A child with intravascular fasciitis mimicking deep vein thrombosis: a case report.

BACKGROUND: Intravascular fasciitis (IF) is a benign, reactive, myofibroblastic proliferation that originates from the superficial or deep fascia of small / medium-sized arteries and veins. CASE REPORT: An 8-year-old male patient was admitted to a health center with the complaint of swelling in the inguinal region. Lower extremity venous Doppler ultrasonography showed deep vein thrombosis (DVT) of the femoral vein and anticoagulation with low-molecular weight heparin (LMWH) was initiated. The patient was referred to our center for follow-up. The D-dimer level was detected within normal limits. Doppler ultrasonography was repeated and showed an intraluminal expanding mass lesion with increasing vascularity, without distinct borders and LMWH was discontinued. This lesion at the sapheno-femoral junction was excised surgically and the histopathological examination revealed intravascular fasciitis. CONCLUSION: Clinicians should be aware that the clinical findings of IF may mimic sarcoma and thrombosis.

Intravascular fasciitis of the scalp as a complication of ICP monitor placement: a case report and review of the literature.

BACKGROUND/IMPORTANCE: There are only 56 documented cases of intravascular fasciitis, a rare variant of nodular fasciitis. Of these cases, only 2 involved the scalp. This lesion is amenable to surgical resection, making it important to differentiate it from soft tissue malignancies of the scalp. CLINICAL PRESENTATION: We report an unusual case of intravascular fasciitis involving the scalp at the site of an intracranial pressure (ICP) monitor of a 13-year-old male patient. The lesion was surgically excised with no recurrence upon 1-month follow-up. CONCLUSION: Intravascular fasciitis is a benign, reactive proliferation of soft tissue that may arise at sites of prior trauma. It appears as a soft, painless, mobile lesion, and immunohistochemical studies are required to differentiate it from malignant lesions. The standard of care is surgical resection of the lesion.

Intravascular fasciitis involving the external jugular vein and subclavian vein: A case report.

BACKGROUND: Intravascular fasciitis (IVF) is a rare nodular fasciitis that often involves the layers and lumens of blood vessels; therefore, it is easily misdiagnosed as a malignant tumor with invasion into blood vessels. CASE SUMMARY: A 13-year-old boy was admitted due to a mass on the left side of his neck. Duplex ultrasonography revealed a circular solid hypoechoic mass in the external jugular vein, and magnetic resonance imaging revealed an enhanced longitudinal mass-like lesion in the left supraclavicular fossa. Surgical treatment was arranged and completed, histopathological analysis showed a large amount of spindle cell proliferation, and immunohistochemistry showed that the spindle cells were positive for the expression of vimentin, caldesmon, and smooth muscle actin and negative for the expression of S-100 protein, desmin, CD34, and c-kit; Ki-67 staining revealed a low proliferative index (5%-10%), which confirmed the differentiation characteristics of myofibroblasts. Fluorescence in situ hybridization detected the rearrangement of USP6. IVF was subsequently diagnosed. CONCLUSION: IVF is characterized by intraluminal, intramural and extramural involvement of small to large arteries or veins. Unless the doctor has a deep understanding of the disease or suspects that there is an initial indicator, IVF may be confused with other intravascular malignancies, leading to unnecessary radical surgery. Imaging examination combined with histopathological examination can improve the diagnostic accuracy of this disease.

Value of high frequency ultrasonography for diagnosis of superficial intravascular tumors / 中华超声影像学杂志

Objective:To explore the high-frequency ultrasonographic and clinical features of superficial intravascular tumors.Methods:Thirteen superficial intravascular tumor patients who underwent ultrasound examination form Beijing Jishuitan Hospital during 2016-2020 were retrospectively analyzed. The location, anatomic blood vessels, shape, size, boundary, internal echo, blood flow and clinical characteristics of the tumors were analyzed.Results:Among the 13 cases, most of the tumors were oval like or long strip, and a few were round like. All 11 cases of primary intravascular tumors showed hypoechoic mass; 2 cases of intravascular metastasis or recurrence showed solid hypoechoic with hyperechoic mass. Arterial blood flow spectrum was detected in 12 cases. Two patients with glomus tumor showed typical tenderness at the fixed point. Two patients had a history of bone tumors in the upper or lower extremities.Conclusions:High frequency ultrasound can clearly recognize the location of the superficial intravascular tumors, describe the morphological characteristics and sonographic features of the tumor, then help to make a more accurate qualitative diagnosis.

Intravascular Fasciitis of the Jugular Vein Mimicking Thrombosis and Sarcoma: A Case Report.

Background: Intravascular fasciitis is a rare disease that is a reactive proliferative lesion of myofibroblasts. There are rare reports that intravascular fasciitis has invaded the jugular vein as seen in this case. Case Presentation: A 41-year-old female presented with right neck dull pain for 20 days. The appearance of the subcutaneous mass was oval, pink hyaline, well-demarcated, and measuring ~5 mm in diameter. Microscopically, the mass was composed of spindle cells arranged in intersecting fascicles. Immunohistochemical stains showed that the spindle cells were positive for smooth muscle actin and negative for S-100, Desmin, MyoD1, and elastin stains. The nuclei of the spindle cells were relatively uniform, and mitotic activity was observed. The overall morphological and immunohistochemical features are consistent with intravascular fasciitis. Conclusion: Due to the rapid growth and vascular invasion, intravascular fasciitis created a high risk of misdiagnosing it as a sarcoma or thrombosis. Reporting this uncommon case, we raise awareness of this non-neoplastic lesion, and careful, light microscopic examination combined with immunohistochemical staining aids in the diagnosis of intravascular fasciitis.

Intravascular fasciitis of the hip joint in a postpartum female: misdiagnosed as low grade fibromyxoid sarcoma.

Intravascular fasciitis is a special type of nodular fasciitis. It is an uncommon lesion. We report here the first case of intravascular fasciitis involving the deep muscle of the hip joint. The female, postpartum patient presented with a large, firm, painless tumoral mass in the anterolateral muscles of the right hip. The diagnosis of intravascular fasciitis was difficult because of the large size and location of the lesion. The false positive immunohistochemistry for MUC4 initially caused our team to misdiagnose the intravascular fasciitis as a low grade malignant fibromyxoid sarcoma. Our case adds to the literature on intravascular fasciitis. Since the operation about 20 months prior, the tumor in this case has not recurred.

Intravascular Fasciitis in the Femoral Vein with Hypermetabolic Signals Mimicking a Sarcoma: The Role of Preoperative Imaging Studies with Review of Literature.

Intravascular fasciitis (IVF) is a very rare disease that is difficult to diagnose preoperatively. Frequently, it can be misdiagnosed as a malignancy or deep vein thrombosis. A 26-year-old man presented with a 6-month history of intermittent cramping pain in the right calf. Duplex ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography were performed in various hospitals. The work-up revealed a hypermetabolic mass in the femoral vein, suggestive of a malignancy, such as leiomyosarcoma. The tumor was located inside the femoral vein with no invasion, and the mass was resected en bloc with the vein wall. Intraoperative frozen section biopsy revealed no malignancy, and the final pathological diagnosis was IVF. Herein, we report a case of IVF and discuss the role of imaging studies in its preoperative diagnosis, with an extensive literature review.

Intravascular fasciitis presenting as recurrent deep venous thrombosis.

Intravascular fasciitis is a rare variant of nodular fasciitis, a benign process that results from proliferation of myofibroblasts in the soft tissues. Nodular fasciitis occurs most often in the upper extremities but can also develop in the head, neck, trunk, and lower extremities of young patients. The intravascular variant occurs within small- and medium-size vessels. We have described a case of femoral vein intravascular fasciitis presenting as recurrent deep venous thrombosis.

Novel CTNNB1-USP6 fusion in intravascular fasciitis of the large vein identified by next-generation sequencing.

Intravascular fasciitis (IVF) is considered a rare variant of nodular fasciitis, which often involves small- and medium-sized blood vessels. Approximately 43 cases of IVF have been reported in the English literature to date. Here, we report an IVF case arising from the common iliac vein of the pelvic cavity in a 19-year-old Chinese man. Histologically, the lesion was confined within the vascular lumen and consisted of regular myofibroblasts immersed in a fibromyxoid stroma. The tumor cells showed a USP6 rearrangement by fluorescence in situ hybridization but were negative for MYH9-USP6 fusion by reverse transcription polymerase chain reaction. Subsequent next-generation sequencing identified the CTNNB1-USP6 fusion. To the best of our knowledge, the vessel involved in this case is the largest vein among the reported cases. The present case might be the first example of a USP6-rearranged lesion in this entity, suggesting that IVF should be included in the USP6-induced family.

Intravascular fasciitis leading to an aortic dissection. A case report.

Here we report on the case of a 61-year-old female with an accidental finding of intravascular fasciitis (IVF) affecting the ascending aorta in a specimen resected due to an acute aortic dissection. No infiltrative process of the aorta or surrounding soft tissues was grossly apparent. Microscopically, the lesion had poorly defined margins and was composed of plump spindle- and oval-shaped cells set in an abundant myxoid stroma. Immunohistochemically, cytoplasmic positivity for ß-catenin was observed and about 25% of cells were positive for calponin. The Ki-67 index was approximately 25% (increasing to about 50% in hot spot areas). Occasional isolated cells also showed positivity for alpha actin. Other markers were all negative in the tumor cells including; smooth muscle actin, desmin, h-caldesmon, D2-40, DOG1, S100 protein, CD34, CD31, ERG, melan A, HMB45, IgG, IgG4, ALK, cytokeratin AE1/AE3, and LCA. Intravascular fasciitis is a benign myofibroblastic proliferation which most commonly occurs in subcutaneous tissues and may mimic malignancy. To the best of our knowledge this is only the 2nd ever reported case of IVF affecting the aorta. Keywords: intravascular fasciitis - nodular fasciitis - soft tissue lesions - myofibroblasts - aorta.

A Case Report of the Intravascular Fasciitis of a Neck Vein Mimicking Intravascular Tumorous Conditions.

Intravascular fasciitis is a rare variant of nodular fasciitis, which can be easily misdiagnosed as a tumorous condition. We had a patient with an intravenous mass of a neck vein, and surgical excision was successful. Although all preoperative imaging studies and intraoperative pathologic reports suggested certain tumorous conditions as differential diagnosis results, the final diagnosis confirmed that it was an intravascular fasciitis based on its fibromixoid tissues with the proliferation of spindle cells and positive immunohistochemical staining for smooth muscle actin. Unless a physician has an insight of the disease or a suspicion to initiate running differential markers, it may be confused with other intravascular lesions and cause unnecessary radical surgery. Here we report our experience with a patient having this rare vascular disease.

Intravascular Fasciitis: A Case Report of an Intraoral Location / 대한피부과학회지

Intravascular fasciitis (IVF), a rare distinct variant of nodular fasciitis, possesses the same clinical and histologcal features of nodular fasciitis, but in addition, involves predominantly small to medium- sized veins and/or arteries intraluminally, intramurally and extramurally. Only 3 cases of intraoral IVF have been reported in the English literature. Herein we report a case of IVF developing on the inner lower lip and it was successfully treated with simple excision.