RESUMEN
To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9-59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team's newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research.
Asunto(s)
Neuroendoscopía , Impresión Tridimensional , Humanos , Femenino , Masculino , Adulto , Adolescente , Niño , Persona de Mediana Edad , Neuroendoscopía/métodos , Estudios Retrospectivos , Adulto Joven , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Imagenología Tridimensional/métodos , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/patología , Tomografía Computarizada por Rayos XRESUMEN
RATIONALE: Rectal cavernous hemangioma is a rare, benign vascular disease that seldom causes lower gastrointestinal bleeding, characterized by a high rate of misdiagnosis and missed diagnoses. Surgical treatment is considered to be relatively effective; however, it is accompanied by certain employed in the treatment of superficial hemangioma, boasting the advantages of minimally invasive surgery, including safety, effectiveness, reduced trauma, and rapid recovery. However, there is a lack of literature regarding the application of foam sclerosing agents for gastrointestinal hemangiomas. CASE CONCERNS: We present a case of a 60-year-old male who was admitted to our hospital with a history of recurrent hematochezia for >1 year and worsening symptoms for 1 week. The patient's medical history was unremarkable. DIAGNOSES: Following colonoscopy, nuclear magnetic resonance imaging, computed tomography, and other examinations, the final diagnosis was rectal cavernous hemangioma. INTERVENTIONS: Due to the patient's refusal of surgery, endoscopic foam sclerotherapy using a lauromacrogol injection was performed after obtaining informed consent from the patient and their relatives. OUTCOMES: Post-sclerotherapy, hematochezia symptoms ceased, and no adverse reactions were observed. Two months later, colonoscopy and nuclear magnetic resonance imaging showed that the hemangioma had almost completely disappeared, with only a small amount of tumor remnants, yielding a satisfactory curative effect. CONCLUSION: Our findings indicate that endoscopic injection of a lauromacrogol foam sclerosing agent is a safe, effective, and minimally invasive treatment option for gastrointestinal cavernous hemangiomas.
Asunto(s)
Colonoscopía , Hemangioma Cavernoso , Neoplasias del Recto , Soluciones Esclerosantes , Escleroterapia , Humanos , Masculino , Persona de Mediana Edad , Hemangioma Cavernoso/terapia , Hemangioma Cavernoso/diagnóstico por imagen , Escleroterapia/métodos , Soluciones Esclerosantes/uso terapéutico , Soluciones Esclerosantes/administración & dosificación , Neoplasias del Recto/terapia , Colonoscopía/métodos , Polidocanol/uso terapéutico , Polidocanol/administración & dosificación , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapiaRESUMEN
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.
Asunto(s)
Hemangioma Cavernoso , Enfermedades de la Médula Espinal , Vértebras Torácicas , Humanos , Masculino , Persona de Mediana Edad , Vértebras Torácicas/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagen , Enfermedades de la Médula Espinal/cirugía , Enfermedades de la Médula Espinal/diagnóstico por imagen , Enfermedades de la Médula Espinal/diagnóstico , Enfermedades de la Médula Espinal/patología , Neoplasias Epidurales/cirugía , Neoplasias Epidurales/diagnóstico , Neoplasias Epidurales/patología , Neoplasias Epidurales/complicaciones , Imagen por Resonancia MagnéticaAsunto(s)
Hemangioma Cavernoso , Linfoma de Células B Grandes Difuso , Neoplasias Orbitales , Humanos , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/patología , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/patología , Masculino , Femenino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/patología , Imagen por Resonancia MagnéticaAsunto(s)
Resección Endoscópica de la Mucosa , Hemangioma Cavernoso , Neoplasias del Recto , Humanos , Resección Endoscópica de la Mucosa/métodos , Neoplasias del Recto/cirugía , Neoplasias del Recto/patología , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/patología , Masculino , Femenino , Persona de Mediana EdadAsunto(s)
Hemangioma Cavernoso , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/patología , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Hemangioma Cavernoso del Sistema Nervioso Central/patología , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Imagen por Resonancia MagnéticaRESUMEN
Vascular anomalies comprise a wide spectrum of clinical manifestations related to disturbances in the blood or lymph vessels. They correspond to mainly tumors (especially hemangiomas), characterized by high mitotic activity and proliferation of the vascular endothelium, and malformations, endowed with normal mitotic activity and no hypercellularity or changes in the rate of cell turnover. However, the classifications of these lesions go beyond this dichotomy and consist various systems adapted for and by different clinical subgroups. Thus, the classifications have not reached a consensus and have historically caused confusion regarding the nomenclatures and definitions. Cavernous venous malformations of the orbit, previously called cavernous hemangiomas, are the most common benign vascular orbital lesions in adults. Herein, we have compiled and discussed the various evidences, including clinical, radiological, morphological, and molecular evidence that indicate the non-neoplastic nature of these lesions.
Asunto(s)
Hemangioma Cavernoso , Neoplasias Orbitales , Humanos , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/patología , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/patología , Órbita/irrigación sanguínea , Órbita/diagnóstico por imagen , Órbita/patología , Malformaciones Vasculares/diagnóstico por imagen , Malformaciones Vasculares/patologíaRESUMEN
An 8-year-old boy presenting with left-angle paralysis, tremor in upper and lower extremities, and diplopia was diagnosed with hemorrhage from a mesencephalic cavernous hemangioma. He underwent hemangiomectomy through the occipital transtentorial approach 4 weeks post-hemorrhage, after which Holmes tremor (HT) markedly reduced. A year later, hemangioma has not recurred; he is now independent in his daily activities. Early intervention in the subacute stage allows for the complete removal of brainstem cavernomas (BSCs), with minimal risk of complications or sequelae. Proper timing and surgical approach for BSCs can prevent re-bleeding and improve HT after an initial hemorrhage, without any lasting negative consequences.
Asunto(s)
Neoplasias del Tronco Encefálico , Hemangioma Cavernoso del Sistema Nervioso Central , Temblor , Humanos , Masculino , Niño , Neoplasias del Tronco Encefálico/cirugía , Neoplasias del Tronco Encefálico/complicaciones , Neoplasias del Tronco Encefálico/diagnóstico por imagen , Temblor/etiología , Temblor/cirugía , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Hemangioma Cavernoso del Sistema Nervioso Central/complicaciones , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/complicaciones , Hemangioma Cavernoso/diagnóstico por imagen , Procedimientos Neuroquirúrgicos/métodos , Tronco Encefálico/cirugía , Tronco Encefálico/diagnóstico por imagenRESUMEN
Hepatic hemangiomas are the most common benign liver tumors. Typically, small- to medium-sized hemangiomas are asymptomatic and discovered incidentally through the widespread use of imaging techniques. Giant hemangiomas (>5 cm) have a higher risk of complications. A variety of imaging methods are used for diagnosis. Cavernous hemangioma is the most frequent type, but radiologists must be aware of other varieties. Conservative management is often adequate, but some cases necessitate targeted interventions. Although surgery was traditionally the main treatment, the evolution of minimally invasive procedures now often recommends transarterial chemoembolization as the treatment of choice.
Asunto(s)
Carcinoma Hepatocelular , Quimioembolización Terapéutica , Hemangioma Cavernoso , Hemangioma , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Carcinoma Hepatocelular/terapia , Imagen por Resonancia Magnética/métodos , Hemangioma/diagnóstico por imagen , Hemangioma/terapia , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/terapiaRESUMEN
Intraosseous vascular pathology of the turbinates is extremely rare in the practice of an otorhinolaryngologist and can be presented in various histopathological variants. The article presents two clinical cases in which an intraosseous cavernous hemangioma was hidden under the mask of a hypertrophied middle turbinate. The final diagnosis was established by the results of histological examination. The analysis of these clinical cases indicates that, despite the low prevalence, atypical clinical and CT picture, intraosseous formations of the nasal cavity can be of a vascular nature and certainly require a comprehensive examination, including CT, CT with contrast and/or MRI of the nose and paranasal sinuses. These clinical observations indicate that preliminary embolization of feeding vessels before surgical treatment is not required.
Asunto(s)
Hemangioma Cavernoso , Cráneo/anomalías , Columna Vertebral/anomalías , Cornetes Nasales , Malformaciones Vasculares , Humanos , Cornetes Nasales/diagnóstico por imagen , Cornetes Nasales/cirugía , Cornetes Nasales/patología , Tomografía Computarizada por Rayos X/métodos , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Cavidad Nasal/cirugíaRESUMEN
BACKGROUND: Lesions situated within the orbit pose significant challenges in management due to the confined space they occupy and their proximity to critical anatomical structures. The objective of our study is to assess the feasibility of the ipsilateral endoscopic endonasal approach for orbital cavernous hemangiomas and to comprehend the surgical anatomy of the orbital apex and inferomedial orbital structures. METHODS: Thirteen patients (8 women, 5 men), with ages ranging from 25 to 54 years (mean 35.2 ± 8.3 years), with orbital cavernous hemangioma who underwent surgery via the ipsilateral mononostril endoscopic endonasal approach between August 2018 and August 2023 were retrospectively evaluated. Demographic characteristics, clinical data, radiographic images, and clinical outcomes of the patients were collected from digital medical records. RESULTS: The left orbit was more commonly affected (9 left, 4 right). The average postoperative follow-up duration was 22.2 months (range: 6-50 months). Among the 13 cases of orbital cavernous hemangioma, 1 (7.7%) was located in the extraconal compartment, and 12 (92.3%) were situated in the intraconal compartment. Complete surgical resection of the tumor was successfully achieved in all patients. CONCLUSIONS: Our study highlights the potential advantages of employing a purely ipsilateral mononostril endoscopic endonasal approach for orbital surgery, particularly for accessing the orbital apex and managing medial and inferomedial orbital lesions. This technique holds promise for reducing morbidity and enhancing outcomes, especially when combined with careful patient selection, preoperative planning, and advanced endoscopic skills.
Asunto(s)
Órbita , Neoplasias Orbitales , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Neoplasias Orbitales/cirugía , Neoplasias Orbitales/diagnóstico por imagen , Estudios Retrospectivos , Órbita/cirugía , Órbita/diagnóstico por imagen , Cirugía Endoscópica por Orificios Naturales/métodos , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/diagnóstico por imagen , Cavidad Nasal/cirugía , Cavidad Nasal/diagnóstico por imagen , Resultado del Tratamiento , Neuroendoscopía/métodosAsunto(s)
Neoplasias de Cabeza y Cuello , Hemangioma Cavernoso , Neoplasias de las Glándulas Salivales , Humanos , Diagnóstico Diferencial , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/patología , Masculino , Femenino , Adulto , Persona de Mediana EdadRESUMEN
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.
Asunto(s)
Angiografía con Fluoresceína , Hemangioma Cavernoso , Imagen Multimodal , Neoplasias de la Retina , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Masculino , Angiografía con Fluoresceína/métodos , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/diagnóstico , Neoplasias de la Retina/diagnóstico , Neoplasias de la Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Adulto Joven , Fondo de OjoAsunto(s)
Ecocardiografía Tridimensional , Ecocardiografía Transesofágica , Neoplasias Cardíacas , Hemangioma Cavernoso , Humanos , Persona de Mediana Edad , Tabique Interatrial/diagnóstico por imagen , Ecocardiografía Tridimensional/métodos , Ecocardiografía Transesofágica/métodos , Neoplasias Cardíacas/diagnóstico por imagen , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/cirugíaAsunto(s)
Hemangioma Cavernoso , Neoplasias Meníngeas , Meningioma , Humanos , Meningioma/diagnóstico por imagen , Meningioma/cirugía , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Duramadre , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/cirugía , Diagnóstico DiferencialRESUMEN
Orbital cavernous hemangiomas are the most common primary orbital tumors in adults, providing challenges for optimal surgical approach planning within an anatomically complex area with close proximity to vital neurovascular structures. The authors present an individualized lateral mini-orbitozygomatic approach for the resection of an orbital cavernous haemangioma based on a preoperative 3-dimensional-printed model. This individualized approach enabled the surgeons to achieve optimal exposure while maintaining safety during the resection of the lesion, but also to respect the patient's physiognomy and hairline. In addition, the model was used for patient informed consent, helping the patient understand the procedure. Although adding additional effort to preoperative planning, 3-dimensional model-based approaches can offer great benefits when it comes to customizing surgical approaches, especially for anatomically challenging resections.
Asunto(s)
Hemangioma Cavernoso , Neoplasias Orbitales , Adulto , Humanos , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/cirugía , Neoplasias Orbitales/patología , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/cirugía , Impresión TridimensionalRESUMEN
Kimura's disease (KD) is an immune-mediated disorder which mainly affects Asian men. It appears as head and neck subcutaneous masses, with inflammatory infiltrate and elevated serum immunoglobulin E levels. The clinical presentation of KD resembles that of various diseases. Here, we report the case of a 30-year-old Filipino man with KD mimicking cavernous hemangioma who was treated by surgery. Careful survey for possible KD cases is crucial. Misdiagnoses are prone to futile interventions and unwanted effects. Surgery with adjuvant therapy is superior to other forms of KD treatment.