Unusual Number of Phleboliths in a Lip Vascular Malformation – A Case Report

Rationale: Vascular malformation (VM) associated with jaws may cause jaw size discrepancy. Multiple phleboliths in VM are relatively rare. This case report aims to present one such case. Patient Concerns: A 33?year?old female patient sought surgical correction of her abnormally sized jaw and on examination, she was identified with VM. Diagnosis: Subsequent imaging tests revealed the presence of several phleboliths. Treatment: The patient was treated for an abnormal?sized mandible as well as partial removal of the superficial part of VM. Outcomes: The patient had satisfactory esthetics and there was less bleeding than anticipated. Take?away Lessons: VMs could cause jaw size discrepancy and the extent of the malformation could cause blood flow abnormalities leading to multiple phlebolith formation. Proper surgical planning and education of the patient are essential for successful treatment.

Spontaneous Epidural Hematoma Associated with Venous Phlebolith in Cervical Spine and Possible Pathogenesis

Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm. Magnetic resonance imaging showed epidural hematoma at the C5–7 level, and computed tomography revealed a calcified nodule in the left epidural hemorrhage at C6 level. During left partial laminectomy, epidural venous plexus, and thick epidural hematoma were found, and hematoma removal revealed a white, ovoid, smooth, hard mass of diameter 3 mm. Histopathologic examination confirmed the mass as a venous phlebolith. The presence of a calcified solitary nodule in dorsal epidural space indicates the presence of phlebolith and the risk of SSEH. In such cases, the authors recommend spine surgeons should take into consideration the possibility of epidural hemorrhage.

Hemangioma with Phleboliths, Misdiagnosed as Sialoliths in Submandibular Gland

Hemangiomas are relatively common benign lesions in head and neck, and are easily diagnosed when they present as cutaneous lesions. However, when a vascular lesion is located within the deeper tissues without a cutaneous component, it results in a large differential diagnosis and sometimes is misdiagnosed even using modern imaging studies. In certain instances, simple radiographic studies may be helpful in diagnosis. Hemangioma in the submandibular gland is extremely rare and when it has phleboliths within it, it is easily confused with calculis in the salivary gland. Recently we experienced one such case. The 63-years-old man complained of a painful bulging mass without cutaneous lesions in the right submandibular area, which had occurred in 2 or 3 times over a 2 year periods. Plain skull films revealed two radioopaque densities in submandibular area and ultrasonography revealed similar findings. Preoperatively he was thought to have sialoliths of a submandibular gland, but it was confirmed as a hemangioma with phleboliths after the operation.

A Case of Cutaneous and Gastric Cavernous Hemangiomas / 대한소화기내시경학회지

A hemangioma is a common soft tissue tumor, usually affecting the cutaneous regions of the head and neck in infancy and childhood. A hemangioma in the gastrointestinal tract is rare occurrence which is usually found in the submucosa of the small and large intestine, but rarely in the stomach. Infrequently, multiple cavernous hemangiomas have been reported on skin and in the intestines. A 23-year-old man was admitted with hematemesis. An upper endoscopy revealed a purple colored sessile lesion at the posterior wall side of the fundus which had surface erosion and erythema. This lesion was easy to bleed when the patient retched. Another sessile lesion was detected at the greater curvature side of the upper body. The patient had two intradermal soft masses at the back and left forearm. An X-ray revealed a phebolith that suggested a cavernous hemangioma. An abdomen CT and angiography revealed that these lesions were highly suggestive of hemangioma. Gastric wedge resection was performed and the histological diagnosis was gastric cavernous hemangiomas.