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1.
Rev. med. Risaralda ; 27(1): 92-95, ene.-jun. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280498

ABSTRACT

Resumen Las malformaciones venosas son lesiones vasculares benignas infrecuentes que se presentan en el útero. Están conformadas por venas anormales, de diferentes tamaños y proporciones, con configuración espongiforme y disposición al azar. En la literatura, han sido previamente reportados algunos casos, usando el término "hemangioma cavernoso", pero según los cambios recientes en la terminología, aprobados por Sociedad Internacional para el Estudio de las Anormalidades Vasculares (ISSVA), se desaconseja el uso de este término y se sugiere el de "Malformación venosa", si se cumplen los hallazgos histopatológicos al momento de hacer el diagnóstico. Presentamos el caso de una mujer de 44 años, con cuadro de hemorragia vaginal anormal y diagnóstico clínico de miomatosis y mioma abortado por el orificio cervical interno, el estudio histopatológico reveló la presencia de una malformación venosa que comprometía el miometrio y endometrio, con formación subsecuente de un pólipo.


Abstract Venous malformations are benign vascular lesions that rarely appear in the uterus. They are made up of abnormal veins, of different sizes and proportions, with spongiform configuration and random disposition. In the literature, some cases have been previously reported, using the term "cavernous hemangioma", but according to recent changes in terminology, approved by the International Society for the Study of Vascular Abnormalities (ISSVA), the use of this term is discouraged, and the diagnosis of Venous malformation is suggested, if the histopathological findings are met. We present the case of a 44-year-old woman, with abnormal vaginal bleeding and a clinical diagnosis of myomatosis and myoma aborted by the internal cervical orifice, in whom the histopathological study revealed the presence of a venous malformation that compromised the myometrium and endometrium, with subsequent formation of a polyp.


Subject(s)
Humans , Female , Adult , Uterus , Vascular Malformations , Hemangioma, Cavernous , Uterus/pathology , Vascular System Injuries , Hemangioma , Morphogenesis
2.
MedUNAB ; 24(1): 72-79, 23-04-2021.
Article in Spanish | LILACS | ID: biblio-1222634

ABSTRACT

Introducción. Las malformaciones arteriovenosas son lesiones relativamente raras e infrecuentes. Se caracterizan por presentar un aumento anormal en el número de vasos sanguíneos como consecuencia de un defecto en el desarrollo vascular. Constituyen un desafío diagnóstico y terapéutico para el médico tratante. Su incidencia es de alrededor el 1.5% de la población general. Dentro de las opciones terapéuticas se incluye la embolización selectiva, la resección quirúrgica o ambas. El objetivo del presente artículo es reportar un caso de una patología poco frecuente y hacer una revisión literaria del tema para arrojar luz sobre su diagnóstico. Reporte de caso. Se presenta el caso de un paciente adulto joven que consulta por presentar una masa en glúteo derecho de 6 años de evolución. Esta es diagnosticada erróneamente como lipoma, por lo que se lleva al paciente a cirugía sin la realización de imágenes diagnósticas previas. En la cirugía, el paciente presenta choque hipovolémico. Posteriormente, se documenta la masa como malformación arteriovenosa profunda. Discusión. Es poco usual la ubicación de dichas malformaciones en los miembros inferiores, como en el paciente del actual caso. El diagnóstico de estas lesiones puede ser clínico, pero requiere del conocimiento o sospecha de esta entidad, ya que pueden ser lesiones clínicamente no visibles, lo que lleva a que pasen inadvertidas o se diagnostiquen de forma errónea. Conclusión. Aunque se trata de una patología poco frecuente, esta puede generar repercusiones clínicas, físicas, psicológicas y estéticas importantes, por lo que es indispensable realizar adecuados métodos por imágenes que permitan establecer su correcto diagnóstico y manejo. Cómo citar. Rodriguez-Londoño NH. Malformación arteriovenosa de alto flujo en un adulto joven. MedUNAB. 2021;24(1): 72-79. doi: https://doi.org/10.29375/01237047.3785


Introduction. Arteriovenous malformations are relative rare and infrequent injuries. Their main characteristic is an abnormal increase in the number of blood vessels as a result of defective vascular development. They represent a diagnostic and therapeutic challenge for the treating physician. Their incidence in the general population is around 1.5%. Some therapeutic options include selective embolization, surgical resection, or both. The purpose of this article is to report a case of an infrequent pathology and to perform a literature review on the topic to shed light on its diagnosis. Case report. The case involves a young adult patient who inquired about the presence of a mass in the right buttock with six years of evolution. It was erroneously diagnosed as a lipoma, as a result of which the patient was taken to surgery without performing preliminary diagnostic images. During surgery, the patient went into hypovolemic shock. Afterwards, the mass was documented as a profound arteriovenous malformation. Discussion. Such malformations are rarely found in the lower limbs, as in this case. These injuries may be clinically diagnosed, but knowledge or suspicion on the existence of this entity is required, because such injuries might not be clinically visible, which implies that they may go unnoticed or be erroneously diagnosed. Conclusion. Even though it is an infrequent pathology, it may have substantial clinical, physical, psychological and aesthetic implications, which implies that it is indispensable to perform adequate imaging-based procedures to enable its adequate diagnosis and management. Cómo citar. Rodriguez-Londoño NH. Malformación arteriovenosa de alto flujo en un adulto joven. MedUNAB. 2021;24(1): 72-79. doi: https://doi.org/10.29375/01237047.3785


Introdução. As malformações arteriovenosas são lesões relativamente raras e infrequentes. São caracterizadas por apresentarem um aumento anormal do número de vasos sanguíneos como consequência de um defeito no desenvolvimento vascular. Constituem um desafio diagnóstico e terapêutico para o médico que trata. Sua incidência gira em torno de 1.5% da população geral. As opções de tratamento incluem embolização seletiva, ressecção cirúrgica ou ambas. O objetivo deste artigo é relatar um caso de patologia pouco frequente e fazer uma revisão bibliográfica sobre o assunto para lançar luz sobre seu diagnóstico. Relato de caso. Apresentamos o caso de um paciente adulto jovem que consultou por apresentar uma massa na nádega direita, de 6 anos de evolução. Isso é diagnosticado erroneamente como um lipoma, então o paciente é levado para cirurgia sem imagens diagnósticas prévias. Na cirurgia, o paciente apresenta um choque hipovolêmico. Posteriormente, a massa é documentada como uma malformação arteriovenosa profunda. Discussão. A localização dessas malformações nos membros inferiores é incomum, como no caso deste paciente. O diagnóstico dessas lesões pode ser clínico, mas requer conhecimento ou suspeita dessa entidade, pois podem ser lesões clinicamente invisíveis, o que as leva a passar despercebidas ou mal diagnosticadas. Conclusão. Embora seja uma patologia pouco frequente, pode gerar importantes repercussões clínicas, físicas, psicológicas e estéticas, pelo que é imprescindível a realização de métodos de imagem adequados para estabelecer seu correto diagnóstico e tratamento. Cómo citar. Rodriguez-Londoño NH. Malformación arteriovenosa de alto flujo en un adulto joven. MedUNAB. 2021;24(1): 72-79. doi: https://doi.org/10.29375/01237047.3785


Subject(s)
Vascular Malformations , Shock , Angiography , Embolization, Therapeutic , Neovascularization, Pathologic
3.
Int. j. morphol ; 38(6): 1842-1848, Dec. 2020. graf
Article in Spanish | LILACS | ID: biblio-1134518

ABSTRACT

RESUMEN: El síndrome de Klippel-Trenaunay-Weber (SKTW) es una enfermedad congénita poco frecuente caracterizada por hipertrofia de un miembro que afecta a los huesos y a las partes blandas, con extensos angiomas planos, várices y otras anomalías vasculares, como fístulas arteriovenosas. Su incidencia es de 1:100.000 personas. El objetivo fue describir un caso raro de SKTW bilateral, confirmado con hallazgos clínicos e imagenológicos en un niño de 9 años de edad, de sexo masculino, con antecedentes de sangrado digestivo bajo, herniorrafía inguinal izquierda y orquidopexia ipsilateral. En ambos miembros inferiores se identificaron lesiones hemangiomatosas e hipertrofia muscular y edema en miembro inferior izquierdo con ausencia de segundo y tercer dedos del pie izquierdo por antecedente quirúrgico de amputación. Adicionalmente, presentaba adenopatías cervicales e inguinales. Dentro de los hallazgos radiográficos importantes, se observó una cortical ósea delgada en el fémur del miembro inferior izquierdo. El SKTW afecta típicamente a los miembros inferiores de forma unilateral; este es un caso infrecuente de afección bilateral (con predominio izquierdo). Algunos pacientes, registran compromiso visceral con hemorragia digestiva baja, además de alteraciones genitourinarias, presentes en el 30% de los casos. La presentación de adenopatías es inusual.


SUMMARY: Klippel-Trenaunay-Weber syndrome (KTWS) is a rare congenital disease characterized by limb hypertrophy affecting bones and soft tissues, with extensive flat angiomas, varicose veins, and other vascular abnormalities, such as arteriovenous fistulas. Its incidence is 1: 100,000 people. The aim of this work was to describe a rare case of bilateral KTWS, confirmed with clinical and imaging findings in a 9-year-old male, with a history of lower gastrointestinal bleeding, left inguinal herniorrhaphy and ipsilateral orchidopexy. In both lower limbs, hemangiomatous lesions and muscle hypertrophy were identified, and in the left lower limb edema was identified with absence of the second and third toes due to a surgical history of amputation. Additionally, the patient presented cervical and inguinal lymphadenopathy. Among the important radiographic findings, in the left lower limb femur a thin bony cortex was observed. KTWS typically affects the lower limbs unilaterally; this is an infrequent case of bilateral affection (predominantly left). Some patients have visceral involvement with lower gastrointestinal bleeding, as well as genitourinary alterations, present in 30 % of cases. The presentation of lymphadenopathy is unusual.


Subject(s)
Humans , Male , Child , Klippel-Trenaunay-Weber Syndrome/diagnostic imaging , Magnetic Resonance Imaging , Radiography , Ultrasonography , Vascular Malformations/diagnostic imaging , Hypertrophy/diagnostic imaging , Musculoskeletal Abnormalities/diagnostic imaging
4.
Braz. dent. j ; 31(3): 344-348, May-June 2020. graf
Article in English | LILACS, BBO | ID: biblio-1132304

ABSTRACT

Abstract Caliber persistent labial artery (CPLA) consists in a dilated portion of the main branch of the labial artery without loss of size. The aim of this study is to report a case of a patient diagnosed with CPLA in the upper lip, emphasizing unusual histopathological and immunohistochemical findings. A 67-year-old female patient with complaint of a pulsating upper lip lesion without painful symptomatology. Under a clinical diagnosis of CPLA, and considering that the patient was edentulous and used a total prosthesis, an excisional biopsy of the lesion was performed to avoid future traumas in the region and consequently possible exuberant local bleeding. At anatomopathological examination structures suggestive of lymphoid follicles and germinal centers were visualized. Immunohistochemistry showed positivity for CD20, CD68, desmin and CD34 and negativity for CD4. The patient did not have a history of allergies, cardiovascular, rheumatic or systemic diseases that could justified the findings. The case presents unusual histopathological structures, evidencing the necessity of more studies about this pathology so scarce in the literature.


Resumo Artéria labial de calibre persistente (ALCP) consiste em uma parte dilatada do ramo principal da artéria labial que penetra no tecido submucoso sem perda de calibre. O objetivo desse estudo é relatar um caso de uma paciente diagnosticada com ALCP em lábio superior, enfatizando os achados histopatológicos e imuno-histoquímicos incomuns. Paciente de 67 anos, sexo feminino, com queixa de lesão em lábio superior, pulsante, sem sintomatologia dolorosa. Diante do diagnóstico clínico de ALCP, e considerando que a paciente era edêntula e usuária de prótese total, foi realizada biópsia excisional para evitar futuros traumas na região e, consequentemente, sangramento local exuberante. Ao exame anatomopatológico foram visualizadas estruturas sugestivas de folículos linfoides e com formações sugestivas de centros germinativos. No exame imuno-histoquímico observou-se imunopositividade para CD20, CD68, desmina e CD34 e sem imunomarcação para CD4. A paciente relatou não possuir histórico de alergias, doenças cardiovasculares, reumáticas ou sistêmicas que justificassem os achados. O caso apresenta estruturas histopatológicas incomuns, corroborando a necessidade de mais estudos acerca dessa lesão tão pouco discutida na literatura.


Subject(s)
Humans , Female , Aged , Vascular Malformations , Lip Diseases , Arteries , Biopsy , Lip , Mouth Mucosa
5.
Int. j. odontostomatol. (Print) ; 14(1): 48-54, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1056500

ABSTRACT

RESUMEN: Las anomalías vasculares de cabeza y cuello son un grupo de lesiones que afectan vasos sanguíneos y linfáticos donde el tratamiento sigue siendo un desafío. La clasificación actualizada de anomalías vasculares de cabeza y cuello es la clasificación de Mulliken modificada, que las subdivide en a) tumores vasculares y, b) malformaciones vasculares. En este reporte, presentamos dos casos clínicos de pacientes de sexo masculino, con diagnóstico de anomalías vasculares que afectan al labio y paladar duro, diagnosticados como malformación arteriovenosa y malformación venosa, respectivamente. Dichas lesiones remitieron completamente mediante tratamientos conservadores (agentes esclerosantes) y/o quirúrgicos (exéresis quirúrgica completa de la lesión) logrando una remisión completa. Consecutivamente, presentamos una revisión de la literatura enfocado a la clasificación actual, enfoques terapéuticos actuales y futuros.


ABSTRACT: Vascular anomalies of the head and neck are a group of lesions that affect blood and lymph vessels where treatment remains a challenge. The updated classification of head and neck vascular anomalies is the modified Mulliken classification, which subdivides them into a) vascular tumors and b) vascular malformations. In this report, we present two clinical cases of male patients, with diagnosis of vascular anomalies affecting the lip and hard palate, diagnosed as arteriovenous malformation and venous malformation, respectively. These lesions were completely treated with conservative (sclerosing agents) and/or surgical (complete surgical exeresis of the lesion) treatments, achieving a complete remission. Consequently, we present a review of the literature focused on the current classification, current and future therapeutic approaches.


Subject(s)
Humans , Male , Adult , Middle Aged , Vascular Neoplasms/pathology , Vascular Malformations/surgery , Mouth/physiopathology , Postoperative Period , Chile , Treatment Outcome , Vascular Malformations/classification , Mouth/injuries
6.
Int. j. odontostomatol. (Print) ; 14(3): 373-379, 2020. tab, graf
Article in English | LILACS | ID: biblio-1114910

ABSTRACT

Benign oral vascular lesions are anomalies characterized by the blood vessels proliferation or malformation and the treatment with the sclerosing agent ethanolamine oleate acts irrigating the vessel producing a sterile inflammatory response. The objective of this study was to report and discuss the results from treatment of benign oral vascular lesions with non-diluted ethanolamine oleate through the analysis of clinical records. The sample was composed by the selection of twenty-six patients (12 male and 14 female), with oral vascular malformations. All lesions were treated with intralesional injections of undiluted ethanolamine oleate. These patients attended in Oral Medicine outpatient clinic of the Federal University of Paraná between the years of 2011 to 2015. The average age was 60.65 years, with a higher prevalence for women. The majority of the individuals had one lesion and its location was mostly in the lower lip. The main complaint was about a physical discomfort. The lesions had the average size of 6.52 mm and received a median number of 2.32 applications. Only one patient reported feeling pain in the postoperative week. In most cases the resolution of the lesion was considered partial. Follow-up was obtained up to one month after the end of treatment. The sclerotherapy with undiluted ethanolamine oleate shows acceptable results in the treatment of small benign oral vascular lesions with a few minor side effects.


Las lesiones vasculares orales benignas son anomalías caracterizadas por la proliferación o malformación de los vasos sanguíneos y el tratamiento con el agente esclerosante etanolamina oleato actúa irrigando el vaso produciendo una respuesta inflamatoria estéril. El objetivo de este estudio fue informar y discutir los resultados del tratamiento de lesiones vasculares orales benignas con oleato de etanolamina no diluido a través del análisis de historias clínicas. La muestra estuvo compuesta por la selección de veintiséis pacientes (12 hombres y 14 mujeres), con malformaciones vasculares orales. Todas las lesiones fueron tratadas con inyecciones intralesionales de oleato de etanolamina sin diluir. Estos pacientes acudieron a la clínica ambulatoria de Medicina Oral de la Universidad Federal de Paraná entre los años 2011 a 2015. La edad promedio fue de 60,65 años, con una mayor prevalencia para las mujeres. La mayoría de los individuos tenían una lesión y su ubicación era principalmente en el labio inferior. La queja principal era sobre una molestia física. Las lesiones tenían un tamaño promedio de 6,52 mm y recibieron una mediana de 2,32 aplicaciones. Solo un paciente informó haber sentido dolor en la semana postoperatoria. En la mayoría de los casos, la resolución de la lesión se consideró parcial. El seguimiento se obtuvo hasta un mes después del final del tratamiento. La escleroterapia con oleato de etanolamina sin diluir muestra resultados aceptables en el tratamiento de pequeñas lesiones vasculares orales benignas con algunos efectos secundarios menores.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Oleic Acids/administration & dosage , Sclerotherapy/methods , Ethanolamine/administration & dosage , Vascular Malformations/therapy , Mouth Diseases/therapy , Sclerosing Solutions/administration & dosage , Blood Vessels/abnormalities , Mouth Neoplasms/therapy , Injections, Intralesional , Follow-Up Studies , Treatment Outcome , Patient Satisfaction , Hemangioma/therapy , Lip/blood supply
7.
Rev. méd. Minas Gerais ; 30(supl.5): 32-38, 2020.
Article in Portuguese | LILACS | ID: biblio-1223944

ABSTRACT

Objetivo: Avaliar a casuística de malformações vasculares do serviço de pneumologia de um hospital público referência estadual para o atendimento pediátrico e analisar os achados clínicos predominantes associados a estas malformações. Métodos: Foi realizado um levantamento de todos os casos de malformações vasculares pulmonares diagnosticadas no serviço, no período de agosto de 1986 a dezembro de 2003. Por meio da análise de prontuários destes pacientes, as seguintes variáveis foram avaliadas: alteração estrutural pulmonar, as manifestações clínicas, a idade média ao diagnóstico, o sexo do paciente e evolução clínica. Resultados: As patologias encontradas foram: sequestro pulmonar - 6 casos (25%), agenesia e/ou hipoplasia pulmonar - 7 casos (30%), fístulas artériovenosas - 4 casos (16%), anel vascular ­ 6 casos (25%) e agenesia da valva pulmonar - 1 caso (4%). Nove pacientes pertenciam ao sexo masculino e 13 ao sexo feminino. A idade ao diagnóstico variou de 1 mês a 58 anos A sintomatologia variou de acordo com a patologia: infecção respiratória de repetição, estridor, cianose e dispneia foram os achados mais frequentes. Dos 22 pacientes estudados, 11 (50%) casos foram passíveis de correção cirúrgica. Conclusão: As malformações vasculares pulmonares são patologias raras, porém o pediatra deve tê-las em mente para se obter um diagnóstico precoce, propedêutica correta e se possível correção cirúrgica dessas patologias. (AU)


Objective: To evaluate the casuistry of vascular malformations in our division and to analyze the predominant clinical findings of these malformations. Methods: A survey was carried out searching for all cases of pulmonary vascular malformations diagnosed, from August 1986 to December 2003. Through the analysis of the medical records of these patients, the following variables were evaluated: structural pulmonary alteration, clinical presentation, mean age at diagnosis, gender and clinical evolution. Results: The pathologies found were: pulmonary sequestration - 6 cases (25%), agenesis and / or pulmonary hypoplasia - 7 cases (30%), arteriovenous fistulas - 4 cases (16%), vascular ring - 6 cases (25%) and pulmonary valve agenesis - 1 case (4%). Nine patients were male and 13 were female. Age at diagnosis ranged from 1 month to 58 years. The symptoms varied according to the pathology. The most frequent were recurrent respiratory infection, stridor, cyanosis, dyspnea. Of the 22 patients studied, 11 (50%) cases were amenable to surgical correction Conclusion: Pulmonary vascular malformations are rare pathologies, but pediatricians should keep them in mind to obtain an early diagnosis, correct propaedeutics and, if possible, surgical correction of these pathologies. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Vascular Malformations , Lung , Pediatrics , Congenital Abnormalities , Congenital Abnormalities/diagnosis
8.
Rev. colomb. cir ; 35(4): 647-658, 2020. tab, fig
Article in Spanish | LILACS | ID: biblio-1147911

ABSTRACT

Introducción. Las malformaciones vasculares son anomalías que están presentes desde el nacimiento, no desaparecen y pueden crecer a lo largo de la vida. Se ha demostrado en estudios retrospectivos que la terminología para clasificar las anomalías vasculares es inexacta en un 69 % de casos, por lo que se hace un diagnostico inadecuado y en un 53 % de casos se brinda al paciente y su familia una información incorrecta del tratamiento y el curso clínico. Métodos. Estudio prospectivo longitudinal, realizado entre 2016 y 2019, donde se incluyeron pacientes con anomalías vasculares, que consultaron a nuestra institución, fueron valorados por el servicio de cirugía vascular, se hizo un plan diagnóstico y manejo integral, vía endovascular, quirúrgica o mixta, de acuerdo con cada caso. Resultados. La malformación más común fue la de tipo venoso, en el 40,3 % de los casos. Se realizó manejo endovascular en el 93,1 % de casos de malformaciones vasculares y quirúrgico en el 6,9 %. La mejoría de los síntomas que motivaron la consulta fue del 100 % para los tumores vasculares y del 70,8 % para las malformaciones. Sin embargo, los resultados son heterogéneos. Discusión. Es necesario realizar un adecuado diagnóstico de las anomalías vasculares, para alcanzar un trata-miento eficaz, con mejoría de los síntomas


Introduction. Vascular malformations are abnormalities that are present from birth, do not disappear and can grow throughout life. It has been shown in retrospective studies that the terminology to classify vascular anomalies is inaccurate in 69% of cases, an inappropriate diagnosis is made and in 53% of cases the patient and their family are given incorrect information on the treatment and the clinical course.Methods. Longitudinal prospective study conducted between 2016 and 2019. Patients with vascular anomalies and consulted to our institution were included. They were evaluated by the vascular surgery service, and a comprehensive diagnosis and management plan was made, including endovascular, surgical or mixed, according to each case. Results. The most common malformation was the venous type in 40.3% of the cases. Endovascular management was performed in 93.1% of cases and surgery in 6.9%. The improvement in the symptoms that led to the con-sultation was 100% for vascular tumors and 70.8% for malformations. However, the results are heterogeneous.Conclusions. It is necessary to obtain an adequate diagnosis of vascular anomalies, to achieve an effective treatment, with improvement of the symptoms


Subject(s)
Humans , Vascular Malformations , Vascular Surgical Procedures , Blood Vessel Prosthesis , Neoplasms, Vascular Tissue
9.
Acta odontol. Colomb. (En linea) ; 10(2): 112-126, 2020. ilus, tab, ilus, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1123481

ABSTRACT

Objetivo: identificar el manejo y respuesta a tratamientos que presentaron los pa-cientes pediátricos diagnosticados con hemangiomas y malformaciones vasculares en cabeza y cuello, que acudieron al servicio de Cirugía Oral y Maxilofacial de la Fundación Hospital de la Misericordia (HOMI) durante el período 2012­2019. Métodos: 11 p a c i e n-tes fueron atendidos en el servicio de cirugía oral y maxilofacial de la Fundación HOMI, entre enero de 2012 y noviembre de 2019, con diagnóstico de hemangioma y/o malfor-maciones vasculares. De estos, 9 fueron tratados con doxiciclina como agente esclero-sante. Resultados: se atendieron 5 pacientes masculinos y 6 femeninos con rango de edad entre los 8 meses y 13 años, con un promedio de 86,8 meses. La escleroterapia se realizó con doxiciclina en dosis de 100 mg disuelta en una ampolla de bicarbonato de sodio de 10 ml, inyectada en 5 pacientes con ecografía y en 4 por aspiración directa. De los 11 pacientes, 9 fueron tratados con escleroterapia; de estos 5 recibieron una sesión de escleroterapia, mientras que a los otros 4 se les realizó entre 2 y 3 sesiones. En 5 pacientes fue posible hacer seguimiento, ya que la atención depende de la autorización de la EPS. Conclusiones: la doxiciclina como agente esclerosante utilizado en lesiones vasculares ha demostrado ser un medicamento seguro, de bajo costo y efectivo como tratamiento inicial de hemangiomas y malformaciones vasculares en la cara. El número de aplicaciones depende del tipo de lesión a tratar.


Objective: Identify the treatment provided to patients with hemangioma and vascular deformities diagnosis .in head and neck who resorted to Oral and Maxillofacial service in Fundación Hospital de la Misericordia (HOMI) from 2012-2019 and the outcome of this treatments. Methods: Eleven (11) patients were admitted and treated by the surgical and maxillofacial team in "Fundación Hospital la Misericordia HOMI", between January 2012 and November 2019 with the hemangioma and vascular deformities diagnosis. Nine (9) of them were treated using doxycycline as a sclerosing agent. Results: Out of the eleven (11) patients, five (5) were males and the other six (6) were females, with an age range going from 8 months, up to 13 years, for an average of 86,8 months. A sclerotherapy was performed using doxycycline, with a dosage of 100 mg dissolved in a syringe with 10 mL of sodium bicarbonate on five (5) patients with ultrasound, and four (4) with direct aspiration. Out of the eleven (11) patients, five (5) received one sclerotherapy session the remaining four (4) received 2 or 3 sessions. In five (5) of the patients it was possible to complete follow-ups since the attention depends on their healthcare provider. Conclusions: Doxycycline as a sclerosing agent used in vascular lesions has demonstrated to be a safe treatment, with low cost, and effective as an initial treatment for hemangiomas and vascular deformities on the face. The number of sessions depend on the lesion that is going to be treated.


Subject(s)
Humans , Infant , Child , Doxycycline , Lymphangioma , Therapeutics , Sclerotherapy , Vascular Malformations
13.
Rev. chil. pediatr ; 90(6): 662-667, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058198

ABSTRACT

INTRODUCCIÓN: El síndrome de CLOVES se caracteriza por sobrecrecimiento lipomatoso asociado a malformaciones vasculares, representando un desafío diagnóstico y terapéutico. La rapamicina, un inhibidor de la vía mTOR, ha demostrado ser una buena alternativa terapéutica en un grupo de anomalías vasculares. Reportamos dos casos de síndrome de CLOVES con buena respuesta al tratamiento con rapamicina oral. OBJETIVO: Reportar la experiencia del uso de rapamicina oral en el tratamiento de dos pacientes con síndrome de CLOVES. CASOS CLÍNICOS: Caso 1: preescolar femenino de tres años de edad con sín drome de CLOVES e historia de hospitalizaciones reiteradas por infección severa de malformaciones linfáticas macroquísticas y episodios trombóticos. Evoluciona con mala calidad de vida, múltiples hospitalizaciones, riesgo quirúrgico y progresión de las lesiones, por lo que se indicó rapamicina oral. A los 6 meses de tratamiento se evidenció reducción clínica y radiológica del tamaño de las masas lipomatosas y linfáticas, ausencia de linforrea cutánea y mejoría significativa de la calidad de vida, sin requerir nuevas hospitalizaciones. Caso 2: escolar femenino de diez años de edad, portadora de síndrome de CLOVES, que desarrolló escoliosis y deterioro de su capacidad motora, haciéndose dependiente del uso de silla de ruedas. Se indicó rapamicina oral, evidenciándose a los cuatro meses de tratamiento mejoría en su capacidad física, independencia y autovalencia, con desaparición de la linforrea. CONCLUSIÓN: Proponemos la rapamicina oral para el tratamiento de pacientes con sín drome de CLOVES que presenten complicaciones y deterioro de la calidad de vida producto de su enfermedad.


INTRODUCTION: CLOVES syndrome is characterized by lipomatous overgrowth associated with vascular malforma tions, representing a diagnostic and a therapeutic challenge. Rapamycin, an mTOR inhibitor, has proved to be a good therapeutic option in some vascular anomalies. In this article, we report two ca ses of CLOVES syndrome with good response to oral rapamycin treatment. OBJECTIVE: To report the outcome of two patients with CLOVES syndrome treated with oral rapamycin. CLINICAL CASES: Case 1: A three-year-old female preschooler with CLOVES syndrome and history of repeated hospita lizations due to severe infections resulting from macrocystic lymphatic malformations and due to thrombotic episodes. The patient evolved with poor quality of life, multiple hospitalizations, surgical risk and progression of the lesions, therefore, oral rapamycin was indicated. After six months of treatment, clinical and radiological reduction in the size of the lipomatous and lymphatic masses, cutaneous lymphorrhea absence and a significant improvement of her quality of life were observed, without requiring new hospitalizations. Case 2: a ten-year-old female schooler with CLOVES syndro me, who developed scoliosis and deterioration of her motor skills, becoming wheelchair-dependent. Oral rapamycin was indicated, showing improvement in her physical capacity, independence and au tonomy, and absence of lymphorrhea after four months of treatment. CONCLUSION: We propose oral rapamycin for the treatment of patients with CLOVES syndrome who present with complications and deterioration in the quality of life as a result of the disease.


Subject(s)
Humans , Female , Child, Preschool , Child , Sirolimus/therapeutic use , Vascular Malformations/drug therapy , Lipoma/drug therapy , Antibiotics, Antineoplastic/therapeutic use , Musculoskeletal Abnormalities/drug therapy , Nevus/drug therapy , Administration, Oral , Sirolimus/administration & dosage , Antibiotics, Antineoplastic/administration & dosage
14.
Arch. argent. pediatr ; 117(6): 679-683, dic. 2019. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1051379

ABSTRACT

Las infecciones por Streptococcus pyogenes son frecuentes en la población pediátrica en forma de faringoamigdalitis o cuadros cutáneos. Con menor frecuencia, se presenta con formas invasivas, tales como piomiositis o fascitis necrotizante. La mortalidad en niños reportada en estas últimas es de un 7,69 %. Se presenta a una paciente de 11 años con malformación venolinfática subescapular que consultó por síndrome febril asociado a dolor y aumento agudo del tamaño de la lesión. Durante la internación, se arribó al diagnóstico de piomiositis por Streptococcus pyogenes


Streptococcus pyogenes infections are common in the pediatric population in the form of tonsillopharyngitis or cutaneous disease. Less frequently, it presents with invasive forms such as pyomyositis or necrotizing fasciitis. Mortality in children is of 7 %. We present an 11-year-old patient with a subscapular venolymphatic malformation who consulted for febrile syndrome associated with pain and an acute increase in the size of the lesion. During the hospitalization, diagnosis of pyomyositis due to Streptococcus pyogenes was reached.


Subject(s)
Humans , Female , Child , Pyomyositis/diagnosis , Streptococcus pyogenes , Bacteremia , Vascular Malformations
15.
Rev. bras. cir. cardiovasc ; 34(6): 765-768, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057488

ABSTRACT

Abstract Clinical data: Infant, 7 months, female, referred to our department at one month of age, suspecting of congenital heart disease for further investigation. Chest radiography: Demonstrates cardiomegaly and prominent pulmonary vascular markings. Electrocardiography: Shows right ventricular hypertrophy and left anterior fascicular block. Echocardiography: Evidenced common atrioventricular valve with two orifices and the left superior pulmonary vein draining on the brachiocephalic vein. Computed tomography angiography: This complementary imaging exam was performed to confirm the diagnosis. Diagnosis: The patient presented an association between AVSD and PAPVC, a rare combination. The clinical picture of heart failure was preponderant, characterized by need for diuretics and complementary exams findings, and early surgical treatment was indicated. Operation: The operation was performed through a median sternotomy with 123 minutes of cardiopulmonary bypass and 89 minutes of cross-clamping time. The patient had no postoperative complications, remaining 10 days hospitalized.


Subject(s)
Humans , Female , Infant , Abnormalities, Multiple/diagnostic imaging , Vascular Malformations/diagnostic imaging , Heart Defects, Congenital/diagnostic imaging , Heart Septal Defects, Atrial/diagnostic imaging , Pulmonary Veins/abnormalities , Pulmonary Veins/surgery , Abnormalities, Multiple/surgery , Cardiopulmonary Bypass , Electrocardiography , Vascular Malformations/surgery , Computed Tomography Angiography , Heart Defects, Congenital/surgery , Heart Septal Defects, Atrial/surgery
16.
Bol. méd. postgrado ; 35(2): 23-29, Jul.-Dec. 2019. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1120193

ABSTRACT

Se realizó un estudio cuasi-experimental de series temporales para evaluar la efectividad del propranolol en el tratamiento de malformaciones vasculares cutáneas en 48 pacientes que asistieron a la consulta del Servicio de Dermatología del Hospital Central Universitario Dr. Antonio María Pineda durante el período febrero-julio 2018. Los resultados muestran que existen diferencias estadísticamente significativas (p <0.05; p0,0001) antes y después del primer mes de tratamiento con propranolol, las cuales se mantiene hasta los seis meses, con respecto al tamaño, color, consistencia y temperatura. Se espera que los resultados sirvan para proponer el uso de propranolol como una opción terapéutica no invasiva en el tratamiento de las malformaciones vasculares cutáneas(AU)


A quasi-experimental study of time series was carried out to evaluate the effectiveness of propranolol in the treatment of cutaneous vascular malformations in 48 patients attending the Dermatology Service of the Hospital Central Universitario Dr. Antonio Maria Pineda during the period February - July 2018. The results show that there are statistically significant differences (p <0.05; p0,0001) before and after treatment with propranolol starting one month post-treatment which are kept until six months, related to size, color, consistency and temperature of lesions. We hope that these results will encourage the use of propranolol as a non-invasive therapeutic option in the treatment of cutaneous vascular malformations(AU)


Subject(s)
Humans , Male , Female , Propranolol/therapeutic use , Skin Diseases, Vascular/diagnosis , Skin Diseases, Vascular/drug therapy , Vascular Malformations/physiopathology , Medication Therapy Management , Dermatology , Vascular Malformations/diagnosis
17.
An. bras. dermatol ; 94(5): 521-526, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054866

ABSTRACT

Abstract Background The use of monoethanolamine oleate 5% is effective for the treatment of vascular malformations with low blood flow. Objectives To report a case series of vascular malformations in the mouth and oral cavity treated with monoethanolamine oleate 5%. Methods A retrospective descriptive study was performed in electronic patient charts covering seven years. Patient demographics, diagnostic resources, lesion site, size, and number of applications of monoethanolamine oleate 5% were collected. Results A total of 21 vascular malformations were recorded, located mostly on the lower lip (52.3%) and resolved in a single application in 14 patients. The authors found 19 patients treated with sclerotherapy. Thirteen were women and six were men, with a mean age of 61 years. Study limitation Small sample size. Conclusions Sclerotherapy is an effective treatment for vascular malformations of the lips and oral cavity, with resolution after only one or two applications (n = 16).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sclerosing Solutions/administration & dosage , Oleic Acids/administration & dosage , Sclerotherapy/methods , Vascular Malformations/therapy , Mouth Diseases/therapy , Time Factors , Injections, Intralesional , Retrospective Studies , Treatment Outcome , Esthetics , Lip/blood supply , Lip/pathology , Mouth Diseases/pathology
18.
Autops. Case Rep ; 9(3): e2019097, July-Sept. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1020996

ABSTRACT

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of uncertain tissue origin. Although it has been classified as a benign tumor under the WHO classification, it is locally aggressive, and multiple recurrences have been reported. PHAT commonly involves the lower extremities; however, various unusual sites of origin have been reported. We present the case of a 30-year-old female with dysmenorrhea, who presented a presacral mass on imaging. The core biopsy confirmed the diagnosis of PHAT. She underwent laparotomy and excision. Histopathology confirmed the presence of a tumor comprised of aggregates of ectatic vessels with perivascular hyalinization. An immunohistochemical study showed diffuse CD34 positivity, but S100, MDM2, and smooth muscle actin negativity. After surgical procedures, the patient is disease free as at the 12-month follow-up. Only 120 cases have been published in the English literature to date. Our study is only the third case of PHAT arising from the pelvis to be reported. Though considered to be a rare condition, the diagnosis of PHAT should always be considered in the differential diagnosis of well-defined hypervascular soft tissue mass in the pelvis. The typical histopathological findings along with immunohistochemistry should clinch the diagnosis.


Subject(s)
Humans , Female , Adult , Pelvic Neoplasms/pathology , Sarcoma/pathology , Diagnosis, Differential , Vascular Malformations
20.
Med. UIS ; 32(1): 27-31, ene.-jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1040392

ABSTRACT

Resumen La lesión de Dieulafoy representa aproximadamente el 2% de todos los casos de hemorragia gastrointestinal superior. En la mayoría de casos esta anomalía se ubica en el estómago, principalmente en la curvatura menor. Se presenta el caso de un adulto joven con hematemesis y signos de hipovolemia. Durante la esofagogastroduodenoscopia se evidenció un coágulo adherido en el cuerpo gástrico a nivel de la curvatura mayor, sugestivo de lesión de Dieulafoy. Inicialmente se realizó manejo médico sin mejoría significativa, por lo que se realizó laparotomía exploratoria con resección de la malformación vascular, finalmente con el informe histopatológico se confirmó el diagnóstico. A pesar de ser una causa infrecuente de hemorragia gastrointestinal superior, la lesión de Dieulafoy debe considerarse entre los diagnósticos diferenciales, especialmente si la hemorragia persiste aún con manejo médico. MÉD.UIS.2019;32(i):27-31.


Abstract Dieulafoy's lesion represents approximately 2% of all causes of upper gastrointestinal bleeding. In most cases, this malformation is located in the stomach, mainly in the lesser curvature. We present the case of a young adult with hematemesis and signs of hypovolaemia. During the esophagogastroduodenoscopy, a clot adhering to the gastric body was seen at the level of the greater curvature, suggestive of Dieulafoy's lesion. Initially, medical management was performed without significant improvement, so an exploratory laparotomy was performed with resection of the vascular malformation, the histopathological report confirmed the diagnosis. Despite being an uncommon cause of upper gastrointestinal bleeding, the Dieulafoy lesion must be considered among the differential diagnoses, especially if the hemorrhage persists even with medical management. MÉD.UIS.2019;32(1):27-31.


Subject(s)
Humans , Male , Adult , Vascular Malformations , Pathology, Surgical , Gastrointestinal Diseases , Gastrointestinal Hemorrhage , Laparotomy
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