الملخص
Os hemangiomas são neoplasias benignas dos tecidos moles. São lesões caracterizadas pela proliferação de células endoteliais. Objetivos: O objetivo deste trabalho é demonstrar por meio de uma revisão da literatura os principais hemangiomas de interesse odontológico e suas características clínicas e abordagens terapêuticas. Revisão de literatura: O estudo mostrou prevalência de até 6% na população geral, sendo o tumor mais comum na infância. Essas lesões apresentam rápido crescimento pós-natal, que pode levar meses a dois anos em média, mas geralmente após esse período ocorre sua involução. O diagnóstico é comumente baseado nas características clínicas e na história do paciente. É importante entender que o estudo histopatológico pode ser necessário nos casos em que o diagnóstico é incerto, para diferenciá-lo de outras neoplasias graves. Destacam-se as principais complicações relacionadas a lesões, ulcerações e hemorragias, além de infecções secundárias que podem causar alto índice de morbidade. Assim, é fundamental que o dentista reconheça essas patologias e tenha capacidade para tratá-las. Considerações finais: Foi possível observar que os hemangiomas são manifestações vasculares incomuns para o cirurgião-dentista, porém o profissional deve saber diagnosticá-los e tratá-los. Dentre as áreas acometidas, essas lesões são frequentes na cavidade oral e o tratamento consiste em acompanhamento com intervenções conservadoras(AU)
Hemangiomas are benign soft tissue neoplasms. These are lesions characterized by the proliferation of endothelial cells. Objectives: The objective of this work is to demonstrate through a literature review about the main hemangiomas of dental interest and clinical characteristics and therapeutic approaches. Literature review: The study showed a prevalence of up to 6% in the general population, being the most common tumor in childhood. These lesions presents a rapid postnatal growth, which may take months until two years on average, but usually after this period their involution occurs. The diagnosis is commonly based on clinical characteristics and patient's history. It is important to understand that the histopathological study may be necessary in cases that the diagnostic is uncertainty, in order to differentiate it from other serious neoplasms. Main complications related to injuries, ulceration and hemorrhage can be highlighted, in addition to secondary infections that can cause a high rate of morbidity. Thus, it is essential that dentists recognize such pathologies and be able to treat them. Final considerations: Was possible do observe that hemangiomas are uncommon vascular manifestations for the dental surgeon, however, the professional must know to diagnose and treat them. Among the affected areas, these lesions are frequently seen in the oral cavity and the treatment consists of following up with conservative interventions(AU)
الموضوعات
Soft Tissue Neoplasms , Mouth Neoplasms , Hemangioma , Hemangioma/diagnosis , Hemangioma/therapy , Cell Proliferation , Mouth/injuries , Neoplasmsالملخص
ABSTRACT BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.
الموضوعات
Arteriovenous Malformations/therapy , Port-Wine Stain/surgery , Hemangioma/therapy , Brazil , Systematic Reviews as Topicالملخص
RESUMO O hemangioma de coroide é um tumor vascular benigno, de coloração vermelho-alaranjada, bem delimitado, caracterizado por uma placa elevada. É um tumor raro, com prevalência de um caso a cada 40 tumores de coroide. O diagnóstico pode ser feito por meio da clínica associada à avaliação biomicroscópica e a exames complementares para diferenciação de outros tumores. O tratamento pode ser expectante nos casos assintomáticos. Para os casos sintomáticos ou com presença de fluido sub-retiniano, existem diversas terapias. O objetivo deste estudo foi relatar um caso de hemangioma circunscrito de coroide submetido a tratamento combinado de terapia fotodinâmica com verteporfina e injeção intravítrea de antiangiogênico (bevacizumabe). A decisão de tratar um hemangioma de coroide deve ser individualizada com base nos sintomas, na perda visual e em qualquer potencial de sua recuperação. O exame oftalmológico completo é necessário, mesmo em casos assintomáticos, para rastreamento precoce de doenças oculares.
ABSTRACT Choroid hemangioma is a benign, well-delimited orange-red, vascular tumor characterized by an elevated plaque. It is a rare tumor with a prevalence of one case in every 40 choroidal tumors. It can be diagnosed by the clinic associated with biomicroscopic evaluation and complementary tests to differentiate from other tumors. Treatment can be expectant in asymptomatic cases. For symptomatic cases or those with the presence of subretinal fluid, there are several therapies. The objective of this study was to report a case of circumscribed choroidal hemangioma submitted to combined treatment of photodynamic therapy with verteporfin and intravitreal injection of an antiangiogenic agent (bevacizumab). The decision to treat choroidal hemangioma must be individualized based on symptoms, visual loss, and any potential for recovery. A complete eye examination is necessary, even in asymptomatic cases, for early screening for eye diseases.
الموضوعات
Humans , Male , Middle Aged , Photochemotherapy/methods , Choroid Neoplasms/diagnosis , Choroid Neoplasms/therapy , Tomography, Optical Coherence , Bevacizumab/therapeutic use , Verteporfin/therapeutic use , Hemangioma/diagnosis , Hemangioma/therapy , Fluorescein Angiography , Choroid Neoplasms/pathology , Ultrasonography , Angiogenesis Inhibitors/therapeutic use , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Drug Therapy, Combination , Hemangioma/pathologyالملخص
Resumo As alterações vasculares ocorrem frequentemente em região de cabeça e pescoço, sendo o hemangioma a mais comum. Paciente do sexo feminino, 61 anos, queixou-se de dor intensa em palato duro. Notou-se lesão arroxeada, de 1,5 cm, sensível à palpação e com histórico de hemorragia. A paciente era edêntula total, e a prótese total superior comprimia o local da lesão. Foi realizada a vitropressão, confirmando a origem vascular. A hipótese diagnóstica foi de hemangioma. Na primeira sessão, aplicou-se o laser vermelho (660 nm) em quatro pontos ao redor da lesão, sendo 0,5 J em cada ponto afim de se obter analgesia e iniciar o processo de reparo, além do reembasamento da prótese total superior. Na segunda sessão, foi feita aplicação de 2 mL de oleato de monoetanolamina 5%. Após 14 dias, observou-se regressão total da lesão. Os cirurgiões-dentistas devem estar aptos a reconhecer, diagnosticar e tratar as lesões vasculares em cavidade oral.
Abstract Vascular changes frequently involve the head and neck region and hemagioma is the most common. A 61-year-old female patient complained of severe pain in the hard palate. A purple lesion was found, measuring 1.5 cm, sensitive to palpation, and with a history of hemorrhage. The patient was fully edentulous and her upper denture compressed the lesion site. Diascopy confirmed the lesion's vascular origin. A diagnostic hypothesis of hemangioma was raised. In the first session, red laser light (660nm) was applied at 4 points around the lesion, with 0.5 J at each point, in order to obtain analgesia and trigger the repair process. The upper denture was also relined. In the second session, 2 mL of 5% monoethanolamine oleate was applied. After 14 days, total regression of the lesion was observed. Dental surgeons must be able to recognize, diagnose and treat vascular lesions in the oral cavity.
الموضوعات
Humans , Female , Middle Aged , Sclerotherapy/methods , Palate, Hard/injuries , Low-Level Light Therapy , Vascular System Injuries/therapy , Hemangioma/therapy , Mouth, Edentulous , Oral Medicine , Palate, Hard/blood supply , Denture, Complete, Upper , Hemangioma/diagnosisالملخص
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.
الموضوعات
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 supplyالملخص
Resumen Los hemagiomas infantiles (HI) son los tumores de tejidos blandos más frecuentes de la infancia. Se caracterizan por un crecimiento significativo durante los primeros meses de vida, seguido de una involución lenta y espontánea a lo largo de un periodo que puede durar algunos años. Usualmente, la regresión de la mayor parte del tumor termina a los 4 años de edad. Sin embargo, algunos de los HI desarrollan complicaciones, lo que resulta en alteraciones funcionales, dolor y desfiguramiento. La decisión de administrar tratamiento a un paciente con HI y elegir la mejor opción terapéutica para ese paciente (tratamiento tópico o sistémico) debe ser individualizada, dependiendo de varios factores: el tamaño de la lesión, la localización, la presencia de complicaciones como ulceración, el riesgo de cicatrización o desfiguramiento, la edad del paciente, la tasa de crecimiento o de involución al momento del diagnóstico, los riesgos y beneficios de administrar el tratamiento, la disponibilidad del medicamento, los costos y la experiencia del médico tratante.
Abstract Infantile hemagiomas (IH) are the most common soft tissue tumors in infancy. They are characterized by significant growth during the first months of life, followed by slow spontaneous involution over the ensuring years. The process of involution takes several years, but usually the regression of most of the tumors ends at 4 years of age. Unfortunately, some of the IH develop complications, resulting in functional impairment, pain and disfigurement. The decision to start treatment and the choice of the best therapeutic option (topic or systemic) should be individualized depending on several factors: the size of the lesion, the location, the presence of complications such as ulceration, the risk of scarring or disfigurement, the age of the patient, the rate of growth or regression at the time of diagnosis, the risks and benefits of the treatment, the availability of the medication, the costs, and the experience of the attending physician.
الموضوعات
Child, Preschool , Humans , Infant , Cicatrix/etiology , Hemangioma/therapy , Age Factors , Hemangioma/complications , Hemangioma/pathologyالملخص
Se describe el caso clínico de un recién nacido, asistido en el Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, sin antecedentes patológicos maternos ni familiares, quien presentaba macrocefalia, asimetría de los miembros inferiores, marcada hipertrofia en el miembro inferior izquierdo y macrodactilia, así como angiomas cutáneos en el área inferior del tronco, en el abdomen, la región glútea y las piernas. Luego de una evaluación detallada por parte de un equipo multidisciplinario, que se basó en el cuadro clínico y el estudio radiográfico, se diagnosticó el síndrome de Klippel-Trenaunay. El paciente ha mantenido una evolución favorable hasta el momento actual y se continúa un estricto seguimiento médico.
The case report of a newborn, assisted in Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba is described, without maternal or family pathological history who presented macrocephalic asymmetry of the lower members, marked hypertrophy in the left low member and macrodactilia, as well as cutaneous angiomas in the lower area of the trunk, abdomen, buttocks region and legs. After a detailed evaluation by a multidisciplinary team which was based on the clinical pattern and radiographical study, the Klippel-Trenaunay syndrome was diagnosed. The patient has maintained a favorable clinical course up to now and a strict medical follow-up is carried out.
الموضوعات
Humans , Male , Infant, Newborn , Klippel-Trenaunay-Weber Syndrome/diagnosis , Hemangioma/therapy , Hyperostosis , Interdisciplinary Researchالملخص
Hemangioma é um tumor frequente, geralmente diagnosticado em crianças, constituindo quase 10% das neoplasias benignas. Um hemangioma com crescimento na parede de um vaso é extremamente raro, e deve ser diferenciado de outras malformações vasculares de mesma origem. Apresentamos um caso raro de hemangioma de veia jugular externa e discutimos sua propedêutica e manejo
Hemangioma is a common tumor, normally diagnosed in children, and accounting for almost 10% of benign neoplasms. A hemangioma arising from the wall of a vessel is rare, and must be differentiated from other vascular malformations of the same origin. We report a rare case of a hemangioma arising from the wall of an external jugular vein and discuss diagnostic work-up and management
الموضوعات
Humans , Female , Adult , Head and Neck Neoplasms/diagnostic imaging , Hemangioma/therapy , Jugular Veins , Surgical Procedures, Operative/methods , Thrombosis/diagnostic imaging , Diagnostic Imaging/methods , Echocardiography/methods , Rivaroxaban/therapeutic useالملخص
O hemangioma é uma neoplasia de comportamento benigno, determinada pela proliferação anormal de vasos sanguíneos. São lesões assintomáticas, porém, seu crescimento progressivo pode acarretar danos traumáticos locais, ocasionando dor, ulcerações e até sangramentos, que, dependendo da localização, se tornam de difícil controle, principalmente quando de natureza arterial. Com considerável incidência na região de cabeça e pescoço e na cavidade bucal, acomete mais frequentemente a região de mucosa jugal, lábios e língua. Tendo em vista a sua relevância clínica, por estar presente na sua área de atuação e ser relativamente comum, o conhecimento acerca dessa neoplasia benigna é de fundamental importância ao cirurgião-dentista. Entre os recursos terapêuticos, a escleroterapia química tem sido empregada, apresentando resultados satisfatórios tanto clínicos quanto estéticos. Objetivo: apresentar as características clínicas do hemangioma, os métodos de diagnóstico e o tratamento realizado por meio de escleroterapia química. Relato de caso: são descritos dois casos clínicos de hemangiomas, diagnosticados em duas pacientes do sexo feminino, localizados um em lábio superior e outro em mucosa jugal, tratados por meio de injeção de solução esclerosante. Considerações finais: em ambos os casos, foi possível proporcionar a involução das lesões mediante procedimentos não cirúrgicos, favorecendo, no período pós-operatório, o conforto e a estética, demonstrando a eficiência e a segurança na utilização do oleato de monoetanolamina a 5% (Ethamolin ®). (AU)
Hemangioma is a neoplasm of benign behavior, determined by abnormal proliferation of blood vessels. They are asymptomatic lesions, however, their progressive growth can cause local traumatic injuries, causing pain, ulcerations and even bleeding, which, depending on the location, becomes difficult to control, especially when of an arterial nature. With a considerable incidence in the head and neck region, in the oral cavity, it most frequently affects the region of jugal mucosa, lips and tongue. Due to its clinical relevance, because it is present in the area of practice of the dental surgeon and is relatively common, knowledge about this benign neoplasm is of fundamental importance. Among the therapeutic resources, chemical sclerotherapy is employed presenting satisfactory clinical and aesthetic results. Objective: the purpose of this study is to present the clinical characteristics of hemangioma, the diagnostic methods and the treatment performed through chemical sclerotherapy. Case report: this article describes the description of two clinical cases of hemangiomas diagnosed in two female patients, one located in the upper lip and the other in the jugal mucosa treated with sclerosing solution injection. Final considerations: in both cases, it was possible to provide the involution of the lesions by non-surgical procedures, favoring, in the postoperative period, comfort and aesthetics, demonstrating the efficiency and safety in the use of 5% monoethanolamine oleate (Ethamolin®). (AU)
الموضوعات
Humans , Female , Child , Adult , Lip Neoplasms/therapy , Sclerotherapy/methods , Hemangioma/therapy , Mouth Mucosa , Sclerosing Solutions/therapeutic use , Oleic Acids/therapeutic use , Treatment Outcomeالملخص
Los hemangiomas son tumores benignos infrecuentes en la laringe. El tratamiento está indicado cuando el tumor produce síntomas (disnea, hemoptisis, odinofagia) y también cuando el riesgo de hemorragia severa por traumatismo es alto. Tres hemangiomas de laringe e hipofaringe fueron tratados con éxito por vía transoral con láser de C02 y radiofrecuencia. Todos los pacientes se alimentaron por vía oral a las 24/48 horas y ninguno tuvo traqueostomía. La tasa de resección completa de los hemangiomas tratados por vía transoral fue 100%. (AU)
Hemangiomas are a rare type of benign tumors of the larynx. The treatment is indicated when the tumor produces symptoms (dyspnea, hemoptysis, odynophagia) and also when the risk of severe bleeding from trauma is high. Three hemangiomas of the larynx and hypopharynx were successfully treated transorally with C02 laser and radiofrequency. All were orally fed at 24/48 hours, and none had a tracheostomy The complete resection rate of hemangiomas treated transorally was 100%. (AU)
الموضوعات
Humans , Male , Female , Middle Aged , Surgery, Oral/methods , Hypopharyngeal Neoplasms/surgery , Laryngeal Neoplasms/surgery , Hemangioma/surgery , Radio Waves/therapeutic use , Pharyngitis , Treatment Outcome , Dyspnea , Lasers, Gas/therapeutic use , Hemangioma/diagnosis , Hemangioma/etiology , Hemangioma/therapy , Hemoptysis , Hemorrhage/pathologyالملخص
O hemangioma é considerado como uma neoplasia vascular benigna, caracterizado por uma fase de crescimento rápido, com proliferação de células endoteliais, seguida por uma estabilização gradual. A principal queixa dos pacientes portadores dessa neoplasia é referente à estética e, por esse motivo, a escleroterapia vem sendo uma boa opção de tratamento para obter resultados estéticos satisfatórios. Para esse tipo de tratamento, são utilizadas aplicações com oleato de monoetanolamina a 0,05 g/ml (Ethamolin), que promovem a regressão da lesão por fibrose dos espaços endoteliais. No presente artigo, é descrito um relato de caso clínico de uma paciente do sexo feminino, portadora de um hemangioma no lábio superior esquerdo. Foram realizadas três aplicações do agente esclerosante Ethamolin no interior do tumor, até que ele regredisse o suficiente para ser removido cirurgicamente com maior segurança e eficiência. As aplicações com oleato de monoetanolamina proporcionaram a involução do hemangioma de forma rápida e segura, de modo a promover uma esclerose dos vasos tumorais, favorecendo a remoção cirúrgica.
The hemangioma is considered as a benign vascular neoplasm, characterized by a phase of rapid growth, with proliferation of endothelial cells, followed by gradual estabilization. The main complaint of patients with this neoplasm is related to aesthetics and, for this reason, sclerotherapy has been a good treatment option to obtain satisfactory aesthetic results. For this type of treatment, applications with 0.05 g/ml Monoethanolamine Oleate (Ethamolin), which causes regression of the lesion by fibrosis of the endothelial spaces, are used. In the present article a clinical case report of a female patient with a hemangioma in the upper left lip will be described. As a treatment, three applications of the Ethamolin sclerosing agent were performed inside the tumor until it regress to be excised with greater safety and efficiency. The applications with Monoethanolamine Oleate provided a quick hemangioma involution, in order to promote sclerosis of tumor vessels, favoring it surgical removal.
الموضوعات
Humans , Female , Middle Aged , Hemangioma/therapy , Lip Neoplasms/therapy , Oleic Acid/therapeutic use , Oral Surgical Procedures , Sclerosing Solutions/therapeutic use , Sclerotherapy , Vascular Malformations/drug therapyالملخص
Introducción: Los angiomas venosos (AV) son entidades benignas que infrecuentemente presentan síntomas. Objetivo: Reporte de un caso y revisión del tema. Caso clínico: Escolar, de sexo femenino, 6 años, que inicia cefaleas bifrontales frecuentes 3-4 veces por semana, en relación con trabajo académico, de carácter opresivo, no pulsátil, sin náuseas ni vómitos, rango de intensidad entre 4-6/10. Se inició manejo con calendario de cefaleas, apoyo escolar y evaluación psicológica. La tomografía computarizada cerebral solicitada informó de angioma venoso de núcleo caudado izquierdo, razón por la cual se realizó una resonancia magnética cerebral más angiorresonancia que confirmó angioma venoso y excluyó complicación o asociación a otra malformación vascular. La cefalea respondió bien a terapia psicopedagógica y psicológica. La frecuencia de cefaleas disminuyó a 10-12 al año, agrupadas en periodos de mayores demandas académicas. La paciente es controlada durante 12 años, hasta el egreso de la enseñanza media, sin complicaciones y con un buen manejo de la cefalea tensional. Conclusión: En el estudio de una cefalea el hallazgo de un AV puede ser incidental; una vez reunidos los criterios internacionales de cefalea tensional e iniciado el tratamiento para ello, la monitorización de los AV debe ser clínica. Las complicaciones del AV son infrecuentes y el tratamiento quirúrgico es excepcional.
Introduction: Venous angiomas (VA) are benign entities; however infrequent symptomatic cases may occur. Objective: Case report and literature review. Case report: A 6 year old girl was referred with a history of bi-frontal, non-pulsatile, headache with no nausea or vomiting. Headache intensity was 4-6/10. The episodes were frequent, 3-4 times per week. Triggers include academic work. Computed tomography showed a small VA in left caudate nucleus, which was confirmed by a brain MRI, with no evidence of inflammatory or ischaemic changes, or another vascular malformation. Psychological and psycho-pedagogic techniques were used, combined with relaxation and cognitive-behavioural techniques to reduce the intensity and frequency. There was a good outcome, and the headache decreased to 10 episodes per year. The patient was monitored for 12 years until graduation from high school. The VA remained without complications. Conclusions: In the study of a headache, a VA usually is an incidental finding. The International Classification of Headache Disorders III provides specific criteria of frequent episodic tension-type headache, and allows us begin specific therapy for it. Monitoring of non-symptomatic VA cases should be clinical. The surgical management of these entities is exceptional.
الموضوعات
Humans , Female , Child , Adolescent , Tomography, X-Ray Computed/methods , Headache/etiology , Hemangioma/complications , Magnetic Resonance Imaging/methods , Cognitive Behavioral Therapy/methods , Headache/therapy , Headache/diagnostic imaging , Hemangioma/therapy , Hemangioma/diagnostic imagingالملخص
Introdução: o hemangioma da infância é uma proliferação neoplásica benigna de células endoteliais, decorrente de um desequilíbrio na angiogênese. Atinge 10 a 12% das crianças com menos de ano de vida, sendo, portanto, o tumor mais comum da infância. O tratamento, geralmente, é expectante, mas são utilizados, em alguns casos, propranolol oral, corticosteroides, interferon alfa-2a, laserterapia, embolização, imunomoduladores e cirurgia. Descrição do caso: criança do sexo masculino com hemangioma em couro cabeludo de 3 cm de diâmetro. Utilizou-se maleato de timolol 0,5%, solução oftálmica, três gotas duas vezes ao dia na superfície da lesão, durante dois anos. Após um ano de tratamento, a lesão apresentava-se praticamente plana, com involução quase completa e alopecia residual. Nenhum efeito colateral foi observado durante o período de tratamento. Discussão: o hemangioma da infância possui amplo espectro clínico e graus variados de gravidade, o que torna o seu manejo difícil e controverso. Diante do alto número de efeitos colaterais descritos para os tratamentos convencionais, o timolol tópico tem se tornado excelente alternativa para os casos não complicados. Conclusão: o timolol tópico vem sendo uma nova opção terapêutica eficaz e desprovida de efeitos colaterais para o tratamento do hemangioma da infância, sendo capaz de acelerar sua involução e prevenir complicações. Entretanto, é necessário que sejam realizados estudos que padronizem a dosagem terapêutica mais segura e avaliem o real risco x benefício do uso do fármaco no tratamento desse tipo de tumor.(AU)
Introduction: Infantile hemangioma is a benign neoplastic proliferation of endothelial cells, resulting from an imbalance in angiogenesis. Reaches 10-12% of children under one year old, therefore it is the most commom tumor of childhood. Treatment is usually expectant, but in some cases can be used oral propranolol, corticosteroids, interferon alpha-2a, laser therapy, embolization, immunomodulators and surgery. Case report: Male child with scalp hemangioma of 3 cm diameter. It was used eye drop solution of timolol maleate 0.5%, three drops, twice daily, on the surface of the lesion, during two years. After one year, it was almost plane and completely involuted with residual alopecia. No side effects were observed during the treatment. Discussion: Infantile hemangioma has a wide spectrum of clinical presentation and varying degrees of severity, which make it difficult and controversial management. Due to the high number of side effects reported for conventional treatments, topical timolol has become an excellent alternative for uncomplicated cases. Conclusion: Topical timolol has been an effective therapeutic option devoid of side effects for treatment of infantile hemangioma, being able to accelerate tumors involution and to prevent complications. Still, it is necessary studies to standardize the safest therapeutic dose and evaluate the actual risk-benefit ratio of timolol use in treatment of this tumor.(AU)
الموضوعات
Humans , Male , Infant , Scalp , Skin Neoplasms/drug therapy , Timolol/therapeutic use , Head and Neck Neoplasms/drug therapy , Hemangioma/drug therapy , Skin Neoplasms/therapy , Head and Neck Neoplasms/therapy , Hemangioma/therapyالملخص
Introdução: o hemangioma oral é um tumor vascular benigno caracterizado pela proliferação de vasos sanguíneos. Apresenta-se normalmente como mancha ou nódulo arroxeado, cuja coloração varia do vermelho intenso ao roxo, de acordo com a localização e a profundidade no tecido. As principais queixas dos pacientes portadores de hemangiomas são relacionadas ao distúrbio estético, interferências na função mastigatória e, se estiver em área susceptível a trauma, ao risco de hemorragias. O tratamento pode ser através de uma excisão cirúrgica, bem como métodos menos invasivos como a escleroterapia por fármacos, a laserterapia e a crioterapia. Objetivo: relatar um caso de escleroterapia de hemangiomaoral em mucosa jugal tratado no Serviço de Diagnóstico Histopatológico do Curso de Odontologia da Universidade do Vale do Itajaí. Método: o tratamento preconizado foi a escleroterapia pelo fármaco oleato de monoetanolamina a 5% diluído em soro fisiológico, em três aplicações intralesionais. Resultado e conclusão: a terapia esclerosante descrita apresentou-se como técnica segura e confortável ao paciente, tanto economicamente quanto clinicamente, quando utilizada com um correto diagnóstico.
Introduction: oral hemangioma is a benign vascular tumor characterized by proliferation of blood vessels. Usually appears as purplish spot or nodule, whose color ranges from deep red to purple, according to the location and depth in the tissue. The main complaints of patients with hemangiomas are related to the esthetic disturbance, interference with chewing and if it is located in an area prone to trauma, the risk of bleeding. Treatment can be by surgical excision as well as less invasive methods such as sclerotherapy by drugs, laser therapy and criotherapy. Objective: to report a case of sclerotherapy of an oral hemangioma in the oral mucosa treated in the Diagnostic Histopathology Service of the Dental School at the University of Vale do Itajai. Method: the treatment of the sclerotherapy was done using 5% ethanolamine oleate diluted in saline solution in three intralesional applications. Result and conclusion: sclerosing therapy applied to oral hemangiomas shows up a safe and comfortable technique to the patient both economically and clinically when used consistently with a correct diagnosis.
الموضوعات
Humans , Male , Middle Aged , Hemangioma/diagnosis , Hemangioma/therapy , Sclerotherapy/methodsالملخص
ABSTRACT Space-occupying lessions of the liver may be cystic or solid. Ultrasonography is an extremely useful method for initial screening, and suffices for diagnosis of simple hepatic cysts. Complex cysts and solid masses require computed tomography or magnetic resonance imaging for confirmation. Wide surgical excision is indicated in cystadenoma or cystadenocarcinoma. Clinical and epidemiological data are important, as nodules in noncirrhotic livers are more likely to be benign. Hemangiomas, the most common benign tumors, require no follow-up after diagnostic confirmation if they are small and asymptomatic. Patients with giant, symptomatic hemangiomas or compression of adjacent structures should be referred to hepatobiliary centers for potential surgery. The genetic heterogeneity of hepatocellular adenoms and their epidemiology and prognosis prompted classification of these tumors into four subtypes based on histology and immunohistochemistry. The major complications of hepatocellular adenoms are rupture with bleeding and malignant transformation. Rupture occurs in approximately 30% of cases. The main risk factors are tumors size >5 cm and inflammatory subtype. Hepatocellular adenoms may enlarge during pregnancy due to marked hormonal stimulation. As oral contraceptive pills and anabolic steroids have associated with hepatocellular adenoms growth, particularly of the hepatocyte nuclear factor-1 alfa subtype, these drugs should be discontinued. Focal nodular hyperplasia is the second most common benign tumor of hte liver. It is most frequent in women aged 20 to 60, and 70% to 90% of cases are asymptomatic. In the adsence of a central scar and/or other hallmarks of Focal nodular hyperplasia, with uncertainty between this diagnosis and hepatocellular adenoma, liver-specific contrast agentes are indicated.
RESUMO As lesões que ocupam espaço no fígado podem ser císticas ou sólidas. A ultrassonografia é extremamente útil como rastreamento inicial, bastando como método diagnósticos em casos de cistos simples. Em cistos complexos e em nódulos sólidos é necessária a complementação diagnóstica com tomografia computadorizada ou ressonância magnética. Em casos de cistadenoma ou cistadenocarcinoma, a ampla retirada cirúrgica está indicada. Dados clínico-epidemiológicos são importantes, já que nódulos em fígados não-cirróticos têm maiores probabilidades de serem benignos. Para os hemangiomas, tumores benignos mais frequentes, após a confirmação diagnóstica não existe necessidade de acompanhamento sistemático quando os nódulos são pequenos e assintomáticos. Hemangiomas gigantes sintomáticos ou comprimindo órgãos vizinhos devem ser encaminhados a centros de referência para avaliação de intervenção cirúrgica. A heterogeneidade genética nos adenomas hepatocelulares bem como características epidemiológicas e prognósticas motivou sua classificação em quatro subtipos, com base em achados histológicos e de imunohistoquímica. As principais complicações que ocorrem com o adenomas hepatocelulares são ruptura com hemorragia e transformação carcinomatosa. A primeira ocorre em cerca de 30% dos casos e o principal fator de risco para esta complicação são tumores maiores do que 5 cm, do subtipo hiperplasia nodular focal 1A, esses medicamentos devem ser suspensos. A hiperplasia nodular focal é o segundo tumor benigno mais frequente, mais comum nas mulheres entre 20 e 60 anos, sendo assintomáticos em 70% a 90% dos casos. Na ausência de lesão cicatricial central e/ou outros sinais sugestivos de hiperplasi nodular focal, havendo dúvida diagnóstica com adenoma hepatocelular, o uso de contraste hepatespecíficos está indicado.
الموضوعات
Female , Humans , Pregnancy , Liver Neoplasms/diagnosis , Liver Neoplasms/therapy , Adenoma, Liver Cell/diagnosis , Adenoma, Liver Cell/therapy , Brazil , Focal Nodular Hyperplasia/diagnosis , Focal Nodular Hyperplasia/therapy , Hemangioma/diagnosis , Hemangioma/therapy , Societies, Medicalالملخص
Objetivo: reportar tres casos de pacientes con hemangioma de coroides tratados con terapia fotodinámica (TFD) y realizar una revisión de la literatura sobre el tema. Diseño del estudio: estudio retrospectivo intervencionista, tipo serie de casos. Pacientes y metodología: revisión de historias clínicas y de exámenes complementarios de 3 pacientes con diagnóstico de hemangioma de coroides pre y post tratamiento con TFD en la Fundación Oftalmológica Nacional. Resultados: de los 3 casos presentados, dos se presentaron como hemangiomas de coroides circunscritos y uno difuso en un paciente con síndrome de Sturge Weber. En todos los casos se observó mejoría de la agudeza visual, resolución del desprendimiento seroso de retina y regresión del tumor, sin efectos secundarios a la TFD. Conclusiones: el hemangioma coroideo es una patología con una baja incidencia, de evolución variable y difícil de predecir. La terapia fotodinámica es una alternativa no invasiva, de elección para hemangiomas coroideos sintomáticos, ya que no produce daño a las estructuras vecinas y presenta pocos efectos colaterales.
Objective: to report three cases of patients with choroidal hemangioma treated with photodynamic therapy (PDT) and review of the literature. Study design: retrospective interventional study, cases reports. Patients and methods: review of medical records and ancillary tests were performed in 3 patients with choroidal hemangioma pre and post PDT treatment. Results: of the 3 cases reported, two had a circumscribed choroidal hemangioma and one a diffuse hemangioma associated with Sturge Weber syndrome. All cases had improvement in visual acuity, resolution of serous retinal detachment and tumor regression without PDT side eff ects after follow-up. Conclusions: choroidal hemangiomas have a low incidence and an uncertain prognosis. Photodynamic therapy remains as a noninvasive alternative for symptomatic choroidal hemangiomas, without damage to surrounding structures and few side effects.
الموضوعات
Hemangioma/therapy , Diagnostic Techniques, Ophthalmological/statistics & numerical data , Eye Diseases/therapy , Photochemotherapy/statistics & numerical dataالملخص
Los hemangiomas infantiles (HI) son los tumores vasculares benignos m s frecuentes en ni¤os. Los hemangiomas infantiles en 80% se localizan en cabeza y cuello; 10% tienen crecimiento agresivo, que puede afectar la funci¢n o desfiguraci¢n del rea afectada; por lo tanto, el tratamiento es una necesidad. En la actualidad, el propranolol es considerado como de primera elecci¢n en el tratamiento de los hemangiomas infantiles. Se presenta el caso de una lactante portadora de un hemangioma profundo mixto en el cuello y s¡ndrome obstructivo bronquial recurrentes con excelente respuesta al tartamiento con propranolol.
Infantile hemangiomas (HI) are the most common benign vascular tumors in children; 80% of the infantile hemangioma is located in the head and neck; 10% have aggressive growth that may affect the function or disfigurement of the affected area; therefore, the treatment is a necessity. Today propranolol is considered as the first choice in the treatment of infantile hemangiomas. We present the case of an carring a deep mixted hemangioma in the neck and.
الموضوعات
Humans , Female , Infant , Hemangioma , Hemangioma/etiology , Hemangioma/therapy , Medical Illustration , Propranolol/therapeutic useالملخص
Los hemangiomas de la infancia (HI) son los tumores de partes blandas más frecuentes de la infancia. Se presentan en un 5 por ciento- 10 por ciento de la población pediátrica. El comportamiento de estos tumores es especial, ya que, a diferencia de otras neoplasias benignas, los HI tienden a regresar e involucionar espontáneamente en un 90 por ciento. Algunos pacientes con HI pueden sufrir complicaciones tales como ulceración y hemorragia. Estas complicaciones han llevado a la búsqueda de alternativas terapéuticas, donde, por mucho tiempo fueron los esteroides la primera opción de tratamiento. Esto hasta el año 2008, cuando se descubre accidentalmente el propranolol administrado por vía oral, como alternativa terapéutica para los HI severos, convirtiéndose hasta el día de hoy, en el gold standard de tratamiento. Dado la diversidad en su presentación, y las diferentes alternativas de manejo existentes, es que esta revisión pretende abordar la patogenia, clínica y enfrentamiento de estos tumores de la infancia.
Hemangiomas of infancy (HI) are the most common soft tissue tumors of childhood. They occur in up to percent-10 percent of the pediatric population and they have a special behaviour because, unlike other benign neoplasms, HI tend to regress spontaneously in up to 90 percent of the cases. Complications such as ulceration and hemorrhage can occur. These complications have led to search for new therapeutic options. Steroids were the first choice of treatment for a long time, until 2008, when oral propranolol was accidentally discovered as a potential treatment for large HI4. Today, propranolol is the gold standard for treatment. Given their variable clinical presentation and different therapeutic options available nowadays, this paper to review the pathogenesis, clinical presentation and approach of these tumors of infancy.
الموضوعات
Humans , Child , Hemangioma/diagnosis , Hemangioma/therapy , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/therapy , Diagnosis, Differential , Hemangioma/classification , Hemangioma/complications , Hemangioma/etiology , Soft Tissue Neoplasms/classification , Soft Tissue Neoplasms/complications , Soft Tissue Neoplasms/etiologyالملخص
We report on a two year old female patient who presented with expansion to the left side of the ramus and body of the mandibule. Imaging studies revealed a lesion with characteristics suggestive of vascular origin. Histopathological analysis determined the presence of an intraosseous Hemangioma. Embolization guided angiography of the left external carotid artery was performed followed by surveillance to monitor regression of the lesion.
Se presenta en una paciente de sexo femenino de dos años que presentó expansión del lado izquierdo de la rama y cuerpo de la mandíbula. Los estudios de imágenes revelaron una lesión con características sugerentes a un origen vascular. El análisis histopatológico determinó la presencia de un hemangioma intraóseo. Se realizó la embolización guiada por angiografía de la arteria carótida externa izquierda junto y seguimiento de control para supervisar la regresión de la lesión.