Hemangioma segmentario de la barba / Segmental Beard Hemangioma

Los hemangiomas infantiles son el resultado de la proliferación de células del endotelio vascular y representan los tumores benignos más frecuentes en la infancia, con una incidencia estimada del 4-10% en bebés caucásicos. Se clasifican según el número, la profundidad y la distribución. Dentro de esta última clasificación se encuentran aquellos denominados segmentarios, que se caracterizan por su distribución extensa en áreas de prolongaciones mesodérmicas embrionarias. Se comunica el caso de una paciente evaluada al mes y medio de vida, con un hemangioma extenso del área mandibular y cuello anterior (hemangioma segmentario de la barba). Se describe la importancia de los estudios complementarios para evaluar el compromiso de órganos subyacentes, para detectar síndromes asociados y definir el tratamiento sobre la base de estos resultados. (AU)

Infantile hemangiomas arise from the proliferation of vascular endothelial cells and represent the most common benign tumors in infancy, with an estimated incidence of 4-10% in Caucasian infants. They vary according to their number, depth, and distribution. Within the latter classification are the so-called segmental ones, which feature an extensive distribution in areas of embryonic mesodermal extensions. We report the case of a patient evaluated at one and a half months of life with an extensive hemangioma of the mandibular area and anterior neck (segmental hemangioma of the beard). We describe the importance of complementary studies for evaluating the involvement of underlying organs, detecting associated syndromes, and defining the treatment based on these findings. (AU)

Pyogenic granuloma of the gums and lips caused by camrelizumab: case report and literature review / 口腔疾病防治

Objective@# To investigate the clinical manifestations, pathological features, and treatment of oral and maxillofacial pyogenic granulomas induced by camrelizumab. @*Methods@# A case of pyogenic granuloma of the gums and lips caused by camrelizumab was reported along with a literature review. @*Results@# After 4 months of treatment with camrelizumab for liver cancer, the patient developed systemic reactive capillary hyperplasia (RCH), followed by multiple masses on the lower lip and gingiva. After periodontal therapy, the masses on the lower lip and the gingiva were removed, and camrelizumab administration was stopped. The pathological result was gingival pyogenic granuloma/granulomatous hemangioma. No new masses were found in the oral cavity during postoperative follow-up. A review of the literature showed that RCH is the most common adverse drug reaction to camrelizumab but it occurs infrequently in the oral cavity. At present, the etiology of RCH has not been clarified, but the research has shown that camrelizumab may trigger tissue proliferation into hemangiomas by activating vascular endothelial cells, and the combined use of camrelizumab is safer than single use. RCH is self-limiting and most cases resolve spontaneously after discontinuation of the drug. If the mass causes dysfunction, surgical excision is feasible.@*Conclusion @#Camrelizumab can cause oral and maxillofacial reactive capillary hyperplasia complicated by pyogenic granuloma.

Oral sirolimus in the treatment of adult eruptive cherry angiomas

Introduction@#Cherry angiomas are a common type of acquired vascular proliferation of the skin which manifest as single or multiple bright red spots that usually appear on the trunk and arms. They are generally asymptomatic; patients may opt to remove the lesions for cosmetic reasons and prevention of bleeding. Conventionally, most cherry angiomas are treated with curettage, laser, and electrosurgery. Herein, we report a case of multiple cherry angiomas managed alternatively with oral sirolimus. @*Case@#A 47-year-old Filipino female presented with a 10-month history of gradually enlarging multiple bright-red papules and pedunculated nodules with a propensity to spontaneously bleed on gentle manipulation involving the scalp and forehead. Clinicopathological correlation suggests a diagnosis of eruptive cherry angiomas. The patient was started on oral sirolimus, a mammalian target of rapamycin (mTOR) inhibitor.@*Conclusion@#We present a case of a patient with eruptive cherry angiomas who experienced significant decrease in size and bleeding with treatment of oral sirolimus with minimal adverse effects. For patients with eruptive cherry angiomas, especially with contraindicated comorbidities, first-line therapeutic option treatments with oral sirolimus can be beneficial.

Variétés histologiques des tumeurs bénignes du septum nasal une série documentaire de 30 cas

Contexte et objectif. Les variétés histologiques de tumeurs du septum nasal sont peu documentées dans les pays d'Afrique. La présenté étude avait pour objectif de décrire les variétés histologiques de tumeurs septales bénignes. Méthodes. C'était une analyse rétrospective de dossiers des patients admis pour tumeurs septales bénignes, entre janvier 1998 et aout 2021 ; à l'hôpital Dr Dorban en Algérie. Les variables d'intérêt englobaient les données cliniques et histopathologiques. Résultats. En 23 ans, seulement trente dossiers de tumeurs bénignes du septum nasal ont été colligés. Leur âge moyen était de 36,2 ans avec les extrêmes entre 13 et 70 ans avec une prédominance du sexe féminin (63,3 %). Les tumeurs vasculaires étaient prépondérantes (83,3 %) en particulier les hémangiomes capillaires (92 %) suivies des variétés épithéliales (13,3%) et un seul adénome pléomorphe septal. L'évolution clinique était émaillée par 3 récidives pour les hémangiomes, et absence de récidive pour l'adénome pléomorphe après 120 mois de recul. Trois autres cas étaient perdus. Conclusion: Les tumeurs bénignes du septum nasal sont rares et diversifiées sur le plan histologique. A coté des formes classiques et communes (hémangiomes, papillomes, adénomes), il existe des variétés rares et qui nécessitent une étude spécifique et une expertise dédiée.

Hemangiomas en población pediátrica de la provincia de Camagüey

RESUMEN Introducción: Los hemangiomas infantiles son los tumores benignos más comunes de la niñez. La mayoría no están presentes al nacer, aunque puede existir una lesión precursora. Objetivo: Caracterizar desde la óptica clínica y epidemiológica a los pacientes con hemangiomas en la provincia de Camagüey. Métodos: Estudio descriptivo con los pacientes con hemangiomas que acudieron a la consulta del Hospital "Eduardo Agramonte Piña" entre enero 2019 a enero del 2020. El diagnóstico se basó en las manifestaciones clínicas referidas por los padres de los pacientes, así como en los datos positivos al examen dermatológico. Se confeccionó una ficha de recolección de datos que permitió organizar la información y que se convirtió en el registro definitivo de la investigación. Los resultados se expresaron en números absolutos y porcentajes. Resultados: Existió un predominio en lactantes de 0 a 3 meses con 19 pacientes (95 %). Del sexo femenino se diagnosticaron 14 casos (70 %). Se comprobó un predominio de lactantes de piel blanca con 14 niños (70 %). El 60 % del total presentó lesión única. Las localizaciones más frecuentes fueron la cara con 15 pacientes (46,9 %) y tronco con 10 casos (31,3 %). Conclusiones: En la provincia de Camagüey los hemangiomas infantiles predominaron en niños menores de tres meses, del sexo femenino y piel blanca. Las localizaciones más frecuentes son la cara y el cuero cabelludo. Más de la mitad de los pacientes presentaron lesión única.

ABSTRACT Introduction: Children's hemangiomas are the most common benign tumors inchildhood. Most are not present at birth, although there may be a precursor lesion. Objective: Characterize from the clinical and epidemiological perspective patients with hemangiomas in Camagüey province. Methods: Descriptive study of patients with hemangiomas who attended "Eduardo Agramonte Piña" Hospital's consultation between January 2019 and January 2020. The diagnosis was based on the clinical manifestations referred by the parents of the patients, as well as on the positive data to the dermatological examination. A data collection sheet was prepared that allowed the information to be organized and became the definitive record of the research. The results were expressed in absolute numbers and percentages. Results: There was a predominance in infants aged 0 to 3 months with 19 patients (95%). From the female sex, 14 cases (70%) were diagnosed. A predominance of white-skinned infants was found in 14 children (70%). 60% of the total had a single lesion. The most frequent locations were the face with 15 patients (46.9%) and trunk with 10 cases (31.3%). Conclusions: In the Camagüey province, children's hemangiomas predominated in children under three months of age, of the female sex and with white skin. The most frequent locations are the face and the scalp. More than half of the patients had just a single lesion.

Application value of Laennec approach in laparoscopic anatomical right hemihepatectomy / 中华消化外科杂志

Objective:To investigate the application value of Laennec approach in laparoscopic anatomical right hemihepatectomy (LARH).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 2 female patients who underwent LARH via Laennec approach in the First Affiliated Hospital of Kangda College of Nanjing Medical University from May to July 2020 were collected. The two patients were 51 and 57 years old, respectively. Observation indicators: (1) surgical situations; (2) postoperative situations and follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect post-operative survival and tumor recurrence of patients up to December 2020. Count data were repre-sented as absolute numbers.Results:(1) Surgical situations: 2 patients successfully underwent LARH via Laennec approach, without conversion to open surgery. The operation time was 180 minutes and 185 minutes, and the volume of intraoperative blood loss was 200 mL and 400 mL, respectively. No blood transfusion or gastrointestinal decompression was performed in either patient. (2) Postoperative situations and follow-up: 2 patients began to take liquid diet on the first day and out-of-bed activities on the postoperative second to third day. There was no postoperative bile fistula or bleeding, but different degrees of peritoneal and pleural effusion occurred to the 2 patients after operation. One case was improved after right-sided thoracentesis and chest tube drainage due to dyspnea, and the other case was cured after conservative therapy. There was no perioperative death. The duration of postoperative hospital stay of 2 patients was 13 days and 11 days, respectively. Results of pathological examination showed 1 case of hepatic hemangioma and 1 case of primary liver cancer, respectively. The Laennec capsule was observed on the hepatic vein branches of segment Ⅴ, Ⅵ, Ⅶ, Ⅷ, and the gap existed between the Laennec capsule and the hepatic vein. Two patients were followed up for 7 months and 5 months，respectively. They survived during the follow-up，without tumor recurrence.Conclusion:It is safe and feasible to perform LARH by Laennec approach.

Intrathoracic hemangioma

We report the very rare case of recurrent unilateral pleural effusion in a 53-year-old male. Computed tomography (CT) scan and magnetic resonance imaging revealed a left-sided paravertebral mass at D3 level. Multiple biopsy and CT scan lead us to the diagnosis of “Angiomatous Malformation.” The lesion was excised surgically which on final histopathological report termed hemangioma

Salvage therapy of reactive capillary hemangiomas: Apatinib alleviates the unique adverse events induced by camrelizumab in non-small cell lung cancer

Background: Camrelizumab is a promising anti-programmed cell death-1 agent for non-small cell lung cancer (NSCLC) and induces reactive capillary hemangiomas (RCHs). Routine clinical management of this unique and prevalent toxicity has been summarized in previous studies. The objective of this study was to provide evidence of apatinib as a salvage therapy for RCHs. Materials and Methods: In this single-center, observational study, patients with NSCLC who were over 18 years of age and treated with camrelizumab were enrolled. The incidence of RCHs, onset and duration time, severity, evolution, and clinical practices, especially with apatinib, for their management and impact on quality of life, were recorded during a 6-month follow-up. Results: A total of 28 patients were included. The incidence of RCHs was 28.6% (8/28). The median onset and duration time were 6 weeks and 8 weeks, respectively. Six (21.4%) patients had mild and moderate RCHs and four (9.3%) patients achieved a rapid regression of RCHs with the application of apatinib. The impact of the RCHs on quality of life was limited and assessed with Dermatology Life Quality Index scores. No treatment-associated termination was observed. Conclusion: The combination of camrelizumab and apatinib in the treatment of NSCLC reduced the incidence of RCHs. Apatinib appeared to be a salvage therapy of RCHs, which leads to rapid regression of RCHs with no impairment on the quality of life

Classification of Vascular Anomalies Using Clinico- Radiological Parameters – Is It Sufficient?

To classify vascular anomalies using clinico-radiological parameters. Settings: Government Medical College Srinagar and Army Hospital Research and Referral New Delhi. Methods: 129 cases of vascular anomalies were studied and classified using clinical and radiological methods from March 2011 to June 2018. Outcome: Vascular anomalies were broadly classified into vascular tumours and vascular malformations and these anomalies were further sub-classified based on clinical and radiological parameters. Results: Among 129 vascular anomalies studied there were 51 vascular tumours which included 50 hemangiomas (H) and 1 case of pyogenic granuloma (PG). Among Hemangiomas there were 34 Hemangiomas of Infancy (HOI) and 16 Congenital Hemangiomas (CH). Among HOI there were 26 Simple (Localized-17, Segmental-2, Indeterminate-6, Multifocal-1), 8 complex visceral hemangiomas (Liver-2, Subglottic-2, Parotid-4). Among Congenital Hemangiomas there were 4 Rapidly Involuting Congenital Hemangiomas (RICH) and 12 Non involuting congenital hemangiomas (NICH). There were 78 vascular malformations which included 51 slow flow malformations and 27 fast flow malformations based on colour doppler studies. Among slow flow there were 42 Simple {2 Capillary Malformations, 26 Venous Malformations (VM), 14 Lymphatic Malformations (LM), 4 Combined (2 each of Lymphohemangiomas - LH and Lymphovenous Malformations – LVM} and 5 Complex-combined (4 Klipple Trenaunay Syndrome – KTS and 1 case of Blue Rubber Bleb Nevus Syndrome - BRBNS). Among fast flow there were 6 simple (Nasopharyngeal Angiofibromas), 20 combined (Arteriovenous Malformations - AVM) and 1 Complex combined malformation (Sturge Weber Syndrome - SWS). Conclusion: Newborn with birthmark should always be documented by the attending health care provider at birth and referral to an expert for proper evaluation and careful parental/Guardian counseling. Doppler US should be the first line of investigation in broadly classifying vascular anomalies whereas CT Scan, MRI/MRA/MRV, Angiography, Venography help in further sub-classification. Some confusion still persists in classifying few lesions like Lympho-hemangioma (LH), Complex combined Malformations (Syndromes) like Sturge Weber Syndrome (SWS), Blue Rubber Bleb Nevus Syndrome (BRBNS), and Nasopharyngeal Angiofibroma (NPA).

A case of retinal cavernous hemangioma analyzed with optical coherence tomography angiography

Retinal cavernous hemangiomas is a rare vascular tumor, isolated and non-progressive. This tumor is incidentally diagnosed on fundus examination and visual impairment can be rare presentation from vitreous hemorrhage, pre-retinal traction, hyphema, or macular scarring. The tumor has typical appearance of grape-like clusters of dilated vascular sacs with variable surface gliosis. Characteristic imaging findings aids in diagnosis. Newly emerged imaging tool is optical coherence tomography angiography (OCT A) which obtains high-resolution visualization of retinal vasculature in non-invasive fashion. In the present case report, we analyzed various diagnostic tool available for retinal cavernous hemangiomas; illustrating on the OCT A features.

Cirugía transoral en hemangiomas de laringe e hipofaringe en adultos / Transoral surgery in laryngeal hemangiomas e hypopharynx in adults

Los hemangiomas son tumores benignos infrecuentes en la laringe. El tratamiento está indicado cuando el tumor produce síntomas (disnea, hemoptisis, odinofagia) y también cuando el riesgo de hemorragia severa por traumatismo es alto. Tres hemangiomas de laringe e hipofaringe fueron tratados con éxito por vía transoral con láser de C02 y radiofrecuencia. Todos los pacientes se alimentaron por vía oral a las 24/48 horas y ninguno tuvo traqueostomía. La tasa de resección completa de los hemangiomas tratados por vía transoral fue 100%. (AU)

Hemangiomas are a rare type of benign tumors of the larynx. The treatment is indicated when the tumor produces symptoms (dyspnea, hemoptysis, odynophagia) and also when the risk of severe bleeding from trauma is high. Three hemangiomas of the larynx and hypopharynx were successfully treated transorally with C02 laser and radiofrequency. All were orally fed at 24/48 hours, and none had a tracheostomy The complete resection rate of hemangiomas treated transorally was 100%. (AU)

Prevalencia y caracterización de Hemangiomas en niños / Prevalence and Characterization of Hemangiomas in children

Introducción: Los hemangiomas son tumores vasculares benignos comunes en la infancia y son causa de preocupación por la familia debido a sus localizaciones cuando son visibles por razones estéticas. Objetivos: Conocer la prevalencia y caracterización de hemangiomas, así como la frecuencia del género, edad media diagnosticada y el método diagnóstico usado y el tratamiento establecido. Métodos: La muestra del estudio constituida por 71 pacientes del Área Pediátrica del Instituto de Dermatología y Cirugía de Piel durante el año 2017. Es un estudio transversal retrospectivo en el cual incluye pacientes pediátricos con diagnóstico de hemangioma. Resultados: La prevalencia de hemangiomas fue del 0.77%, más frecuente en niñas y una edad media al diagnóstico de 8.28 meses. La mayoría de característica superficial y focal. La localización anatómica más frecuente en cabeza y rostro. El diagnóstico se realizó clínicamente y el tratamiento utilizado prevaleció la terapia farmacológica. Conclusiones: Se estableció una prevalencia de 0.77% de hemangiomas pediátricos, siendo los más frecuentes de característica superficial y focal, la mayoría en cabeza y rostro. El diagnóstico fue clínico y el tratamiento fue principalmente farmacológico. Palabras clave: Prevalencia, hemangiomas pediátricos, caracterización.

Introduction: Hemangiomas are benign vascular tumors common in childhood but with a burden of family concern from the esthetic point of view. Objectives: To know the prevalence and characterization of hemangiomas, frequency of gender, average age for diagnosis, method used for diagnosis, as well as its treatment. Methods: Retrospective cross-sectional study in pediatric patients with a diagnosis of hemangioma, diagnosed at the Institute of Dermatology and Skin Surgery during the year 2017. Results: A total of 71 patients included, with a prevalence of 0.77% in the area of pediatric dermatology. A difference was established being more frequent in girls with a median age for diagnosis of 8.28 months. Hemangiomas were more common superficial type and with focal characteristic being most frequently located in head and face. Clinically diagnosed, the majority treated pharmacologically. Conclusions: A prevalence of 0.77% of hemangiomas found, mostly superficial and focal with location in head and face. The diagnosis was mainly clinical and the treatment was mostly pharmacological. Key words: Prevalence, pediatric hemangiomas, characterization

Síndrome PHACES: comunicación de un caso con compromiso hepático e intestinal / PHACES syndrome: a report of a case with liver and intestinal involvement

El síndrome PHACES representa un espectro de anormalidades: malformaciones de la fosa posterior, hemangiomas segmentarios, anomalías vasculares, cardíacas, oculares y hendidura esternal o rafe supraumbilical, asociado también a hemangiomatosis extracutánea.Comunicamos el caso de una paciente de 4 meses de edad, con un hemangioma segmentario gigante en la hemicara izquierda, además de la presencia de una malformación de Dandy-Walker, malformación cardiovascular, hendidura esternal e hipotiroidismo.También tenía un hemangioma en el hígado y otras lesiones vasculares en el intestino.

PHACES syndrome represents a spectrum of anomalies such as posterior fossa malformations, segmental hemangiomas, vascular and cardiac abnormalities, eye abnormalities and sternal cleft or raphe supraumbilical, hemangiomatosis extracutánea. We present a 4 months of age female, who presented a segmental giant hemangioma in the left hemiface with Dandy-Walker malformation, cardiovascular malformation, sternal cleft and hypothyroidism, who also presented an hemangioma in the liver and other vascular lesions in the intestine.

Antihypertensives in dermatology Part I - Uses of antihypertensives in dermatology

Hypertension is a global health problem. Antihypertensives are the mainstay of treatment for hypertension. Some of them were accidentally found to be useful in alopecias and infantile hemangiomas and have now become standard treatment for these conditions as well. Antihypertensives are also being studied for other dermatological indications, where they have shown promising efficacy. This review focuses on the dermatological indications for antihypertensives, discussing the drugs that have been tried, as well as their efficacy, dosage, duration of therapy, and adverse effects.

Manejo quirúrgico de pacientes adultos con anomalías vasculares: serie de casos / Surgical management of adult patients with vascular anomalies: series of cases

Introducción: Las anomalías vasculares son un grupo heterogéneo de patologías, que considera tanto tumores como malformaciones vasculares. Son, habitualmente, de diagnostico y manejo durante la infancia, algunas lesiones persisten hasta la edad adulta. El tratamiento habitual considera terapias poco invasivas, siendo la alternativa resecctiva un opcion infrecuente. Objetivos: El objetivo de este estudio es presentar el manejo quirúrgico de pacientes portadores de anomalías vasculares realizado por el equipo de Cirugía Plástica y Reconstructiva del Hospital Clínico de la Universidad de Chile. Material y Métodos: Serie de casos retrospectiva de pacientes con diagnóstico de anomalias vasculares, sometidos a manejo quirúrgico por el equipo de Cirugía Plástica y Reconstructiva del Hospital Clínico de la Universidad de Chile. Se incluyó todos los pacientes con diagnóstico de anomalías vasculares intervenidos entre los años 2010 ­ 2016. Se realizó una revisión del historial clínico de cada paciente elaborando un análisis descriptivo. Resultados: Serie de 9 pacientes, 6 (66,6%) de sexo femenino, con edad promedio de 34,88 ±15,70 años. De los cuales 6 (66,67%) presentaron malformaciones vasculares y 2 (22,22%) tumores vasculares. Se observo compromiso de cabeza en 6 (66,67%) casos y 2 (22,22,%) genital. Se utilizo colgajos locales de avance en 6 (66,67%) y colgajos de transposición en 2 (22,22%) casos. Conclusiones: El manejo quirúrgico es una alternativa terapéutica segura que ofrece resultados buenos a las lesiones complejas. Y por tanto, creemos que es necesario un trabajo multidisciplinario entre pediatras, dermatólogos, radiólogos fisiatras, psicólogos y cirujanos plásticos para poder ofrecer mejores resultados a nuestros pacientes.

Introduction: Vascular anomalies are a heterogeneous group of pathologies, which considers tumors and vascular malformations. Usually diagnosed and treated during childhood, some lesions persist into adulthood. The usual treatment considers non-invasive therapies, being the respective alternative an uncommon option. Objectives: Present the surgical management of adults patients with vascular anomalies performed by the Plastic and Reconstructive Surgery team of the Clinical Hospital of the University of Chile. Material and methods: Retrospective case series of patients with diagnosis of vascular anomalies submitted to surgical management by the Plastic and Reconstructive Surgery team of the Clinical Hospital of the University of Chile. All patients with diagnosis of vascular anomalies operated between the years 2010 - 2016 were included. A review of the clinical history of each patient was carried out and a descriptive analysis was done. Results: Series of 9 patients, 6 (66.6%) female, with a mean age of 34.88 ± 15.70 years. Of these, 6 (66.67%) had vascular malformations and 2 (22.22%) had vascular tumors. Head involvement was observed in 6 (66.67%) cases and 2 (22.22%) genital. Local flaps were used in 6 (66.67%) and transposition flaps in 2 (22.22%) cases. Conclusions: Surgical management is a safe therapeutic alternative that offers beneficial results to complex lesions. Therefore, we believe a multidisciplinary work between pediatricians, dermatologists, radiologists.

A prospective randomized controlled study of different doses of oral propranolol in infantile hemangiomas / 中华整形外科杂志

Objective@#To study the efficacy of 1 mg·kg-1·d-1 and 2.0 mg·kg-1·d-1 of propranolol in the treatment of infantile hemangiomas, so as to provide an ideal dosage for clinical treatment.@*Methods@#From September 2015 to October 2016, there were 89 patients in accordance with the inclusion criteria of infantile hemangiomas. According to randomized and controlled principle, the patients were assigned to receive two propranolol regimens, Group A(n=45): propranolol at a dose of 1 mg·kg-1·d-1; Group B(n=44): propranolol at a dose of 2 mg·kg-1·d-1. 1 or 2 mg of propranolol base per kilogram per day, divided into two doses.The first dose was taken at 9, next at 15.The effective rate, cure rate and adverse effect rate were compared at the six months after treatment. The duration of the treatment was compared after 12 months′ treatment, and the recurrence rate was compared at the three months after being cured.The data were statistically processed with SPSS 22.0. The sample rate was compared with χ2 test, and the data were compared with t test. P<0.05 was statistically significant difference.@*Results@#Group A: Treatment for 6 months, 45 children were evaluated as follows: the effective rate was 91.1%(41/45), the cure rate was 60%(27/45). The incidence of adverse reactions was 13.3%(6/45). The cure rate of group A at 12 months was 86.7%(39/45). The duration of treatment was 7.6±2.7 months.The recurrence rate was 9.5%(4/42). Group B: Treatment for 6 months, 44 children were evaluated as follows: the effective rate was 90.9%(40/44), the cure rate was 72.7%(32/44). The incidence of adverse reactions was 15.9%(7/44). The cure rate of group B at 12 months was 88.6%(39/44). The duration of treatment was 6.2±1.9 months. The recurrence rate was 11.9%(5/42). The effective rate of the two groups at 6 months was not statistically significant(χ2=2.583, P=0.461). The cure rate of the two groups at 6 months was statistically significant(χ2=8.339, P=0.004). The incidence of adverse effects was not statistically significant(χ2=0.118, P=0.731). The cure rate of the two groups at 12 month was not statistically significant(χ2=0.080, P=0.778). The duration of treatment between the groups was statistically significant (t=0.290, P=0.009). The recurrence rate of the two groups after 3 months withdrawal was no statistical difference(χ2=0.124, P=0.724).@*Conclusions@#The propranolol doses at 1 mg·kg-1·d-1 and 2 mg·kg-1·d-1 in the treatment of infantile hemangiomas are safe and effective. The propranolol dose at 1 mg·kg-1·d-1 doesn′t decrease the effective and cure rate, not increase the recurrence rate in infantile hemangiomas. Low dose at 1 mg·kg-1·d-1 can be used as a common dose of propranolol in infantile hemangiomas.

Surgical treatment of hepatic hemangiomas: a study of 908 patients / 中华肝胆外科杂志

Objective To study the surgical treatment of hepatic hemangiomas and the timing of surgery.Methods A retrospective study was conducted on 908 patients with giant hemangiomas who underwent surgery between December 1997 and December 2017.The clinical data,surgical indications,surgical outcomes,lesion size,and the effect of TAE were compared.Results The diameter (mean + /-S.D.)of the resected hepatic cavernous hemangiomas was (11.1 ± 6.2) cm (the longest diameter was 60 cm).585 patients (64.4％) underwent enucleation of hepatic hemangiomas and 323 patients (35.6％) underwent anatomical hepatectomy.Six patients died perioperatively (mortality rate 0.7％).The incidence of severe complication (Clavien-Dindo grade 3 ～ 5) was 3.8％.The incidence of severe postoperative complication for enucleation (2.7％) was significantly less than anatomic liver resection (5.6％,P ＜0.05).When the lesion was more than 20 cm,the complication and mortality rates were significantly higher than those less than 20 cm (P ＜ 0.05).The complication and mortality rates in patients who underwent TAE before surgery were significantly higher than those without TAE (P ＜ 0.05).Conclusions Surgical enucleation of hemangiomas was superior to anatomical hepatectomy.With increase in tumor size,the risk of surgery increased.Surgical treatment was safe and effective for giant hepatic hemangiomas.For giant hepatic hemangiomas with significant increase in size,prompt surgical treatment is recommended.

Application value of two-step separation approach in laparoscopic hemihepatectomy / 中华消化外科杂志

Objective To investigate the application value of two-step separation approach in laparoscopic hemihepatectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 81 patients who underwent laparoscopic hemihepatectomy in the People's Hospital of Hunan Provincial between January 2015 and December 2017 were collected.Patients underwent laparoscopic hemihepatectomy using two-step separation approach after preoperative assessment.Hepatic pedicle,hepatic vein and branches were processed in the liver parenchyma,without intrathecal anatomy.Observation indicators:(1) preoperative assessment,intraand post-operative recovery;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed up to February 2018.Patients with hepatolithiasis received abdominal CT reexaminations at 5-7 days postoperatively for observing postoperative residual stones,and patients with malignant tumor were regularly followed up for 1-3 years.Measurement data with normal distribution were represented as (x)±s.Count data were described as frequency and percentage.Results (1) Preoperative assessment,intra-and post-operative recovery:81 patients underwent preoperative blood biochemistry,tumor biomarker and imaging examinations,and remaining functional liver volume and a liver model in 9 patients were respectively calculated and built using the 3D reconstruction software and 3D printing technology.Of 81 patients,68 underwent left hemihepatectomy and 13 underwent fight hemihepatectomy;77 underwent successful laparoscopic hemihepatectomy using two-step separation approach,4 were converted to open operation,with a rate of 4.9％ (4/81).Of 4 patients with conversion to open operation,1 had difficult tumor separation due to tumor invading port vein induced to close adhesion,1 had stone removal difficulties under laparoscopy due to hepatolithiasis,and 2 were converted to open operation due to severe liver cirrhosis induced to massive intraoperative bleeding.Of 81 patients,70 gained dividing line of hemiliver by intraoperatively hemihepatic blood flow occlusion,and then got effectively control of bleeding combined with Pringle blood flow occlusion,and 11 received Pringle blood flow occlusion in whole liver.Laparoscopic fluorescence imaging technology was intraoperatively used for 2 patients.Operation time,volume of intraoperative blood loss,rate of intraoperative blood transfusion and duration of hospital stay in 81 patients were respectively (206±42)minutes,(195±134)mL,11.1％(9/81) and (11.5+2.7)days.Eighty-one patients were complicated with bile leakage and were cured by conservative treatment,with a bile leakage incidence of 2.5％ (2/81),and without severe complications,such as postoperative bleeding,hepatic dysfunction and subphrenic abscess.There was no perioperative death and reoperation within 30 days postoperatively.(2) Follow-up and survival situations:55 patients with hepatolithiasis were followed up and underwent CT examinations of upper abdomen at 5-7 days postoperatively,including 52 with depletion of stones;3 with residual stones received removal of stones by choledochoscope at 3 months postoperatively,without residual stones.Seventeen patients with malignant tumor were followed up for 12-36 months,with a median time of 15 months,16 had tumor-free survival,and 1 was complicated with intrahepatic metastasis at 1 year after resection of hepatocellular carcinoma,and then underwent transcatheter arterial chemoembolization (TACE) and survived with tumor.Nine patients with benign liver diseases had good recovery during follow-up.Conclusion Two-step separation approach that is rationally used in laparoscopic hemihepatectomy is safe,effective and convenient.

Afecciones de hemangiomas cutáneos en la infancia registrados en Villa Clara desde 2012 hasta 2015 / Cutaneous hemangiomas in children, registered in Villa Clara from 2012 to 2015

Introducción: los hemangiomas son el tumor cutáneo más común en la infancia. Se clasifican dentro de las anomalías vasculares congénitas. Objetivo: identificar el comportamiento clínico-epidemiológico y resultados terapéuticos de los hemangiomas en pacientes atendidos en el Hospital Infantil "José Luis Miranda" de Santa Clara, Villa Clara en el período 2012-2015. Materiales y Métodos: se empleó el método bibliométrico y técnicas de visualización y representación de información. El estudio clasifica como descriptivo de tipo longitudinal retrospectivo. El universo lo constituyó todos los niños con hemangiomas cutáneos atendidos en el Hospital Infantil "José Luis Miranda", de Villa Clara. Las variables que se analizaron fueron: edad, tipo de lesión, localización, complicaciones, afecciones por sexo, raza, antecedentes familiares del padecimiento, así como el tratamiento prescripto y su evaluación. Resultados: se determinaron las afecciones por raza, edad, sexo y antecedentes familiares de los infantes. Se estudiaron las lesiones por tipos y complicaciones. El comportamiento de las afecciones de hemangiomas cutáneos en la infancia registrada en Villa Clara, entre los años 2012 y 2015, coincide con criterios descritos por varios especialistas e investigadores de esta afección. Conclusiones: se corroboró que el sexo femenino, niños menores de 1 año y de piel blanca, fueron los pacientes afectados con mayor regularidad. Se identificó que las lesiones se localizaron con mayor frecuencia en cara, cuero cabelludo y tronco. Los tratamientos más efectivos fueron la cirugía, electrodesecación y los esteroides locales y sistémicos (AU).

Introduction: hemangiomas are the most common cutaneous tumor in the childhood. They are classified among the congenital vascular anomalies. Objective: to identify the clinic-epidemiological behavior and therapeutic outcomes of the hemangiomas attended in the Infantile Hospital "Jose Luis Miranda", of Santa Clara, Villa Clara, in the period 2012-2015. Materials and Methods: the bibliographic method and techniques of information visualization and representation were used. The study classifies as retrospective, descriptive of longitudinal type. The universe was composed by all the children with cutaneous hemangiomas attended at the Infantile Hospital "José Luis Miranda", of Villa Clara. The analyzed variables were: age, kind of lesion, location, complications, conditions by sex, race, and family antecedents and also the prescribed treatment and evolution. Results: the conditions were determined by the children´s race, age, sex and family antecedents. Lesions were studied according to their kind and complications. The behavior of the cutaneous hemangiomas in childhood registered in Villa Clara between 2012 and 2015 agree with the criteria described by several specialists and researchers of this condition. Conclusions: it was corroborated that the patients more regularly affected were the female, white ones, aged less than a year. Lesions were located more frequently on the face, the scalp and the trunk. The most effective treatments were surgery, electro-desiccation and local and systemic steroids (AU).

Propranolol inhibits the proliferation, migration and tube formation of hemangioma cells through HIF-1α dependent mechanisms

The aim of this study was to investigate the mechanism of propranolol on the regression of hemangiomas. Propranolol-treated hemangioma tissues were collected and the expression of hypoxia inducible factor-1α (HIF-1α) was examined. We also established HIF-1α overexpression and knockdown hemangioma cells, and determined the effects of HIF-1α on the hemangioma cells proliferation, apoptosis, migration and tube formation. Significantly increased HIF-1α level was found in the hemangioma tissues compared to that in normal vascular tissues, whereas propranolol treatment decreased the HIF-1α level in hemangioma tissues in a time- and dose-dependent manner. Moreover, propranolol treatment significantly decreased cell proliferation, migration and tube formation as well as promoted cell apoptosis in HIF-1α overexpression and knockdown hemangioma cells. Propranolol suppressed the cells proliferation, migration and tube formation of hemangioma cells through HIF-1α dependent mechanisms. HIF-1α could serve as a novel target in the treatment of hemangiomas.