Angioma capilar espinal intradural: reporte de un caso y revisión de la literatura / Spinal cord capillary hemangioma: a case report and literature review

INTRODUCTION: Capillary angiomas are extremely rare in the spinal intradural space (being even less frequent in the intramedullary location)10-24. We analyze the characteristics of these lesions. METHODS: We present a case report of a patient with a symptomatic spinal-intradural capillary hemangioma at the thoracic level, followed by a review of the literature. RESULTS: We found a total of 41 patients reported with single angiomas, and three more patients with multiple lesions. Most patients were male (33/44 patients), and the mean age was 53,5 years. The localization of these lesions was mainly in the dorsal spine (24), cauda equina (15) and conus medullaris (6), with one case reported in the cervical spine 11. Most patients presented with back pain, mielopathy or radiculopathy. Contrary to the case of cavernous angiomas, we did not find cases of capillary angiomas presenting with subarachnoid or intramedullary hemorrhage. The imaging characteristics (isointense at T1WI, hyperintense at T2WI and with intense contrast enhancement) were constant in almost all the reports. CONCLUSIONS: Spinal intradural capillary angiomas are rare vascular lesions, frequently mistaken for intradural tumors. It affects mostly males in the fifth or sixth decade of life, and is preferentially located in the thoracolumbar spine. It can be occasionally associated with marked spinal cord edema, specially when there is a intramedullary component. These lesions have a good prognosis after surgical treatment, and must be taken into account in the differential diagnosis of intradural tumors of thoracolumbar spine and cauda equina.

Hemangiomas infantiles / [Infantile hemangiomas].

Infantile hemangiomas are the most common benign tumors of infancy. While most of them have an uncomplicated course, between 10 and 15

are at risk for complications, especially during the proliferative phase, and can cause impairment of vital functions or produce permanent cosmetic disfigurement. In this update we delineate the natural history of infantile hemangiomas, with special emphasis on identifying those that require special diagnostic evaluations and multidisciplinary and closer follow-up, reviewing the study and treatment indications and current treatment modalities.

Testicular capillary hemangioma - A case report of a rare tumor.

Testicular hemangioma is a very rare benign vascular neoplasm, mostly occurring in children and young adults. We present a case of capillary hemangioma of the testis in a twenty three years old male who presented with painless mass in the right scrotum of 2 months duration. He was diagnosed with a right testicular tumor based on the physical examination, ultrasonography and magnetic resonance imaging studies. Serum tumor markers were normal. Right radical orchiectomy was performed. On histology, the tumor was diagnosed as capillary hemangioma of the testis. Immunohistochemical staining for CD31 and factor VIII confirmed the vascular nature of the tumor. To our knowledge, there are only twenty two cases of testicular hemangiomas reported in the literature. Although it is a rare tumor, surgeons and pathologists should be aware of it especially with the negative tumor marker findings. Intra-operative frozen section examination may be requested as tumor enucleation with testicular sparing surgery is considered adequate.

Síndrome de POEMS con lesión lítica aislada y hemangiomas glomeruloides: caso clínico / POEMS syndrome with an isolated lytic lesion and glomeruloid hemangiomas: report of one case

POEMS syndrome (polyneuropathy, organomegaly, endocrine abnormality, M-protein, plasma cell dyscrasia, and skin lesions) is a rare atypical plasma cell dyscrasia with characteristic para neoplastic manifestations. Glomeruloid hemangioma is a typical skin change pathogenetically related with elevated levels of Vascular Endothelial Growth Factor (VEGF). We report a 69 year-old woman that presented cachexia associated with diabetes, hypothyroidism and severe sensitive motor polyneuropathy. Her skin changes included hyper pigmentation, acrocyanosis and glomeruloid hemangioma. The subsequent study revealed a monoclonal gammopathy lambda type; a unique lytic vertebral lesion and a clonal plasma cell proliferation. Treatment with prednisone 0.5 mg/kg and melphalan 0,25 mg/kg in cycles of 4 days every 4 weeks was started, but the patient was lost from follow up.

Small bowel haemangioma: a rare cause of intestinal obstruction in infant

Haemangiomas of small bowel are rare benign tumors. They present diversely, with intestinal obstruction being rare. We describe a two years old female baby with intestinal obstruction. Exploration revealed a diffusely infiltrating haemangioma of middle one third of ileum. Resection of affected segment and end to end bowel anastomosis was made. Post- operative recovery was un- eventful. Histopathological report was consistent with capillary haemangioma of small intestine

Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy.

We report successful surgical management of a circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy (TTT). A 33-year-old man with symptomatic serous macular detachment in the left eye (Snellen acuity: 20/200) secondary to a paramacular choroidal hemangioma was treated with TTT. The nonresponsive detachment was subsequently managed by vitrectomy, endophotocoagulation and silicon-oil tamponade. It resulted in complete resolution of the tumor and the detachment. Silicon oil was removed at four months. Visual acuity improved to 20/80 by the last follow-up visit at 10 months without any recurrence.

Actualización en el diagnóstico y tratamiento de los hemangiomas / Update on diagnosis and treatment of hemangiomas

Enfatizar en la correcta clasificación es aún una alta prioridad en la literatura ya persiste una gran desinformación al respecto. Nuevos progresos en la ciencia han permitido una mejor comprensión de estas lesiones. El avance en el diagnóstico precoz y la experiencia terapéutica han mejorado nuestra habilidad para tratar lesiones extensas y mejorar la calidad de vida de los pacientes.

Emphasis on correct classification is still a high priority in the literature and yet there remains a great deal of misinformation. Many new developments in the basic science of these lesions are allowing better understanding of why these lesions occur while improving our management in these patients. Advances in early diagnosis and therapeutic experience have improved our ability to treat extensive lesions and also improve patients' quality of life.

Hemangioma capilar da medula: relato de caso / Capillary hemangioma of the spinal cord: case report

Descrevemos um caso raro de hemangioma capilar da medula em mulher de 79 anos, que se apresentou com paraparesia progressiva, no período de 8 meses. Radiologicamente, esta lesão lembra outros tumores vasculares da medula espinhal. A paciente foi submetida a tratamento cirúrgico com boa recuperação. Em relação à histopatologia, a lesão assemelhou-se ao hemangioma capilar da pele e tecidos moles, composto de lóbulos de pequenos capilares associados a vasos nutridores, envolvidos por uma cápsula fibrosa. É realizada uma revisão dos casos publicados na literatura, assim como uma discussão dos aspectos clínicos, radiológicos, histológicos e do diagnóstico diferencial da lesão. O conhecimento da sua existência pode evitar erros de diagnóstico desta lesão benigna.

Intramuscular hemangioma complicated by a Volkmann's like contracture of the forearm muscles.

Intramuscular hemagiomas are rare tumors constituting less than 1% of all hemangiomas. The clinical picture is usually unlike a conventional vascular tumor. Pre-operative diagnosis is very difficult and most often, the condition is recognized only during surgery or after histopathological examination. This is a report of one such rare tumor,which presented as a painful mass in the Flexor Digitorum Superficialis. It was accompanied by the hitherto unreported complication of a Volkmann's like contracture of the deeper forearm muscles. The peculiar feature of this tumor are highlighted and are discussed with a review of relevant literature.