHHs and 1 had multifocal GFHHs. Surgery was performed, and the diagnosis was confirmed histopathologically in two patients. There were 8 cases with echocardiography-based evidence of pulmonary hypertension, 11 cases had a cardiothoracic ratio > 0.6, and 4 cases had hepatic arteriovenous fistula (AVF). The median follow-up time was 37 months (range: 14-70 months). During the follow-up, 12 patients received medical treatment with propranolol as the first-line therapy. The treatment group had a higher ratio of cardiothoracic ratio > 0.6 (P = 0.022) and lower albumin levels (P = 0.018). Four (14.8%) lesions showed postnatal growth before involuting. Complete response was observed in 13 (13/29) patients, and partial response was observed in 16 (16/29) patients. CONCLUSIONS Fetal giant hepatic hemangioma is mainly localized, and its clinical outcome conforms to RICH (rapidly involuting) and PICH (partially involuting), but some fetal giant hepatic hemangiomas will continue to grow after birth and then gradually decrease. For uncomplicated giant fetal hepatic hemangioma, postnatal follow-up is the main concern, while those with complications require aggressive medical treatment. Propranolol may have no effect on the volume change of GFHH.
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Affiliation(s)
- Lu-Lu Xie
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, 200032, China
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Yan-Bing Huang
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Kui-Ran Dong
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Shao-Bo Yang
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
| | - Chun Shen
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
| | - Yang-Yang Ma
- Department of Pathology, Children's Hospital of Fudan University, Shanghai, China
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Feng X, Li H. Endoscopic Ultrasound-Guided Sclerotherapy With Lauromacrogol: A Novel Therapy for A Giant Esophageal Hemangioma. Am J Gastroenterol 2024; 119:24. [PMID: 37734340 DOI: 10.14309/ajg.0000000000002514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Xiuxue Feng
- Department of Gastroenterology, the First Medical Center of PLA General Hospital, Beijing, China
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Cakir E, Onder RO, Tosun A. Typical vertebral hemangioma with aggressive transformation. Joint Bone Spine 2024; 91:105616. [PMID: 37478966 DOI: 10.1016/j.jbspin.2023.105616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/13/2023] [Accepted: 06/27/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Ertugrul Cakir
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey.
| | - Ramazan Orkun Onder
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey
| | - Alptekin Tosun
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey
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Wang Q, Huang H, Li J, Fan W. Intraosseous hemangioma of the nasal cavity. Am J Med Sci 2024; 367:e12-e13. [PMID: 37716596 DOI: 10.1016/j.amjms.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/19/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Qi Wang
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
| | - Hai Huang
- Department of Pathology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
| | - Jun Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
| | - Wanfeng Fan
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
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Borella Y, Portmann A, Affortit A, Abdelmassih Y, Caputo G. [Atypical circumscribed choroidal hemangioma: A challenging diagnosis assisted by multimodal imaging]. J Fr Ophtalmol 2024; 47:103934. [PMID: 37659886 DOI: 10.1016/j.jfo.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 09/04/2023]
Affiliation(s)
- Y Borella
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France.
| | - A Portmann
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France
| | - A Affortit
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France
| | - Y Abdelmassih
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France
| | - G Caputo
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France
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33
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Sun Y, Cai X, Wang Z, Sun Y, Cheng J. Elevated 18 F-AIF-FAPI-04 Uptake in Hepatic Hemangioma. Clin Nucl Med 2024; 49:e25-e27. [PMID: 38015630 DOI: 10.1097/rlu.0000000000004965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
ABSTRACT A 67-year-old woman who was diagnosed with intrahepatic cholangiocellular carcinoma (CCC) by biopsy underwent 18 F-FDG and 18 F-AIF-FAPI-04 PET/CT for initial and treatment assessment. In addition to CCC, she had a history of hepatic hemangioma for 3 years. 18 F-FDG PET/CT images showed increased uptake in CCC, but no uptake in hemangiomas. However, images on 18 F-AIF-FAPI-04 PET/CT indicated negative 18 F-AIF-FAPI-04 uptake in CCC, but intense activity in hemangiomas. Our case illustrates that hepatic hemangioma demonstrated intense 18 F-AIF-FAPI-04 uptake, and final diagnosis should be made with caution.
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Barros Alves F, Ribeiro Morgado M, Carvalho A, Vasconcelos M, Rodrigues-Pereira P, Alves S, Macedo F, Madureira AJ. Pericardial hemangioma - Imaging with pathologic correlation of an extremely rare mediastinal lesion. Rev Port Cardiol 2024; 43:49-50. [PMID: 37353195 DOI: 10.1016/j.repc.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/01/2023] [Accepted: 02/21/2023] [Indexed: 06/25/2023] Open
Affiliation(s)
- Filipe Barros Alves
- Department of Radiology, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal.
| | | | - André Carvalho
- Department of Radiology, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal
| | - Mariana Vasconcelos
- Department of Cardiology, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal
| | | | - Sara Alves
- Department of Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal
| | - Filipe Macedo
- Department of Cardiology, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal
| | - António José Madureira
- Department of Radiology, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal
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Cao C, Guo S, Liang Q, Feng C, Ni M, Zhou F, Ye H. Ossifying hemangioma of the frontal sinus: a case report. Braz J Otorhinolaryngol 2024; 90:101341. [PMID: 37865036 PMCID: PMC10594554 DOI: 10.1016/j.bjorl.2023.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/23/2023] Open
Affiliation(s)
- Changxing Cao
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China.
| | - Shasha Guo
- Guizhou Provincial People's Hospital, Department of Paediatrics, Guizhou, China
| | - Qiulin Liang
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China
| | - Chao Feng
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China
| | - Maomei Ni
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China
| | - Feng Zhou
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China; Staff Hospital of Guizhou Province, Department of Pathology, Guizhou, China
| | - Huiping Ye
- Guizhou Provincial People's Hospital, Department of Otolaryngology, Guizhou, China.
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Ohtani T, Ishida T, Ozaki K, Takahashi K, Shimada M, Kidoya E. [Usefulness of Electron Density Calculated from Dual Energy CT in Differential Diagnosis between Hepatocellular Carcinoma and Hepatic Hemangioma]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:1337-1343. [PMID: 37704452 DOI: 10.6009/jjrt.2023-1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE The aim of this study were to compare electron density (ED), obtained by dual energy computed tomography (DECT), between hepatocellular carcinoma (HCC) and hemangioma, and to assess the differential diagnostic performance of ED between HCC and hemangioma. METHODS A total of 46 patients (27 men and 19 women; mean age, 65.7±14.0 years) diagnosed with HCC or hemangioma who underwent upper abdominal DECT between October 2021 and December 2022 were included. ED of each lesion was measured. Relative ED (rED), which is normalized by the ED of background liver parenchyma, was calculated. ED and rED of HCC and hemangioma were statistically analyzed. RESULTS The HCC group showed significantly higher ED (48.1±5.2) and rED (80.0±7.3) than the hemangioma group (43.7±4.1, 69.7±7.2, respectively) (p<0.01). The area under the curve of rED was greater than that of ED, but no significant difference was found (p=0.153). CONCLUSION ED may help in the differential diagnosis between HCC and hemangioma.
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Affiliation(s)
| | | | - Kumi Ozaki
- Department of Radiology, University of Fukui Hospital
| | | | | | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital
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37
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Cai Z, Ding M, Wang T, Zhuang X. Hemangioma of glans penis: A case report. Asian J Surg 2023; 46:5719-5720. [PMID: 37657975 DOI: 10.1016/j.asjsur.2023.08.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Affiliation(s)
- Zhenxin Cai
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Meixuan Ding
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Tao Wang
- The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China.
| | - Xuan Zhuang
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China.
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38
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Agarwal N, Papanna R, Bergh EP, Hernandez-Andrade E, Backley S, Salazar A, Johnson A, Espinoza J. Management of large placental chorioangioma: two-port laser approach for fetal intervention. Ultrasound Obstet Gynecol 2023; 62:882-890. [PMID: 37448172 DOI: 10.1002/uog.26307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/09/2023] [Accepted: 05/12/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES There is a paucity of literature providing evidence-based guidelines for the management of large placental chorioangioma (≥ 4 cm in diameter). The objectives of this study were to compare outcomes between patients managed expectantly and those undergoing in-utero intervention and to describe the different in-utero techniques used for cessation of blood flow to the tumor and the associated outcome. METHODS This was a retrospective cohort study of 34 patients referred for the management of large placental chorioangioma in a single center between January 2011 and December 2022, who were managed expectantly or underwent in-utero intervention. In-utero intervention was performed when the fetus developed any signs of impending compromise, including high combined cardiac output (CCO), worsening polyhydramnios or abnormal fetal Doppler velocimetry findings. Interventions included radiofrequency ablation (RFA), interstitial laser ablation (ILA) and single-port or two-port fetoscopic laser photocoagulation (FLP). Treatment selection was dependent on the proximity of the tumor to the umbilical cord insertion (UCI) and placental location. The two-port technique was performed in patients with a chorioangioma with large feeding vessels (≥ 3 mm) located in the posterior placenta, in which one port was used for occlusion using bipolar forceps and the other port was used for laser photocoagulation of the feeding vessels downstream. The single-port technique was used for chorioangioma with small feeding vessels (< 3 mm) located in the posterior placenta. ILA or RFA was performed in cases with an anterior placenta. Supportive treatments, including amnioreduction and intrauterine transfusion (IUT), were performed for worsening polyhydramnios and suspected fetal anemia based on middle cerebral artery Doppler flow studies, respectively. Comparative statistical analysis between cases undergoing expectant management vs in-utero intervention was performed. Descriptive details were provided for patients who underwent in-utero intervention. RESULTS Thirty-four cases of large chorioangioma were evaluated, of which 25 (73.5%) were managed expectantly and nine (26.5%) underwent intervention. The frequency of polyhydramnios was significantly higher in the intervention group compared with the expectant-management group (66.7% vs 8.0%, P < 0.001). The live-birth rate among expectantly managed cases with large chorioangioma was significantly higher compared with that in cases that underwent in-utero intervention (96.0% vs 62.5%, P = 0.01). In the intervention group, preoperative CCO was elevated in all cases with available information and preoperative hydrops was present in 33.3% (3/9) of cases. One patient experienced fetal demise following IUT prior to planned FLP. Among the remaining eight patients, four underwent two-port FLP, two underwent single-port FLP, one underwent ILA and one underwent both ILA and RFA. All three cases in which hydrops was present at the time of intervention resulted in fetal demise. CONCLUSIONS In-utero interventions aimed at cessation of blood flow in the feeding vessels are a therapeutic option for the management of cases with large chorioangioma. The two-port percutaneous technique appears to improve the efficiency of FLP when a large chorioangioma with large feeding vessels is located in the posterior placenta. We propose that in-utero interventions for large chorioangioma should be initiated prior to the development of fetal hydrops. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N Agarwal
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E P Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E Hernandez-Andrade
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - S Backley
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Salazar
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - J Espinoza
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
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Braun A, Solari M, Gattuso P, Agarwal I. Benign Vascular Lesions of the Breast: A Clinical, Radiographic, and Pathologic Review. Int J Surg Pathol 2023; 31:1437-1448. [PMID: 37032453 DOI: 10.1177/10668969231160254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Vascular lesions of the breast are uncommon, however, these are increasingly encountered now due to more frequent use of magnetic resonance imaging. They comprise a spectrum of lesions including benign, atypical, and malignant tumors. The prototype is a hemangioma, which is most often nonpalpable and is detected on routine screening. Different histopathologic subtypes of hemangioma have been described, including perilobular, venous, cavernous, and capillary hemangioma. Other benign vascular lesions include anastomosing hemangioma, a well-circumscribed proliferation of anastomosing blood vessels with lobular or diffuse growth pattern which affects a large segment of the breast, presenting as a painless slow enlarging palpable mass. Recent data suggest that benign vascular lesions diagnosed on core needle biopsy with concordant radiologic and pathologic findings do not require excision and have an excellent prognosis, except angiomatosis, which can be locally aggressive and may recur. The main focus of this study is to present the radiographic, gross, and histopathologic characteristics of benign vascular lesions of the breast and their differential diagnoses.
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Affiliation(s)
- Ankica Braun
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
| | - Mariana Solari
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
- Rush University Medical Center, Department of Radiology, Chicago, IL, USA
| | - Paolo Gattuso
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
| | - Indu Agarwal
- Rush University Medical Center, Department of Radiology, Chicago, IL, USA
- Northwestern University, McGaw Medical Center, Department of Pathology, Chicago, IL, USA
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Wang X, Zhang H, Zhang M, Guo Y. A giant head and neck hemangioma of the fetus: A case report. Medicine (Baltimore) 2023; 102:e35855. [PMID: 38013270 PMCID: PMC10681613 DOI: 10.1097/md.0000000000035855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023] Open
Abstract
RATIONALE Hemangioma is a common benign disease in clinical practice, but it is rare to find a giant hemangioma in the fetal period. PATIENT CONCERNS Here, we report a case of a giant hemangioma of the fetal head and neck measuring approximately 10.1 × 6.5 cm. DIAGNOSES At first, only ultrasonography was used to diagnose the suspected hemangioma. The pregnant woman refused to undergo further testing and requested induction of labor, after which the tumor was finally sent for pathological examination to confirm hemangioma. INTERVENTIONS AND OUTCOMES Additionally, the fetus developed severe edema (fluid accumulation in the thoracic, abdominal, and pericardial cavities), which can be fatal to the fetus. Finally, the mother refused to continue the pregnancy and underwent induction of labor with rivanol. LESSONS Most hemangiomas are small and asymptomatic. Giant hemangiomas are rare and associated with a variety of maternal and fetal complications. Therefore, this article aims to summarize the knowledge related to hemangioma through this case, strengthen doctors' understanding of this disease, and bring the attention of pregnant women to this disease to ensure early diagnosis and treatment and prevent a poor prognosis.
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Affiliation(s)
- Xueying Wang
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Hongwei Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Maochun Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Yuanyuan Guo
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
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Zhang Z, Ji J, Qiu G, Hou Z, Mi S, Jin Z, Dai Y, Xie Q, Zeng Y, Huang J. Surgical indications for solid hepatic benign tumors: An updated literature review. Biosci Trends 2023; 17:325-334. [PMID: 37599079 DOI: 10.5582/bst.2023.01152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Hepatic hemangioma, focal nodular hyperplasia, and hepatic adenoma are the most common benign solid liver tumors. However, their surgical indications have been the subject of debate. Minimally invasive liver resection reduces the cost of surgery and may lead to overtreatment of benign liver tumors. Recently, there has been a growing understanding of the etiology, pathogenesis, and natural history of these tumors. Great progress has also been made in imaging. The use of MRI and contrast agents has improved the accuracy of non-invasive diagnosis of these tumors, and especially in the identification of specific molecular subtypes of liver adenoma. These factors have resulted in alterations of surgical indications for these tumors. This article examines recent literature and it discusses the surgical indications for hepatic hemangioma, focal nodular hyperplasia, and hepatic adenoma while summarizing modifications in clinical management.
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Affiliation(s)
- Zhihong Zhang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Ji
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Guoteng Qiu
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ziqi Hou
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shizheng Mi
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxing Jin
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yunlong Dai
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingyun Xie
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Zeng
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiwei Huang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
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Zhang L, Delisle MF, Hendson G, Liauw J. Umbilical Cord Hemangioma with Significant Cord Edema. J Obstet Gynaecol Can 2023; 45:101785. [PMID: 34303858 DOI: 10.1016/j.jogc.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Lisa Zhang
- Faculty of Medicine, University of British Columbia, Vancouver, Canada.
| | - Marie-France Delisle
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Glenda Hendson
- Department of Anatomic Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Jessica Liauw
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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Affiliation(s)
- Geetika Khanna
- From the Department of Radiology and Imaging Sciences (G.K.) and Department of Pediatrics, Aflac Cancer and Blood Disorders Center (M.A.B.), Emory University and Children's Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322
| | - Michael A Briones
- From the Department of Radiology and Imaging Sciences (G.K.) and Department of Pediatrics, Aflac Cancer and Blood Disorders Center (M.A.B.), Emory University and Children's Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322
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Wu Q, Luo H, Zhang B, Chen S. A rare case of ovarian hemangioma. J Clin Ultrasound 2023; 51:1507-1508. [PMID: 37815163 DOI: 10.1002/jcu.23588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023]
Abstract
We report a case of a 55-year-old woman who was accidentally discovered an ovarian mass during physical examination, which was eventually proved as hemangioma of the right ovarian by pathological findings.
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Affiliation(s)
- Qiong Wu
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hong Luo
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Bo Zhang
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shiyu Chen
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, China
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Gaynor T, Sinh V, Reddipogu J. Post-traumatic rupture of hepatic haemangioma. ANZ J Surg 2023; 93:2754-2756. [PMID: 37221936 DOI: 10.1111/ans.18526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023]
Affiliation(s)
- Tessa Gaynor
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
| | - Vanshika Sinh
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
| | - Jonathan Reddipogu
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
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Inarejos Clemente EJ, Diaz Leyva J, Karakas SP, Duarte AM, Mas TR, Restrepo R. Radiologic and Clinical Features of Infantile Hemangioma: Potential Pitfalls and Differential Diagnosis. Radiographics 2023; 43:e230064. [PMID: 37883305 DOI: 10.1148/rg.230064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Infantile hemangioma (IH) is the most common neoplasm in children, but it may mimic other types of vascular anomalies or nonvascular benign and malignant tumors. In most cases, the clinical appearance, time of onset, and pattern of involution facilitate its diagnosis. Imaging evaluation is not always needed since the IH features at clinical presentation are usually characteristic, but when needed, US and frequently MRI are the imaging modalities of choice. Clinical photography or photographic documentation plays a central role in monitoring these lesions over their clinical course. Photographic documentation can also add confidence and alert the radiologist when interpreting imaging studies. Some vascular anomalies, especially vascular malformations, are a frequent source of confusion, as these may resemble IHs clinically and at imaging. The lack of uniform terminology also hinders an accurate diagnosis. To unify the terminology and minimize confusion, the International Society for the Study of Vascular Anomalies created a helpful classification in 1994. In addition, radiologists need to be aware of and become familiar with other neoplasms in children that may resemble IH to avoid misdiagnosis and unnecessary procedures. Fibrous and lipomatous tumors are examples of benign tumors that can mimic IHs clinically and at imaging, whereas rhabdomyosarcoma, infantile fibrosarcoma, neuroblastoma, and lymphoproliferative disorders are examples of malignant neoplasms. The authors review the features of IH at clinical presentation and imaging evaluation, highlighting its different phases of evolution and stressing the importance of photographic documentation. The authors also review pitfalls of IH with helpful pearls for differentiation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material. See the invited commentary by Khanna and Briones in this issue.
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Affiliation(s)
- Emilio J Inarejos Clemente
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
| | - Joana Diaz Leyva
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
| | - S Pinar Karakas
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
| | - Ana Margarita Duarte
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
| | - Thomas R Mas
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
| | - Ricardo Restrepo
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat, Barcelona, Spain (E.J.I.C.); Department of Diagnostic Imaging (J.D.L., S.P.K., R.R.) and Children Skin Center (A.M.D.), Miami Children's Hospital, Miami, Fla; and Ross University School of Medicine, Miramar, Fla (T.R.M.)
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Rutten C, Ackermann O, Lambert V, Durand P, Gonzales E, Kreindel TG, Guérin F, Franchi-Abella S. Pediatric hepatic hemangiomas: spectrum and prognostic significance of initial ultrasound findings. Pediatr Radiol 2023; 53:2446-2457. [PMID: 37773445 DOI: 10.1007/s00247-023-05769-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Hepatic hemangiomas may be associated with serious complications; however, it is unknown whether ultrasound (US) features can predict complications. OBJECTIVE To analyze initial US features of hepatic hemangiomas predictive of complications. MATERIALS AND METHODS This is a single-center retrospective cohort study of clinical, biological, and imaging data of infants with hepatic hemangioma between 2000 and 2018. Patients were categorized as having or not having any complication(s). Associations between initial US features and complications were analyzed through logistic regression. Receiver operating characteristic (ROC) curve analyses were performed to determine optimal cutoff values for continuous variables. Stepwise forward logistic regression was used to construct risk prediction models with training and validation sets. Model calibration and discrimination were evaluated using Hosmer-Lemeshow tests, area under the ROC curve, and overall accuracy. RESULTS Of 112 infants with hepatic hemangioma, 67 (60%) had focal, 32 (28%) had multifocal, and 13 (12%) had diffuse lesions, with complication rates of 51%, 34%, and 92%, respectively, mostly cardiac (54/57, 95%). The US characteristics of the hemangiomas were diverse. Risk factors for complications included diffuse subtype; large tumor volume (focal forms); elevated peak systolic hepatic arterial velocity (PSV); and hepatic vein dilation. For focal forms, initial tumor volume >40 ml and PSV >100 cm/s had >70% sensitivity and specificity, respectively, to predict complications; a model including these variables had 75% overall accuracy in the validation set. For multifocal/diffuse forms, a PSV >115 cm/s had sensitivity and specificity to predict complications of >70%; a model including this variable had 78% overall accuracy in the validation set. CONCLUSION Diffuse subtype, large tumor volume, elevated hepatic arterial PSV, and hepatic vein dilation are risk factors for complications of hepatic hemangiomas.
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Affiliation(s)
- Caroline Rutten
- Department of Pediatric Radiology, Bicêtre Hospital, AP-HP, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Oanez Ackermann
- Department of Pediatric Hepatology and Liver Transplantation, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
- Reference Centre for Vascular Liver Diseases, FSMR Filfoie, European Reference Network On Rare Liver Disorders, Bicêtre Hospital, AP-HP, FHU Hépatinov, Paris-Saclay University, Orsay, France
| | - Virginie Lambert
- Department of Pediatric Radiology, Bicêtre Hospital, AP-HP, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
- Pediatric and Congenital Cardiology, Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Philippe Durand
- Reference Centre for Vascular Liver Diseases, FSMR Filfoie, European Reference Network On Rare Liver Disorders, Bicêtre Hospital, AP-HP, FHU Hépatinov, Paris-Saclay University, Orsay, France
- Department of Pediatric Intensive Care and Neonatal Medicine, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Emmanuel Gonzales
- Department of Pediatric Hepatology and Liver Transplantation, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
- Reference Centre for Vascular Liver Diseases, FSMR Filfoie, European Reference Network On Rare Liver Disorders, Bicêtre Hospital, AP-HP, FHU Hépatinov, Paris-Saclay University, Orsay, France
| | - Tamara G Kreindel
- Department of Pediatric Radiology, Bicêtre Hospital, AP-HP, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Florent Guérin
- Reference Centre for Vascular Liver Diseases, FSMR Filfoie, European Reference Network On Rare Liver Disorders, Bicêtre Hospital, AP-HP, FHU Hépatinov, Paris-Saclay University, Orsay, France
- Department of Pediatric Surgery, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Stéphanie Franchi-Abella
- Department of Pediatric Radiology, Bicêtre Hospital, AP-HP, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
- Reference Centre for Vascular Liver Diseases, FSMR Filfoie, European Reference Network On Rare Liver Disorders, Bicêtre Hospital, AP-HP, FHU Hépatinov, Paris-Saclay University, Orsay, France.
- DMU Smart Imaging, BioMaps UMR 9011 CNRS - INSERM - CEA, Le Kremlin-Bicêtre, France.
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Fiore G, Bertani GA, Tariciotti L, Borsa S, Paolucci A, Taramasso L, Locatelli M, Pluderi M. Vertebral Body Infarction after Transarterial Preoperative Embolization of a Vertebral Hemangioma. J Neurol Surg A Cent Eur Neurosurg 2023; 84:588-592. [PMID: 34897610 DOI: 10.1055/s-0041-1739215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Vertebral hemangioma resection can be a real challenge for spine surgeons, given the high potential of massive intraoperative bleeding. For this reason, preoperative transarterial embolization of this tumor is supported by the available literature. Here, we discuss our difficulties in interpreting an unusual clinical and radiologic picture related to the endovascular procedure. METHODS AND RESULTS A 45-year-old man was referred to our department due to chronic back pain and progressive lower extremity weakness. Radiologic assessment was obtained by means of spinal computed tomography (CT) and magnetic resonance imaging (MRI), which showed an aggressive vertebral hemangioma in T7, compressing the spinal cord. The patient underwent a combined therapeutic approach consisting of preoperative transarterial embolization followed by tumor resection, spinal cord decompression, and posterior thoracic arthrodesis. The patient was dismissed with neither strength nor sensory deficits. Two weeks later, he returned to our department with fever. A new MRI demonstrated multiple areas of altered signal in almost all vertebral bodies from T6 down to the sacrum. After a deep diagnostic process, including new MRI and infectious disease evaluations, the definitive diagnosis of multiple vertebral bone infarction was suggested. CONCLUSION Vertebral infarctions are an extremely rare complication of spinal endovascular procedures. To our knowledge, this is the first case of multiple postembolization vertebral infarctions, without spinal cord involvement. This peculiarity was explained by the presence of direct anastomoses between a posterior intercostal artery and the underlying vertebral bodies.
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Affiliation(s)
- Giorgio Fiore
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Giulio A Bertani
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Leonardo Tariciotti
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Stefano Borsa
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Aldo Paolucci
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Lucia Taramasso
- Department of Infectious Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
| | - Marco Locatelli
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Via Antonio di Rudinì, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, Milan, Italy
| | - Mauro Pluderi
- Department of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, Milan, Italy
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Yang Y, Zhou Z, Li Y. MRI-based deep learning model for differentiation of hepatic hemangioma and hepatoblastoma in early infancy. Eur J Pediatr 2023; 182:4365-4368. [PMID: 37462798 DOI: 10.1007/s00431-023-05113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 10/20/2023]
Abstract
Hepatic hemangioma (HH) and hepatoblastoma (HBL) are common pediatric liver tumors and present with similar clinical manifestations with limited distinguishing value of serum AFP in early infancy. An accurate differentiation diagnostic tool is warranted for optimizing treatments and improving prognosis. The present study aimed to develop an innovative and cost-effective diagnostic tool to differentiate HH and HBL in early infancy using advanced deep learning (DL) techniques. One hundred forty patients ≤4 months old diagnosed as HH or HBL with histological specimens were recruited from two institutions assigned into a training set with cross-validation and a testing set for external validation, respectively. Based on MRI images, imaging diagnoses were interpreted by two radiologists, and imaging-derived radiomic features were extracted by pretrained convolutional neural networks (CNNs)-Xception extractor via DL analysis. A nomogram model was constructed integrating predictive clinical variables, radiologist-based interpretation, and DL features, evaluated comprehensively on diagnostic and calibration accuracy. The DL-based model performed an area under the receiver operating characteristic curve (AUC) of 0.966 for the training cohort and 0.864 for the testing cohort. The radiologist-interpreted differentiation model showed an AUC of 0.837 in the testing cohort. The integrated nomogram model represented an increasing performance with an AUC of 0.887, accuracy of 78.57%, sensitivity of 76.19%, and specificity of 80.95% in the testing cohort. CONCLUSION The MRI-based integrated model, a noninvasive preoperative diagnostic tool, yielded favorable efficacy for differentiating HH and HBL in early infancy, which might reduce the patients' costs of repetitive and unnecessary examinations or over-treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05170282. WHAT IS KNOWN • Hepatic hemangioma (HH) and hepatoblastoma (HBL) are common pediatric liver tumors and present with similar clinical manifestations with limited distinguishing value of serum AFP in early infancy. • Considering the rare incidence of infantile hepatic tumors, the distinguishing accuracy between HBL and HH for cases in early infancy is unsatisfactory for radiologists' recognition solely. WHAT IS NEW • The MRI-based integrated model, a noninvasive preoperative diagnostic tool yielded favorable efficacy for differentiating HH and HBL in early infancy, which might reduce the patients' costs of repetitive and unnecessary examinations or over-treatment.
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Affiliation(s)
- Yuhan Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Zongguang Zhou
- Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
- Department of General Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Yuan Li
- Department of Pediatric Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
- Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
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50
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Kaga T, Noda Y, Asano M, Kawai N, Kajita K, Hyodo F, Kato H, Matsuo M. Diagnostic ability of diffusion-weighted imaging using echo planar imaging with compressed SENSE (EPICS) for differentiating hepatic hemangioma and liver metastasis. Eur J Radiol 2023; 167:111059. [PMID: 37643558 DOI: 10.1016/j.ejrad.2023.111059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE To assess the diagnostic abilities of diffusion-weighted imaging (DWI) with parallel imaging (PI-DWI) and that with Compressed SENSE (EPICS-DWI) for differentiating hepatic hemangiomas (HHs) and liver metastases (LMs). METHOD This prospective study included 30 participants with HH and/or LM who underwent PI-DWI and EPICS-DWI. Two radiologists assessed the DWI images and assigned confidence scores for hepatic lesions conspicuity using 4-point scale. One of the radiologists additionally calculated the contrast-to-noise ratio (CNR) and measured ADC value of the hepatic lesions. The conspicuity, CNR, and ADC values were compared between the two sequences. A receiver operating characteristic (ROC) analysis was performed to assess the diagnostic abilities of the two sequences for differentiating HHs and LMs. RESULTS The conspicuity of LMs was better in EPICS-DWI than in PI-DWI (P < .05 in both radiologists). The CNR of LMs was higher in EPICS-DWI than in PI-DWI (P = .008). No difference was found in the CNR of HHs (P = .52), ADC values for HHs (P = .79), and LMs (P = .29) between the two sequences. To differentiate between HHs and LMs, the cutoff ADC values were 1.38 × 10-3 mm2/s in PI-DWI and 1.37 × 10-3 mm2/s in EPICS-DWI. The area under the ROC curve (P = .86), sensitivity (P > .99), and specificity (P > .99) did not vary. CONCLUSIONS The LMs were more visible in EPICS-DWI than in PI-DWI. However, the cutoff ADC values and diagnostic abilities for differentiating HHs and LMs were almost comparable between the two sequences.
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Affiliation(s)
- Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masashi Asano
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Kimihiro Kajita
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Center for One Medicine Innovative Translational Research, Institute for Advanced Study, Gifu University, Gifu, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
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