Assuntos
Dermoscopia , Neoplasias Faciais/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Idoso , Biomarcadores Tumorais/análise , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/química , Neoplasias Faciais/diagnóstico por imagem , Humanos , Masculino , Melanoma/irrigação sanguínea , Melanoma/química , Melanoma/diagnóstico por imagem , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/química , Neoplasias Cutâneas/diagnóstico por imagemRESUMO
Trichoblastoma is a benign cutaneous neoplasm that is clinically and histologically similar to basal cell carcinoma. We report the dermoscopic features seen in 2 cases of facial trichoblastoma. One case presented with very short, delicate, scarcely branching telangiectases against a pearly white background. In the second case, the veins were also short and scarcely branching, but they were arranged in a crown pattern, with white striae and milia-like cysts. Although dermoscopic evidence of fine, scarcely branching telangiectases is not specific to a diagnosis of trichoblastoma, these features may be useful for differentiating this neoplasm from nodular basal cell carcinoma.
Assuntos
Dermoscopia , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Idoso , Carcinoma Basocelular/diagnóstico , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/diagnóstico , Neoplasias Faciais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/diagnóstico , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Telangiectasia/diagnóstico por imagemRESUMO
The clinical distinction between basal cell carcinoma (BCC) and intradermal melanocytic nevus lesions on the face can be difficult, particularly in young patients or patients with multiple nevi. Dermoscopy is a useful tool for analyzing characteristic dermoscopic features of BCC, such as cartwheel structures, maple leaf-like areas, blue-gray nests and dots, and ulceration. It also reveals arborizing telangiectatic vessels and prominent curved vessels, which are typical of BCC, and comma vessels, which are typical of intradermal melanocytic nevi. It is, however, not always easy to distinguish between these 2 conditions, even when dermoscopy is used. We describe 2 facial lesions that posed a clinical and dermoscopic challenge in two 38-year-old patients; confocal microscopy showed separation between tumor nests and stroma and polarized nuclei, which are confocal microscopy features of basal cell carcinoma.
Assuntos
Carcinoma Basocelular/diagnóstico por imagem , Neoplasias Faciais/diagnóstico por imagem , Microscopia Confocal , Nevo Pigmentado/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Adulto , Carcinoma Basocelular/irrigação sanguínea , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/uso terapêutico , Dermoscopia , Diagnóstico Diferencial , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/diagnóstico , Neoplasias Faciais/patologia , Feminino , Humanos , Nevo Pigmentado/irrigação sanguínea , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/patologia , Psoríase/complicações , Psoríase/tratamento farmacológico , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Ustekinumab/efeitos adversos , Ustekinumab/uso terapêuticoAssuntos
Carcinoma Basocelular/diagnóstico por imagem , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Carcinoma Basocelular/irrigação sanguínea , Carcinoma Basocelular/patologia , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/patologia , Humanos , Microscopia Confocal , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/patologia , Tomografia de Coerência Óptica , Ultrassonografia/métodosAssuntos
Neoplasias Faciais/cirurgia , Nervo Facial/cirurgia , Retalhos de Tecido Biológico , Neurofibromatose 1/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Neoplasias de Tecidos Moles/cirurgia , Adolescente , Adulto , Anastomose Cirúrgica/métodos , Criança , Embolização Terapêutica/métodos , Neoplasias Faciais/irrigação sanguínea , Fáscia/transplante , Retalhos de Tecido Biológico/irrigação sanguínea , Humanos , Masculino , Músculo Esquelético/transplante , Nervo Obturador/cirurgia , Transplante de Pele/métodos , Neoplasias de Tecidos Moles/irrigação sanguíneaAssuntos
Altruísmo , Ameloblastoma/cirurgia , Neoplasias Faciais/cirurgia , Retalhos de Tecido Biológico , Cirurgia de Descompressão Microvascular/métodos , Doenças Negligenciadas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Ameloblastoma/irrigação sanguínea , Ameloblastoma/diagnóstico , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/diagnóstico , Feminino , Humanos , Doenças Negligenciadas/diagnóstico , Vitória , Adulto JovemAssuntos
Carcinoma Basocelular/irrigação sanguínea , Carcinoma Basocelular/patologia , Neoplasias Faciais/irrigação sanguínea , Mancha Vinho do Porto/patologia , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/complicações , Dermoscopia , Diagnóstico Diferencial , Neoplasias Faciais/complicações , Neoplasias Faciais/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mancha Vinho do Porto/complicações , Neoplasias Cutâneas/complicaçõesRESUMO
Solitary fibrous tumour is an uncommon neoplasm that arises predominantly from within the pleura. Extrapleural manifestation of solitary fibrous tumour, particularly in the head and neck area, is extremely rare. Here, we report a solitary fibrous tumour of the face in a 40-year old woman. The tumour was removed with a radiological combined approach, with embolisation of tumour blood vessels prior to excision. Eight months following surgery, the patient is well and free of disease.
Assuntos
Neoplasias Faciais/diagnóstico , Neoplasias de Tecido Fibroso/diagnóstico , Adulto , Angiografia , Biópsia , Meios de Contraste , Diagnóstico Diferencial , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/cirurgia , Feminino , Humanos , Imageamento Tridimensional , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Neoplasias de Tecido Fibroso/irrigação sanguínea , Neoplasias de Tecido Fibroso/cirurgia , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Sinusoidal hemangioma (SH) was described by two pathologists, Calonje and Fletcher, in 1991. This uncommon cutaneous benign vascular lesions with distinctive histologic features was considered a subset of lesions known as "cavernous hemangiomas". It is made of dilated interconnecting ("sinusoidal"), thin-walled channels with a single-layered lining endothelium and a lobular architecture. PATIENTS AND METHODS: Clinical, radiological (CT, MRI and arteriography), evolutive, and histologic data of 4 patients, whose lesions appeared very similar clinically and histologically, were reviewed and compared to the patterns of the so-called SH. RESULTS: There were 2 males and 2 females. Lesions had an infantile onset in 3 (congenital in 2). They exhibited a protracted course over years in the 4, and they all invaded the right forehead, eyelids and orbit areas. Clinically, they appeared as multilobulated, building, firm tumors under a normal shiny skin. Radiologically, lesions were strikingly nodular, with criteria of slow-flow vascular lesions on MRI and arteriograms. Histologically, all lesions were comprised of well-circumscribed nodules with a lobulated architecture, made of greatly dilated, blood-filled, thin-walled vascular channels, with scanty fibrous stroma between them. Interconnecting channels had the distinctive sinusoidal pattern. There were some elongated pseudopapillary structures. Islands of spindle cells were noted in 2 lesions. DISCUSSION: On the one hand histologic features of the lesions in our 4 patients are identical to those described by Calonje and Fletcher as SH, a lesion not to be confused with classic, involuting-type, hemangioma of infancy and childhood, and with venous or lymphatic malformations of the same location. SH fits into the group of lesions defined by pathologists as "cavenous hemangiomas". On the other hand the lesions in our 4 patients differed from the clinical description of SH as a solitary acquired small (less than 3 cm) nodule in adults. Otherwise the four lesions described herein constitute a distinctive clinicopathologic entity with a striking aggressive local growth although there is a histologic malformative pattern. The presence in 2 cases of islands of spindle cells led us to discuss the differences with spindle cell hemangioendothelioma.
Assuntos
Neoplasias Faciais/patologia , Hemangioma Cavernoso/patologia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Angiografia , Vasos Sanguíneos/patologia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/patologia , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/congênito , Neoplasias Faciais/diagnóstico , Feminino , Seguimentos , Testa , Hemangioendotelioma/diagnóstico , Hemangioma Cavernoso/irrigação sanguínea , Hemangioma Cavernoso/congênito , Hemangioma Cavernoso/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/patologia , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/congênito , Neoplasias Cutâneas/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Neurofibromatosis type 1 (von Recklinghausen's disease or peripheral neurofibromatosis) is of particular interest to the plastic surgeon, as it affects the skin. The majority of affected patients require operative procedures for cosmetic and functional reasons. Rarely, vascular lesions such as stenosis, rupture of an aneurysm, and fistula formation in neurofibromatosis type 1 can create some difficulties during operation without any symptoms before surgery. We report the management of a large occipitojugular fistula. This life-threatening fistula was located on the right side of the face of a 28-year-old patient who had been operated six times for the same neurofibromatous mass without any operative complications. During the operation for partial excision of the neurofibromatous mass, life-threatening, uncontrollable hemorrhage began and the operation was ended without excision. Postoperative angiography revealed an arteriovenous fistula between the occipital artery and jugular vein, and also total occlusion/agenesis in the postclinoid cisternal segment of the internal carotid artery. The fistula was obliterated with coil and histoacryl lipiodol mixture. After this procedure partial excision was performed without abnormal bleeding.
Assuntos
Malformações Arteriovenosas/cirurgia , Neoplasias Faciais/cirurgia , Neurofibromatose 1/cirurgia , Adulto , Angiografia , Malformações Arteriovenosas/diagnóstico por imagem , Terapia Combinada , Embolização Terapêutica , Neoplasias Faciais/irrigação sanguínea , Humanos , Veias Jugulares/anormalidades , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/cirurgia , Masculino , Neurofibromatose 1/diagnóstico por imagem , ReoperaçãoAssuntos
Ossos Faciais/diagnóstico por imagem , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Ossos Faciais/irrigação sanguínea , Neoplasias Faciais/irrigação sanguínea , Humanos , Metástase Linfática , Neoplasias Cranianas/irrigação sanguínea , Neoplasias de Tecidos Moles/irrigação sanguínea , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Neoplasias Vasculares/irrigação sanguíneaRESUMO
Two patients (11 and 23 months old, respectively) had successful transcatheter occlusion of congenital arterio-venous or veno-venous malformations using detachable silicone balloons. Patient 1 with a cervicofacial hemangioma had selective embolization of the feeding artery with two balloons. Patient 2, with a veno-venous malformation between a systemic vein and pulmonary vein also had selective embolization of the lesion with two balloons. Follow-up examinations confirm a successful outcome in both cases.
Assuntos
Veias Braquiocefálicas/patologia , Embolização Terapêutica/instrumentação , Neoplasias Faciais/terapia , Fístula/terapia , Hemangioma/terapia , Veias Pulmonares/patologia , Artéria Carótida Externa , Neoplasias Faciais/irrigação sanguínea , Feminino , Seguimentos , Hemangioma/irrigação sanguínea , Humanos , Lactente , Álcool de Polivinil/uso terapêutico , Silicones , Doenças Vasculares/terapiaRESUMO
Reporting 3 cases of hemangiomas of the maxillo-facial area the authors describe, proper use, of RBc scintigraphy, CT with contrast media, MR, angio-MR. Comparing these methods it will results that RBc scintigraphy is a very useful method in a screening phase providing data concerning kind of blood flow, morphology of lesions and also detecting unknown lesions by total body scanning. CT imaging with contrast media is a useful method in a presurgical phase providing the exact anatomical limits of the lesions especially when involving bone tissue. MR imaging provides precise anatomic limits specially for low flow lesions; it also provides a vascular map of the arterial afferent vessels in high flow vascular lesions, without any use of ionogenic radiations. For these reasons MR is advisable in pediatric age and allergic patients. Super-selective embolization, sclerosant therapy and surgery therapy are indicated for treatment of high flow and low flow hemangiomas.
Assuntos
Neoplasias Faciais/diagnóstico , Hemangioma/diagnóstico , Neoplasias Maxilomandibulares/diagnóstico , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Adulto , Eritrócitos/diagnóstico por imagem , Neoplasias Faciais/irrigação sanguínea , Feminino , Câmaras gama , Hemangioma/irrigação sanguínea , Humanos , Neoplasias Maxilomandibulares/irrigação sanguínea , Angiografia por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Cintilografia , Tomografia Computadorizada por Raios XRESUMO
The search for vascular structures in skin tumors by incident light microscopy has revealed a surprisingly high proportion of vascularized tumours. Characteristic vascular patterns, in some cases highly tumour-specific, have been defined. The vascular structure is a valuable feature for characterization and differentiation of skin tumours, especially for amelanotic malignant melanoma. We propose a flowchart procedure for analysis and diagnosis of skin tumours using incident light microscopy, which appears to be valuable for advanced image analytic techniques.
Assuntos
Carcinoma Basocelular/diagnóstico , Melanoma/irrigação sanguínea , Microscopia/instrumentação , Nevo/irrigação sanguínea , Neoplasias Cutâneas/irrigação sanguínea , Capilares/patologia , Carcinoma Basocelular/irrigação sanguínea , Diagnóstico Diferencial , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/diagnóstico , Humanos , Melanoma/diagnóstico , Neovascularização Patológica/diagnóstico , Neovascularização Patológica/patologia , Nevo/diagnóstico , Neoplasias Cutâneas/diagnóstico , Telangiectasia/diagnósticoRESUMO
Twelve patients with hemangiomas of maxillofacial soft tissues aged 9 months to 15 years were examined by B-mode echography and color doppler imaging of the bloodstream. Combination of these two methods helps confirm the presence of a vascular neoformation, assess its dissemination, volume, and syntopy, specify the morphological variant of its structure, evaluate bloodstream velocity in various parts of the neoplasm. The notion of bloodstream intensity is introduced for the first time, reflecting the number of actively functioning vessels per unit of tumor volume. Causes of artefact appearance have been detected and approaches to their elimination out outlined. Echographic signs permitting selection of the optimal treatment strategy for each patient have been defined.
Assuntos
Neoplasias Faciais/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Adolescente , Artefatos , Criança , Pré-Escolar , Estudos de Avaliação como Assunto , Neoplasias Faciais/irrigação sanguínea , Humanos , Lactente , Neoplasias de Tecidos Moles/irrigação sanguínea , Ultrassonografia , Ultrassonografia DopplerRESUMO
513 cases with vascular lesions of oral and maxillofacial regions were followed from 1986 to 1990 by history, physical examination and pathological check. The vascular anomalies which had been termed "hemangioma" in the past were diagnosed anew according to new biological classification of vascular lesions proposed by Mulliken and Glowacki. Hemangioma and vascular malformation were completely different in clinical behavior and endothelial cell characteristics. Hemangiomas are often not present at birth, but appear during the 1st month. Its clinical behavior is that a proliferative phase is followed by a slow involution. Vascular Malformations are always present at birth and never regress, therefore the treatment of hemangioma and vascular malformation is different.
Assuntos
Neoplasias Faciais/irrigação sanguínea , Hemangioma/irrigação sanguínea , Neoplasias Bucais/irrigação sanguínea , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Neoplasias Maxilomandibulares/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Endotélio Vascular/patologia , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/patologia , Hemangioendotelioma/patologia , Recidiva Local de Neoplasia/patologia , Adulto , Diagnóstico Diferencial , Neoplasias Faciais/diagnóstico por imagem , Gadolínio DTPA , Hemangioendotelioma/diagnóstico por imagem , Humanos , Hiperplasia , Imageamento por Ressonância Magnética , Masculino , Compostos Organometálicos , Ácido Pentético/análogos & derivados , CintilografiaRESUMO
The authors reported previously a new technique using a low power argon-pumped tunable dye laser at a wave-length of 577nm (yellow light) to treat port-wine stains in adults. The authors report their results using this same technique as a form of treatment for 92 children with facial port-wine stains.
Assuntos
Neoplasias Faciais/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Hemangioma/cirurgia , Terapia a Laser/métodos , Adolescente , Argônio , Criança , Pré-Escolar , Corantes , Neoplasias Faciais/irrigação sanguínea , Neoplasias Faciais/patologia , Feminino , Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/patologia , Hemangioma/irrigação sanguínea , Hemangioma/patologia , Humanos , Masculino , Indução de RemissãoRESUMO
Twelve patients with port wine stains (both untreated and treated with argon laser) had their microcirculation monitored by laser Doppler flux at rest and after arterial occlusion lasting one minute. The blood cell flux was measured in normal, untreated and treated skin areas. The resting flux was significantly higher in untreated port wine stains than in the normal skin. The reactive hyperemia response was significantly impaired in the untreated skin, although a 60% increase in blood cell flux was achieved by the short arterial occlusion. In most of the recorded parameters the treated areas showed a less pathological reaction than the untreated ones. We conclude that peroperative vasodilation can be induced in port wine stains, and this may be used to improve the outcome of argon laser treatment.