RESUMO
Portal cavernoma thrombosis is a complication of portal cavernoma. We describe the case of a 74-year-old patient who presented to the emergency department with abdominal pain. The computed tomography scan showed a mass from the head of the pancreas to the hepatic hilum not enhanced after injection of iodinated contrast. There was no dilatation of the bile ducts. Abdominal magnetic resonance ruled out a tumour and confirmed a portal cavernoma thrombosis. In 50 % of cases the etiology of the portal cavernoma is unknown. It is often asymptomatic. It may be discovered in case of complications of portal hypertension. In rare cases the portal cavernoma can compress the bile ducts. To our knowledge, portal cavernoma thrombosis has only been described in one article. It is important to search for a thrombophilic disorder when such a complication is found. We share this case report in order to raise awareness in the medical community about this rare complication.
La thrombose de cavernome portal est une complication du cavernome porte. Nous décrivons le cas d'un patient de 74 ans qui s'est présenté aux urgences pour des douleurs abdominales. La tomodensitométrie montrait un syndrome de masse de la tête du pancréas jusqu'au hile hépatique non rehaussé après injection de produit de contraste iodé. Il n'y avait pas de dilatation des voies biliaires. Une imagerie par résonance magnétique abdominale a permis d'infirmer l'hypothèse d'une masse tumorale et d'affirmer une thrombose du cavernome porte. Dans 50 % des cas, l'étiologie du cavernome portal est inconnue. Il est souvent asymptomatique. Il peut être découvert en cas de complications à la suite d'une hypertension portale. Dans de rares cas, le cavernome portal peut comprimer les voies biliaires. À notre connaissance, la thrombose de cavernome portal n'a été décrite que dans un seul article. Il est important de rechercher un désordre thrombophilique quand une telle complication est retrouvée. Nous partageons ce cas clinique afin de sensibiliser la communauté médicale à cette rare complication.
Assuntos
Veia Porta , Humanos , Idoso , Veia Porta/diagnóstico por imagem , Masculino , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/diagnóstico , Trombose Venosa/etiologia , Trombose Venosa/diagnóstico , Trombose Venosa/diagnóstico por imagem , Hipertensão Portal/etiologia , Hipertensão Portal/complicações , Trombose/etiologia , Trombose/diagnóstico por imagem , Trombose/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Pure epidural spinal cavernous hemangiomas are rare, benign vascular tumors that account for approximately 4% of all spinal epidural tumors. Due to their dumbbell shape and propensity for foraminal invasion, they are often misdiagnosed and inadequately treated. We present a case of a 58-year-old male with extra-osseous cavernous hemangioma to better aid in diagnosis and management of these lesions. CASE PRESENTATION: A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. He underwent resection with histopathologic exam revealing a pure epidural cavernous hemangioma. CONCLUSION: Spinal epidural cavernous hemangiomas are exceedingly rare lesions that are often misdiagnosed as nerve sheath tumors and meningiomas. Common features include chronic pain and myelopathy as well as T1 isodensity, T2 hyperintensity, and homogenous enhancement. Uniquely, they present as a lobulated, spindled shape with tapered ends in the dorsal epidural space. Both gross and subtotal resection result in favorable neurologic outcomes.
Assuntos
Hemangioma Cavernoso , Doenças da Medula Espinal , Vértebras Torácicas , Humanos , Masculino , Pessoa de Meia-Idade , Vértebras Torácicas/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/patologia , Neoplasias Epidurais/cirurgia , Neoplasias Epidurais/diagnóstico , Neoplasias Epidurais/patologia , Neoplasias Epidurais/complicações , Imageamento por Ressonância MagnéticaRESUMO
Vascular conjunctival tumors are uncommon, usually benign lesions. Here, we report a 65-year-old male who presented with a nasal interpalpebral bulbar firm, oval, and dark-brown and non-mobile conjunctival mass. The systemic and ocular examinations including fundoscopy and gonioscopy were within normal limits. With a diagnosis of conjunctival malignant melanoma (CMM), the patient underwent excisional biopsy, partial sclerectomy, and cryotherapy. Microscopic examination revealed dilated vascular channels filled by red blood cells, separated by fibrous interstitium and no sign of malignancy. Therefore, a diagnosis of conjunctival cavernous hemangioma was made. Our case demonstrates that the conjunctival cavernous hemangioma can mimic malignant conjunctival lesions as well as extrascleral extension of uveal melanoma or uveal prolapse due to scleral necrosis.
Assuntos
Neoplasias da Túnica Conjuntiva , Hemangioma Cavernoso , Humanos , Masculino , Idoso , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/patologia , Diagnóstico Diferencial , Túnica Conjuntiva/patologiaRESUMO
Cavernous hemangioma, currently known as "cavernous venous malformation," is a common, benign, non-infiltrative, slowly progressive vascular malformation of the orbit presenting in adults. We report the case of a 9-year-old girl who presented with a painless palpable mass over the right upper eyelid of 7 years' duration. A computed tomography scan of the orbits revealed a heterogeneously enhancing, well-circumscribed mass in the right upper eyelid with no orbital extension. A transcutaneous excisional biopsy with histopathology disclosed cavernous venous malformation. The majority of cavernous venous malformations are intraconal and present in the fourth to fifth decade of life.
Assuntos
Hemangioma Cavernoso , Neoplasias Orbitárias , Malformações Vasculares , Adulto , Feminino , Humanos , Criança , Neoplasias Orbitárias/patologia , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/cirurgia , Hemangioma Cavernoso/patologia , Órbita/patologia , Malformações Vasculares/diagnóstico , Pálpebras/patologiaAssuntos
Neoplasias de Cabeça e Pescoço , Hemangioma Cavernoso , Neoplasias das Glândulas Salivares , Humanos , Diagnóstico Diferencial , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Masculino , Feminino , Adulto , Pessoa de Meia-IdadeRESUMO
PURPOSE: Herein, we reported a case of retinal cavernous hemangioma (RCH) and its multimodal imaging. CASE PRESENTATION: Many grape-like lesions were incidentally found along the distal portion of the vascular arcade in a 23-year-old man's superonasal quadrant of the retina. The best-corrected visual acuity was 20/20 in both eyes. The fluorescein angiography showed saccular lesions that slowly filled with hypofluorescence in the early stage and clusters of aneurysms with hyperfluorescence and a special "fluorescein cap" appearance in the late stage. The optical coherence tomography angiography (OCTA) B-scan revealed multilocular cavernous spaces with different sizes in the inner retinal layers, varying signals, and an epiretinal membrane. The enface OCTA of retina showed grape-like changes and multiple highly reflective signal cavities with clear and complete boundaries. CONCLUSION: Different multimodal images are better for understanding the characteristics of RCH and more convenient for its diagnosis and follow-up.
Assuntos
Angiofluoresceinografia , Hemangioma Cavernoso , Imagem Multimodal , Neoplasias da Retina , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Masculino , Angiofluoresceinografia/métodos , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto Jovem , Fundo de OlhoRESUMO
A 37-year-old female patient was admitted to the hospital with a large liver mass, diagnosed as hepatic inflammatory myofibroblastic tumour (HIMT), characterized by unique radiographic features and predominantly occurring in adults. HIMT consists of myofibroblast spindle cells infiltrated by plasma cells and/or lymphocytes, with an unclear aetiology linked to factors like infection and immune response. Treatment typically involves surgical resection, with chemotherapy or targeted therapy options for cases of incomplete resection or metastasis, emphasizing the need for precise diagnosis and tailored treatment strategies.
Assuntos
Hemangioma Cavernoso , Neoplasias Hepáticas , Neoplasias de Tecido Muscular , Adulto , Feminino , Humanos , Diagnóstico Diferencial , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologia , Neoplasias de Tecido Muscular/diagnóstico , Neoplasias de Tecido Muscular/cirurgia , Neoplasias Hepáticas/patologiaRESUMO
Cavernomas are histologically benign vascular malformations found at different sites in the brain. A rare site for such cavernomas, however, is the anterior optic pathway, comprising the optic nerve, chiasma, and optic tract-called optochiasmatic cavernomas (OCC). These lesions usually present with sudden onset or progressive vision loss, headache, and features mimicking pituitary apoplexy. In this paper, we describe a case of OCC operated at our center. We carry out an updated review of literature depicting cases of OCC, their clinical presentation, management, and postoperative complications. We also propose a novel classification system based on lesion location and further analyze these cavernoma types with respect to the surgical approach used and visual outcome. A 30-year-old lady had presented with a 3-week history of progressive bilateral vision loss and headache. Based on imaging, she was suspected to have a cavernous angioma of the chiasma and left optic tract. Due to progressive vision deterioration, the lesion was surgically excised using pterional craniotomy. Postoperatively, her visual symptoms improved, but she developed diabetes insipidus. Clinical and radiological follow-up has been done for 18 months after surgery. A total of 81 cases have been described in the literature, including the present case. Chiasmal apoplexy is the most common presentation. Surgical excision is the standard of care. Our analysis based on lesion location shows the most appropriate surgical approach to be used for each cavernoma type. Visual outcome correlates with the preoperative visual status. Visual outcome is good in patients presenting with acute chiasmal apoplexy, and when complete surgical excision is performed. The endonasal endoscopic approach was found to provide the best visual outcome. In addition to preoperative visual status, complete surgical excision predicts favorable visual outcomes in OCC. Our proposed classification system guides the appropriate surgical approach required for a particular location of the cavernoma.
Assuntos
Hemangioma Cavernoso , Adulto , Feminino , Humanos , Cefaleia , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/cirurgia , Hemangioma Cavernoso/patologia , Quiasma Óptico/cirurgia , Nervo Óptico , Acidente Vascular Cerebral , Transtornos da Visão/etiologiaRESUMO
The cervix of the uterus is a rare site for cavernous hemangiomas. Cervical hemangiomas are slow-growing tumors with characteristic histological findings, including dilated vessels with increased endothelial cells. Although their pathophysiology remains unclear, hormones are believed to play an important role in the development of these vascular tumors. They may be asymptomatic due to their small size, but they can cause gynecological and obstetrical complications, including abnormal uterine bleeding and impaired fertility. Due to their small size, conservative treatment is the first line of management. Hysterectomy is considered for refractory cases or for patients who are not of childbearing age. In this study, firstly, we presented a case of a 60-year-old postmenopausal female without any gynecological-related signs or symptoms with a polypoid nodule hanging over the anterior cervical wall through its stalk. The surgical biopsy revealed no signs of neoplastic changes, with the only notable finding being a benign vascular lesion representing a cavernous hemangiomatous cervical polyp. The patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy and she is currently healthy without any further abnormal findings. Additionally, we provided a comprehensive review of 137 cases in the literature since 1883, detailing their characteristics, signs and symptoms, and pathology.
Assuntos
Hemangioma Cavernoso , Hemangioma , Feminino , Humanos , Pessoa de Meia-Idade , Colo do Útero/patologia , Células Endoteliais/patologia , Hemangioma/cirurgia , Hemangioma/complicações , Hemangioma/patologia , Útero/patologia , Hemangioma Cavernoso/cirurgia , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologiaRESUMO
Cavernous hemangioma is a benign vascular tumor occurring in all parts of the urinary system, including the kidney, bladder, prostate, ureter, and rarely urethra. Urethral cavernous hemangiomas are mostly seen in male patients, and only a few cases of female urethral hemangiomas are reported. Herein, we present the management and follow-up course of 3 cases of female urethral cavernous hemangioma. All 3 cases were menopause women complaining of lower urinary tract symptoms. Definitive diagnosis is made by histopathologic evaluation. In case of large or pedunculated masses, initial surgical resection is highly recommended. Regular follow-up of patients in order to prevent any recurrence is suggested.
Assuntos
Hemangioma Cavernoso , Hemangioma , Humanos , Feminino , Masculino , Uretra/cirurgia , Uretra/patologia , Seguimentos , Hemangioma Cavernoso/cirurgia , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologia , Hemangioma/diagnóstico , Hemangioma/patologia , Hemangioma/cirurgia , Bexiga Urinária/patologiaRESUMO
BACKGROUND Hemangiomas are defined as benign soft tissue vascular tumors that are histologically classified as capillary, cavernous, or mixed types. Hemangiomas can also be described based on clinical appearance as superficial, mixed, or deep lesions. Following a thorough search, only 3 case reports of superficial protruding lip mass were found in the literature. Other cases of tongue hemangioma have been reported in infants or young toddlers, and only rarely in adults. CASE REPORT The first case was a 43-year-old pregnant woman, with an unremarkable medical and surgical history, in the second trimester who presented to the Otolaryngology Clinic with a chief concern of a progressively growing lesion, measuring 0.7×0.5 cm, over the lateral right side of the tongue for the last 2 weeks after accidentally biting her tongue during dinner. The second case was a 26-year-old woman with unremarkable medical and surgical history who presented to our Otolaryngology Clinic with a chief concern of a non-painful soft fungating pink-red lip lesion 1.5×1 cm across the right lower lip growing for the last 4 months. This lesion appeared during the third trimester of pregnancy following a lip injury that was described as minor trauma. CONCLUSIONS Although hemangiomas can occur anywhere on the body, they are most commonly found in the head and neck. These lesions are usually recognized quickly by patients and treating physicians and are thus clinically diagnosed. Most vascular benign lesions regress on their own, but if detected early, they are surgically excised for cosmetic and functional reasons.
Assuntos
Hemangioma Cavernoso , Hemangioma , Adulto , Feminino , Gravidez , Humanos , Hemangioma/diagnóstico , Hemangioma/cirurgia , Veias/patologia , Nariz , Assistência ao Paciente , Hemangioma Cavernoso/diagnósticoRESUMO
Background: Hepatic hemangioma represents the most frequent benign tumor originating from the liver. When the tumor exceeds 10 cm, and in some studies 4 or 5 cm, it is considered giant, which accounts for 10% of all hemangiomas arising from the liver. Histologically, Sclerosing hepatic hemangioma, in particular, is an exceedingly rare subtype of hemangioma. Clinically Bornman-Terblanche-Blumgart syndrome is a very rare complication of hepatic hemangioma. Objective: The aim of this case presentation was to contribute to the literature by documenting a case of giant sclerosing hemangioma diagnosed in a 36-year-old female presenting with Bornman-Terblanche-Blumgart syndrome, along with a brief review of the literature. Case report: The current paper documents two rare clinical and histological features of hepatic hemangioma. Bornman-Terblanche-Blumgart syndrome is complicated a giant hepatic hemangioma found histologically to be sclerosing in nature. Knowledge about the uncommon complications of liver hemangioma permits the implementation of appropriate interventions in a timely manner and, in turn, can enhance the patient's quality of life and minimize rates of associated mortality.
Assuntos
Hemangioma Cavernoso , Hemangioma , Histiocitoma Fibroso Benigno , Neoplasias Hepáticas , Feminino , Humanos , Adulto , Qualidade de Vida , Hemangioma/complicações , Hemangioma/diagnóstico , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologiaRESUMO
Cavernous hemangioma of the retina - a rarely occurring hamartoma that is predominantly found in the young age; it can be accompanied by cavernous hemangiomas of the skin and central nervous system. In Russian scientific literature this disease has not been described in sufficient detail. The article presents two clinical cases of incidentally diagnosed cavernous hemangioma of the retina. Multimodal diagnostics approach was used to confirm histological findings described in literature, which are characteristic of retinal cavernous hemangioma.
Assuntos
Hamartoma , Hemangioma Cavernoso , Humanos , Retina , Hemangioma Cavernoso/diagnóstico , Federação Russa , PeleRESUMO
BACKGROUND Vaginal wall hemangiomas are extremely rare, benign, vascular tumors of the female genitalia. Most cases occur in childhood, but a few cases can be acquired; however, the mechanism of hemangioma formation remains unknown. Most hemangiomas involving female genital organs are small and asymptomatic. However, huge hemangiomas can cause irregular genital bleeding, infertility, and miscarriage. Surgical excision and embolization are the most common treatment options. We reveal that sclerotherapy achieved good outcomes in a patient with an intractable huge vaginal wall hemangioma. CASE REPORT A 71-year-old woman visited a local doctor with concerns of frequent urination. A ring pessary was inserted after a diagnosis of pelvic organ prolapse. However, symptoms did not improve, and the patient consulted another hospital. The previous physician diagnosed vaginal wall tumors and prolapse and performed a colporrhaphy. However, she was referred to our hospital with heavy intraoperative bleeding. Imaging examination revealed a huge hemangioma on the vaginal wall, which was histologically diagnosed as a cavernous hemangioma. Angiography revealed hemorrhage in the right peripheral vaginal artery. Owing to concerns regarding extensive vaginal wall necrosis caused by arterial embolization, sclerotherapy using monoethanolamine oleate was selected. Hemostasis was achieved 1 month after sclerotherapy, and postoperative imaging showed the lesion had shrunk in size. No recurrence of hemangioma was observed 19 months after surgery. CONCLUSIONS We report a case of a large vaginal wall intractable bleeding hemangioma. Sclerotherapy can be a suitable treatment option for large vaginal hemangiomas that are too extensive to be treated using surgery or arterial embolization.
Assuntos
Hemangioma Cavernoso , Hemangioma , Feminino , Humanos , Idoso , Escleroterapia/métodos , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/terapia , Hemangioma Cavernoso/diagnóstico , Hemangioma/diagnóstico , Vagina , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapiaRESUMO
A 12-year-old male neutered Australian Shepherd Dog was presented to Charlotte Animal Referral & Emergency with a history of a thoracic mass. On physical examination, physiological parameters were within the normal ranges, and a complete haemogram and serum biochemistry profile were unremarkable except for mild thrombocytopenia. A computed tomography scan revealed a 21 × 15 × 12.7 cm thoracic mass encompassing the cranial mediastinum and extending to the right caudal thorax. The mass was surgically removed and histopathological evaluation revealed that it comprised remnants of the thymus and a neoplasm composed of large blood-filled vascular spaces lined by a single layer of endothelial cells with mild anisocytosis and anisokaryosis. The neoplastic cells had diffuse strong immunolabeling for endothelial cell marker CD31. Multifocally, there were large cystic degenerated areas of thymic tissue lined by plump cytokeratin AE1/AE3-positive epithelial cells. Based on these findings, a diagnosis of thymic cavernous haemangioma (CH) was made. Thymic CH is rare in animals, with the only reported case in a cross bred cow. To our knowledge, this is the first case of a thymic CH in a dog.
Assuntos
Doenças dos Bovinos , Doenças do Cão , Hemangioma Cavernoso , Masculino , Feminino , Bovinos , Cães , Animais , Células Endoteliais/patologia , Austrália , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/veterinária , Doenças do Cão/patologia , Tomografia Computadorizada por Raios XAssuntos
Adenocarcinoma de Pulmão , Hemangioma Cavernoso , Neoplasias Pulmonares , Neoplasias do Mediastino , Humanos , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagem , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/patologia , Mediastino/diagnóstico por imagem , Mediastino/patologia , Adenocarcinoma de Pulmão/complicações , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnósticoRESUMO
BACKGROUND: Cavernous hemangioma is a rare benign tumor which can sometimes mimic the clinical presentation and radiological findings of malignant tumors. Here we present a rare presentation of cavernous hemangioma in the mediastinum (CHM), along with a literature review among the main databases. CASE PRESENTATION: We present a 48-year-old male who had suffered from persistent cough as the sole symptom of an anterior CHM. Computed tomography scan demonstrated a 12.5 × 10.8 cm mass in the anterior mediastinum. The mass was surgically resected, and histopathological evaluation established the diagnosis of CHM. The patient was discharged in good condition, in which during his four-month follow-up period, no recurrence of the tumor has been observed. CONCLUSION: Although cavernous hemangioma rarely present in the mediastinum, it should be considered in the differential diagnosis of mediastinal tumors. However, our review of literature demonstrated a female dominance and average age of 40 years, with a 52% mortality rate based on previous reports.