Hemangioma capilar en el hallux: presentación de un caso / Capillary hemangioma in the hallux: Case report

Introducción: Los hemangiomas son neoplasias benignas que se originan de células endoteliales; rara vez resultan malignos. El síntoma más común es el dolor, porque el hemangioma comprime un tronco nervioso cercano o un nervio directamente. Presentamos un caso de hemangioma en una región muy poco frecuente. Se trata de una mujer de 35 años que presentaba una tumoración friable, de coloración marrón, dolorosa, en la región distal del hallux, con aumento de tamaño en los últimos meses. Se realizó la exéresis completa de la tumoración. El diagnóstico anatomopatológico fue hemangioma capilar. No se observó recidiva luego de 36 meses de seguimiento. Conclusión: Frente a estas neoplasias, se recomienda la exéresis de la pieza y su posterior estudio. Nivel de Evidencia: IV

Introduction: Hemangiomas are benign neoplasms originating from endothelial cells and may rarely be malignant. The most common symptom is pain, due to the compression of a nerve or nerve trunk by the hemangioma. We present the case of a patient with this type of tumor in an infrequent location. The patient was a 35-year-old female with a painful, brown-colored and friable tumor in the distal region of the hallux which had increased in size in the last months before treatment. Complete surgical resection of the tumor was performed, with a histopathological diagnosis of capillary hemangioma. No recurrence was observed during the 36-month follow-up. Conclusion: We recommend a complete resection of these neoplasms and their posterior histopathology analysis. Level of Evidence: IV

A capillary angioma of the lips: an extremely rare situation in the oral cavity / Angioma capilar de los labios: una situación extremadamente rara en la cavidad oral

Hemangiomas are tumors identified by rapid endothelial cell proliferation in early infancy, followed mostly by involution over the time. However, 10-12 % of true hemangiomas don't involute and require surgical treatment. Hemangiomas are classified on the basis of their histological appearance as capillary, mixed and cavernous. We report a case of capillary angioma in a 13-year old boy who presented with a budding into the lower lip. The lesion was excised and histopathological report confirmed the diagnosis.

Los hemangiomas son tumores identificados por la rápida proliferación de células endoteliales en la primera infancia, seguidos principalmente por involución a lo largo del tiempo. Sin embargo, entre el 10 y el 12 % de los hemangiomas no intervienen y no requieren tratamiento quirúrgico. Los hemangiomas se clasifican en función de su aspecto histológico como capilares, mixtos y cavernosos. Reportamos un caso de angioma capilar en un niño de 13 años que presentó un brote en el labio inferior. La lesión fue extirpada y el informe histopatológico confirmó el diagnóstico.

Pulmonary capillary hemangiomatosis: a lesson learned

Pulmonary capillary hemangiomatosis (PCH) is a rare and controversial entity that is known to be a cause of pulmonary hypertension and is microscopically characterized by proliferation of dilated capillary-sized channels along and in the alveolar walls. Clinically, it is mostly seen in adults. Clinical features are characterized by nonspecific findings such as shortness of breath, cough, chest pain, and fatigue. It can be clinically indistinguishable from pre-capillary pulmonary arterial hypertension disorders such as primary pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension. However, the diagnostic distinction, which usually requires a multidisciplinary approach, is crucial in order to avoid inappropriate treatment with vasodilator medications usually used for PAH treatment. Prognosis of PCH remains poor with lung transplant being the only definitive treatment. We report an autopsy case of pulmonary capillary hemangiomatosis unmasked at autopsy that was treated with a prostacyclin analog, usually contraindicated in such patients. We emphasize that this entity should always be on the differential diagnosis in a patient with pulmonary hypertension and requires great vigilance on the part of the clinician, radiologist and pathologist to make the diagnosis and guide appropriate management.

Capillary hemangioma of the gingiva in an adult: a rare case report

Objective: We report a case of a 40-year-old female with gingival overgrowth in the right maxillary anterior region which has been excised at a peripheral hospital that caused displacement, mobility of associated teeth and lip incompetency. Case description: A case of recurrent gingival overgrowth in the right maxillary anterior region in a 40-year-old female with associated teeth displacement and mobility and lip incompetency. There was a radiologic evidence of bone loss. Excisional biopsy was carried out and the histologic diagnosis was Capillary Hemangioma. Conclusion: Capillary Hemangioma should be considered as one of the differential diagnosis in cases of gingival overgrowth ofmaxillary anterior region, which mimics pyogenic granuloma

A Case of Superficial Spreading Capillary Hemangioma / 대한피부과학회지

No abstract available.

Intramuscular Hemangioma of the Sternocleidomastoid Muscle: An Unusual Neck Mass / 대한이비인후과학회지

Hemangiomas are the most common benign tumors in infancy, occurring most often on cutaneous and mucosal surfaces. Although less than 1% of hemangiomas occur in skeletal muscle, 15% of intramuscular hemangiomas arise in the head and neck musculature. Less than 10 cases of the sternocleidomastoid muscle have been reported in the English literatures. The masseter muscle is most commonly involved in the head and neck. Clinically, these tumors are present as distinct, localized, rubbery swelling. Neck computed tomography scan with enhancement may suggest a vascular mass within the muscle while angiography may detect feeding arteries in large intramuscular hemangiomas. The treatment of the hemangiomas is based on location, accessibility, depth of invasion, age, and cosmetic considerations. The optimal treatment is complete wide resection including the cuff of surrounding muscle. We report a case of hemangioma that occurred in the sternocleidomastoid muscle along with a with literature review.

Intramedullary Spinal Capillary Hemangioma: Case Report

Capillary hemangiomas involving the neuraxis are very uncommon. In the spinal cord, they are located mainly intradural and extramedullary. To our knowledge, only four cases in conus medullaris have been previously described. In our case, a 46-year-old man was admitted with back pain, sphincter disturbances, as well as progressive weakness and numbness on the lower extremities. Magnetic resonance imaging revealed an undefined intramedullary lesion on the conus medullaris. The patient underwent microsurgery, which achieved complete removal. Histopathological diagnosis was compatible with capillary hemangioma. His postoperative course was uneventful and all symptoms, including bladder dysfunction clearly regressed. The treatment of intramedullary capillary hemangiomas is very critical in preventing unnecessary morbidity, providing accurate information with respect to prognosis, and establishes a regular outpatient follow-up. The natural history of this lesion involving the spinal cord is not well described, although they are common elsewhere in the body.

Hemangiomas capilares que envolvem o neuroeixo são raros. Quando localizados na coluna vertebral, geralmente são intradurais e extramedulares. Até a presente data somente 4 casos de hemangiomas no cone medular foram descritos. O caso refere-se a um homem de 46 anos com dor lombar, alterações esfincterianas, fraqueza e parestesias em membros inferiores de evolução progressiva. Ressonância magnética demonstrou lesão no cone medular de aspecto indefinido. Submetido a remoção microcirúrgica completa. Histopatológico compatível com hemangioma capilar. O pósoperatório ocorreu sem intercorrências e houve recuperação dos déficits, inclusive da disfunção esfincteriana. O tratamento dessa lesão não deve acrescentar morbidade. A história natural dessa lesão na medula espinhal ainda não está definida, apesar de ser uma lesão comum em outras partes do organismo.

Hemangiomatosis capilar pulmonar congénita en un recién nacido / Congenital pulmonary capillary hemangiomatosis in a newborn

La hemangiomatosis capilar pulmonar es una entidad poco frecuente, caracterizada por la proliferación de capilares que infiltran paredes alveolares, septos interlobulillares, pleura e intersticio pulmonar, sin características de malignidad, con asociación casi constante a hipertensión pulmonar. Hasta el momento, solo se han reportado en la literatura, dos casos de presentación congénita; este es el tercer caso en un recién nacido y que no se asocia a hipertensión pulmonar. Esta se encuentra en la mayoría de los pacientes con dicha patología, con mayor incidencia entre los 20 y los 40 años de edad. Se presenta a un recién nacido pretérmino de 36 semanas de gestación con dificultad respiratoria progresiva, que requirió asistencia ventilatoria mecánica por desaturaciones constantes en su evolución clínica, sin signos clínicos, radiológicos o ecográficos de hipertensión pulmonar.

Pulmonary capillary hemangiomatosis is a rare entity characterized by the proliferation of capillaries into alveolar walls, interlobular septa, pleura and pulmonary interstitium, without malignant characteristics, with almost constant association with pulmonary hypertension. Until now two cases of congenital presentation have been reported in the literature. This is the third case in a newborn; he has not followed the usual pattern associated with pulmonary hypertension as occurs in most patients with this pathology; the highest incidence is among 20-40 years old. We report a preterm newborn patient of 36 weeks of gestation with progressive respiratory distress requiring mechanical ventilation by constant desaturation during his clinical evolution without clinical, radiological or ultrasonographic signs of pulmonary hypertension.

Oral propranolol therapy for benign capillary hemangiomas in a series of adult and pediatric patients

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe outcomes of oral propranolol therapy in a series of adult and pediatric patients diagnosed with benign capillary hemangioma of the head and neck.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Prospective Case Series<br /><strong>Setting:</strong> Tertiary Government Teaching Hospital<br /><strong>Participants:</strong> Ten (10) patients representing all patients clinically diagnosed with benign capillary hemangioma of the head and neck enrolled in the study from 2012 to 2015.<br /><strong>RESULTS:</strong> Two (2) adults and eight (8) children were enrolled in the study. Although a decrease in lesion size was observed in half of the participants starting at three months, only one (1) attained complete resolution of the lesion-- a 12-year-old girl with hemangioma of the right parotid gland that attained clinical resolution of symptoms after four months of treatment. The remaining nine out of ten (9/10) participants did not attain complete clinical resolution; but there was a decrease in lesion size in four (4) of these participants. For the remaining five (5) participants, there was neither a decrease nor an increase in lesion size. Altogether, of the two adult participants, only one responded to therapy while only 4 out of 8 pediatric participants responded to therapy. There were no noticeable differences between adult and pediatric patients in terms of resolution and plateau. Aside from mild bradycardia expected with propranolol, no adverse reactions were observed during the course of treatment.<br /><strong>CONCLUSIONS:</strong> Although half of our participants responded to oral propranolol therapy whether these observations may be attributable to oral propranolol alone cannot be concluded.</p>

Capillary Hemangioma of the temporal bone

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To discuss a rare case of temporal bone capillary hemangioma and its diagnosis and management.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS</strong>: A 44-year-old woman with a history of on-and-off right ear discharge, tinnitus and decreased hearing, and a pinkish, smooth-surfaced, non-friable, non-pulsating mass occluding the right external auditory canal, was initially treated for chronic suppurative otitis media with aural polyp. A punch biopsy due to persistence of disease despite medical treatment revealed capillary hemangioma. She underwent canal wall down mastoidectomy with obliteration to completely resect the tumor.<br /><strong>CONCLUSION:</strong> Capillary hemangiomas of the temporal bone are benign lesions that may lead to complications such as bone erosion, hearing loss, recurrent infection and bleeding if left untreated. Surgery remains the ideal treatment and recurrence is rare and the prognosis is good if resection is complete.</p>

Capillary Hemangioma of the temporal bone

OBJECTIVES: To discuss a rare case of temporal bone capillary hemangioma and its diagnosis and management.METHODS:Design: Case ReportSetting: Tertiary Government HospitalPatient: OneRESULTS: A 44-year-old woman with a history of on-and-off right ear discharge, tinnitus and decreased hearing, and a pinkish, smooth-surfaced, non-friable, non-pulsating mass occluding the right external auditory canal, was initially treated for chronic suppurative otitis media with aural polyp. A punch biopsy due to persistence of disease despite medical treatment revealed capillary hemangioma. She underwent canal wall down mastoidectomy with obliteration to completely resect the tumor.CONCLUSION: Capillary hemangiomas of the temporal bone are benign lesions that may lead to complications such as bone erosion, hearing loss, recurrent infection and bleeding if left untreated. Surgery remains the ideal treatment and recurrence is rare and the prognosis is good if resection is complete.

Oral propranolol therapy for benign capillary hemangiomas in a series of adult and pediatric patients

OBJECTIVE: To describe outcomes of oral propranolol therapy in a series of adult and pediatric patients diagnosed with benign capillary hemangioma of the head and neck.METHODS:Design: Prospective Case SeriesSetting: Tertiary Government Teaching HospitalParticipants: Ten (10) patients representing all patients clinically diagnosed with benign capillary hemangioma of the head and neck enrolled in the study from 2012 to 2015.RESULTS: Two (2) adults and eight (8) children were enrolled in the study. Although a decrease in lesion size was observed in half of the participants starting at three months, only one (1) attained complete resolution of the lesion-- a 12-year-old girl with hemangioma of the right parotid gland that attained clinical resolution of symptoms after four months of treatment. The remaining nine out of ten (9/10) participants did not attain complete clinical resolution; but there was a decrease in lesion size in four (4) of these participants. For the remaining five (5) participants, there was neither a decrease nor an increase in lesion size. Altogether, of the two adult participants, only one responded to therapy while only 4 out of 8 pediatric participants responded to therapy. There were no noticeable differences between adult and pediatric patients in terms of resolution and plateau. Aside from mild bradycardia expected with propranolol, no adverse reactions were observed during the course of treatment.CONCLUSIONS: Although half of our participants responded to oral propranolol therapy whether these observations may be attributable to oral propranolol alone cannot be concluded.

A Case of Hemangioma in the External Auditory Canal with Pulsatile Tinnitus / 대한이비인후과학회지

Hemangiomas are relatively common in the head and neck region, but their occurrence in the temporal bone are extremely rare. The hemangioma of the external auditory canal (EAC) is a rare otologic entity as only 22 cases of hemangioma of the EAC have been reported worldwide. Here we report a patient presenting with pulsatile tinnitus, which turned out to be caused by capillary hemangioma arising from the posterior medial portion of external auditory canal touching the tympanic membrane. Surgical excision of the tumor was successful. The clinical manifestations and management of benign vascular lesions of the EAC are discussed with a review of literature.

Intradural Extramedullary Capillary Hemangioma In the Upper Thoracic Spine with Simultaneous Extensive Arachnoiditis

Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2–3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma.

Anastomosing Hemangioma Mimicking Renal Cell Carcinoma

Anastomosing hemangioma (AH), a rare benign vascular tumor, is a newly recognized variant of capillary hemangioma. In the microscopic examination, this tumor has characteristic feature of the unique anastomosing sinusoidal capillary sized vessels. It can be misdiagnosed as a malignancy such as renal cell carcinoma or angiosarcoma. Herein, we report a case of AH originating in the right kidney of a 43-year-old man, which was initially considered as cystic renal cell carcinoma on computed tomography (CT). The patient underwent laparoscopic radical nephrectomy, but pathologic result was AH of the kidney. There was no evidence of recurrence or metastasis 5 months after the surgery.

Epidural Capillary Hemangioma of the Thoracic Spine / Hemangioma capilar extradural da coluna torácica

Background Hemangiomas are congenital vascular malformations pathologically considered as harmatomas and classified as capillary, cavernous, arteriovenous or venous, and usually located at soft tissue or bone, mainly in the spinal column. Pure epidural capillary hemangiomas are extremely rare lesions that should be included in the differential diagnosis of spinal epidural lesions; only three patients with epidural capillary hemangiomas have been reported to date. Case Report We report a case of a 57-year-oldman that complained of dorsal and back pain. The neurological examination revealed back tenderness and crural paraparesis. His reflexes were exaggeratedand Babinski signwaspresenton both sides.Amagnetic resonance imaging showed an epidural lesion at the level of T10­12 that demonstrated extension with intense postgadolinium enhancement. These lesions were different from more common lesions, mainly schwanommas, mainly due to the foraminal extension, which sets them apart from cavernous hemangiomas. The surgical ressection was performed. After laminectomy, a reddish epiduralmass that extended intothe right T11­12 foraminawas revealed. Thefeeding vessels had to be identified and divided. In such cases, the surgeonmust carefully dissect the lesion circumferentially away from the dura and employ judicious hemostasis. The patient́s histopathological examination revealed a vascular tumor composed of vessels of several calibers. The imagery obtained from the exams led to the diagnosis of a capillary hemangioma. Conclusions Pure epidural capillary hemangiomas should be included in the differential diagnosis of spinal epidural lesions, mainly schwanommas, especially due to the foraminal extension, which may differentiates them from cavernous hemangiomas. Surgical excision is mandatory and intervertebral foraminal extension may preclude gross total resection.

Introdução Os hemangiomas são malformações vasculares congênitas patologicamente consideradas como hamartomas. Podem ser classificadas como capilar, cavernoso, arteriovenoso ou venoso, e são geralmente localizadas em tecidos moles ou ossos, principalmente na coluna vertebral. Hemangioma capilar epidural puro é uma lesão extremamente rara que deve ser incluída no diagnóstico diferencial das lesões espinais epidurais, foram relatados casos de apenas três pacientes com hemangiomas capilares epidurais. Relato de Caso Relatamos o caso de um homem de 57 anos de idade com queixa de dorsalgia. Ao exame neurológico, paraparesia crural, com hiperreflexia e sinal de Babinski bilateral. A ressonância magnética mostrou uma lesão epidural no nível de T10­12 com intenso realce pós-gadolíneo. Hemangioma capilar deve ser diferenciado de lesões mais comuns, principalmente schwannomas, devido à extensão foraminal. A ressecção cirúrgica foi realizada. Um processo expansivo epidural avermelhado, se estendendo para o forâmen direito de T11­12, tornou-se evidente após a laminectomia. Os vasos que o irrigavam foram identificados e adequadamente separados. A lesão foi cuidadosamente dissecada circunferencialmente e uma hemostasia criteriosa foi realizada. O exame histopatológico revelou um tumor vascular composto por vasos de vários calibres. Exames de imagem corroboraram com a hipótese de um hemangioma capilar. Conclusões Hemangiomas capilares epidurais puros devem ser incluídos no diagnóstico diferencial das lesões da coluna vertebral epidural, principalmente schwanommas, especialmente devido à extensão foraminal. A excisão cirúrgica é obrigatória e a extensão para o forame intervertebral pode impossibilitar a ressecção total.

Giant nasal septalhaemangioma in pregnancy: one case report / 临床耳鼻咽喉头颈外科杂志

A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for six months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis.

Effect of topical propranolol gel on plasma renin, angiotensin II and vascular endothelial growth factor in superficial infantile hemangiomas / 华中科技大学学报（医学）（英德文版）

The effect of topical propranolol gel on the levels of plasma renin, angiotensin II (ATII) and vascular endothelial growth factor (VEGF) in superficial infantile hemangiomas (IHs) was investigated. Thirty-three consecutive children with superficial IHs were observed pre-treatment, 1 and 3 months after application of topical propranolol gel for the levels of plasma renin, ATII and VEGF in Department of General Surgery of Dongfang Hospital from February 2013 to February 2014. The plasma results of IHs were compared with those of 30 healthy infants of the same age from out-patient department. The clinical efficiency of topical propranolol gel at 1st, and 3rd month after application was 45%, and 82% respectively. The levels of plasma renin, ATII and VEGF in patients pre-treatment were higher than those in healthy infants (565.86 ± 49.66 vs. 18.19 ± 3.56, 3.20 ± 0.39 vs 0.30 ± 0.03, and 362.16 ± 27.29 vs. 85.63 ± 8.14, P < 0.05). The concentrations of VEGF and renin at 1st and 3rd month after treatment were decreased obviously as compared with those pre-treatment (271.51 ± 18.59 vs. 362.16 ± 27.29, and 405.18 ± 42.52 vs. 565.86 ± 49.66 P < 0.05; 240.80 ± 19.89 vs. 362.16 ± 27.29, and 325.90 ± 35.78 vs. 565.86 ± 49.66, P < 0.05, respectively), but the levels of plasma ATII declined slightly (2.96 ± 0.37 vs. 3.20 ± 0.39, and 2.47 ± 0.27 vs. 3.20 ± 0.39, P > 0.05). It was indicated that the increased renin, ATII and VEGF might play a role in the onset or development of IHs. Propranolol gel may suppress the proliferation of IHs by reducing VEGF.

Hemangioma of Endolymphatic Sac in Von Hippel-Lindau Patient / 대한이비인후과학회지

The present study reports a rare case of capillary hemangioma of endolymphatic sac. A 23-year-old male who underwent von Hippel-Lindau disease presented with recurrent sudden sensorineural hearing loss. Magnetic resonance imaging revealed a heterogenous enhanced mass in the right endolymphatic sac, which was hyperintense on the enhanced T1-weighted images and inhomogenous on the T2-weighted images. Pre-operatively, this tumor was believed to be an endolymphatic sac tumor because of the history of von Hippel-Lindau disease. During the surgery, vascular tumor was removed by transmastoid approach. A histopathological examination indicated that the tumor was a capillary hemangioma. To the best of our knowledge, the present study is the second case of hemangioma in the endolymphatic sac and first case of von Hippel-Lindau disease.