Angioma de células litorales del bazo: un diagnóstico de lesión focal esplénica: caso clínico / Littoral cell angioma of the spleen: report of one case

Splenic vascular neoplasms are the most common form of spleen tumors. Among them, littoral cell angioma is rare and it is frequently an incidental finding in imaging studies. It has no specific clinical, laboratory or imaging findings. Splenectomy allows definitive diagnosis throughout a histopathological examination. We report a 52-year-old man presenting with asthenia and abdominal distension. Computed tomography with intravenous contrast showed multiple splenic hypodense masses and a prostatic enlargement. Presuming a lymphoma, a laparoscopic splenectomy was performed. Histopathologic examination diagnosed littoral cell angioma. During urological follow-up, a prostate adenocarcinoma was diagnosed.

Malignant glomus tumor of the index finger.

Glomus tumor (GT) is a benign mesenchymal tumor with an estimated incidence of 1.5 to 2% of soft tissue tumors. The majority of glomus tumors are benign and are mostly seen in the superficial skin & soft tissue of upper and lower distal extremity. The malignant variant of the glomus tumor is scarce. We report a case of a recurrent glomus tumor diagnosed in a 28-year-old male patient, who complained of painful swelling in the proximal phalanx of the right index finger. The magnetic resonance imaging of the hand revealed a well-defined multilobulated soft tissue mass at the palmar aspect of the 2nd digit along the shaft of the proximal phalanx. Histopathology revealed a well-circumscribed tumor arranged in solid sheets, nests and cords interconnect by vessels of varying size. The tumor cells were round to oval, showed moderate nuclear pleomorphism, eosinophilic cytoplasm, atypical mitoses (>5/10HPF), and necrosis. Immunohistochemically tumor cells reveal diffuse and strong cytoplasmic positivity with smooth muscle actin (SMA). Based on histomorphology and immunohistochemistry, a final diagnosis of malignant glomus tumor was made. We report this case due to its rarity, and it to be included among the differential if the lesion is painful and recurrent.

Malignant glomus tumor of the index finger

Glomus tumor (GT) is a benign mesenchymal tumor with an estimated incidence of 1.5 to 2% of soft tissue tumors. The majority of glomus tumors are benign and are mostly seen in the superficial skin & soft tissue of upper and lower distal extremity. The malignant variant of the glomus tumor is scarce. We report a case of a recurrent glomus tumor diagnosed in a 28-year-old male patient, who complained of painful swelling in the proximal phalanx of the right index finger. The magnetic resonance imaging of the hand revealed a well-defined multilobulated soft tissue mass at the palmar aspect of the 2nd digit along the shaft of the proximal phalanx. Histopathology revealed a well-circumscribed tumor arranged in solid sheets, nests and cords interconnect by vessels of varying size. The tumor cells were round to oval, showed moderate nuclear pleomorphism, eosinophilic cytoplasm, atypical mitoses (>5/10HPF), and necrosis. Immunohistochemically tumor cells reveal diffuse and strong cytoplasmic positivity with smooth muscle actin (SMA). Based on histomorphology and immunohistochemistry, a final diagnosis of malignant glomus tumor was made. We report this case due to its rarity, and it to be included among the differential if the lesion is painful and recurrent.

Thyroid Gland Solitary Fibrous Tumor: Report of 3 Cases and a Comprehensive Review of the Literature.

Solitary fibrous tumors of the thyroid gland are exceptionally rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, three cases of thyroid gland solitary fibrous tumor were analyzed in conjunction with 35 cases compiled from the English literature. Thyroid gland solitary fibrous tumors showed an equal sex distribution with a mean age at presentation of 54.4 years (range, 28-88 years). The patients typically presented with an asymptomatic, slow growing neck mass. Microscopically, the tumors were characterized by cytologically bland spindle cells with patternless growth, hypocellular and hypercellular areas, variable amounts of collagen, and ectatic, branching blood vessels. Two previous reported tumors were considered to be histologically malignant on the basis of increased mitotic activity, profound pleomorphism and tumor necrosis. Immunohistochemically, the tumor cells are variably positive with CD34, bcl-2, and CD99. STAT6 immunohistochemistry, performed on the current cases, demonstrated a strong, diffuse nuclear expression in all tumors. Among 26 patients with available follow up data (mean 47.3 months), one developed local recurrence and distant metastasis. Solitary fibrous tumors occurring in the thyroid gland are uncommon, but can be reliably diagnosed based on the presence of characteristic morphologic features as well as immunohistochemical expression of STAT6 and CD34. The majority of thyroid gland solitary fibrous tumors have exhibited an indolent clinical course, however experience is limited. The rare potential for aggressive clinical behavior requires clinical surveillance.

Adult-onset kaposiform hemangioendothelioma with neurofibromatosis type 1: A case report and literature review.

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.

Acquired elastotic hemangioma, a little-known entity: report of a case with 15 years of evolution

Abstract: Acquired elastotic hemangioma is a hemangioma variant first described in 2002. It is characterized by being a benign, solitary, slow-growing lesion, that appears in adulthood and is associated with solar exposure. It is a rare hemangioma variant with few cases reported in the literature. We present a case of acquired elastotic hemangioma on the back of the right hand and forearm in a male adult. Acquired elastotic hemangioma is a benign vascular proliferation associated with solar exposure, usually assymptomatic. It affects adults between 59 and 65 years of age. Histopatologically it is characterized by proliferation of small vessels in the upper dermis that are disposed parallel to the epidermis, and significant solar elastosis. The treatment is surgical, with no relapses reported.

Case for diagnosis. Multinucleated cell angiohistiocytoma

Abstract: Multinucleate cell angiohistiocytoma is a rare idiopathic benign fibrohistiocytic and vascular proliferation usually presenting as multiple asymptomatic papules, red to violaceous in colour, primarily located on the extremities of middle-aged females. This entity is probably underdiagnosed due to the lack of recognition by clinicians and pathologists. We describe a patient with a multinucleate cell angiohistiocytoma of the face, a less frequent localization, in order to increase awareness of this entity and elucidate its clinical, histopathological, and immunohistochemistry features.

Adult-onset kaposiform hemangioendothelioma with neurofibromatosis type 1: A case report and literature review

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.

Stewart-Treves Syndrome of the Lower Extremity

Stewart-Treves syndrome is a rare cutaneous angiosarcoma that develops in long-standing chronic lymphedema. Though most commonly this angiosarcoma is a result of post mastectomy lymphoedema, it also develops in Milroy disease, idiopathic, congenital, traumatic and filarial lymphoedema. Despite the rarity of this syndrome and its poor prognosis, early diagnosis associated with radical surgery can provide improved survival. We report a case of angiosarcoma in the lower limb in a patient with chronic lymphedema associated with history of repeated erysipela episodes.

Treatment of oral hemangioma with sclerotherapy: case report / Tratamento de hemangioma oral com escleroterapia: relato de caso

Hemangiomas are benign neoplasms that are common in the head and neck, but relatively rare in the oral cavity. They can cause esthetic and functional impairment, depending on location. The most common site is the upper lip, but they can occur in other areas, such as the tongue, buccal mucosa and palate. Treatment is primarily dependent on correct diagnosis of the lesion and on its anatomic location. The purpose of this article is to provide a description of a case of a hemangioma on the upper lip, treated by therapeutic sclerosis with monoethanolamine oleate (Ethamolin®), covering clinical characteristics and methods for diagnosing these lesions. Precise diagnosis and appropriate therapeutic management resulted in satisfactory esthetic and functional results, with total regression of the lesion and no signs of relapse at 1-year follow-up...

O hemangioma é uma neoplasia benigna comum na região de cabeça e pescoço, e é relativamente rara na cavidade oral, podendo causar prejuízo estético e funcional a depender da sua localização. Sua localização mais frequente é o lábio superior, mas pode ocorrer em outras regiões, como língua, mucosa jugal e palato. O seu tratamento depende, principalmente, do correto diagnostico da lesão, bem como da localização anatômica da mesma. A proposta deste artigo é relatar um caso de hemangioma em lábio superior tratado com esclerose terapêutica com oleato de monoetanolamina (Ethamolin®), considerando as características clínicas e os métodos de diagnóstico desta lesão. Por meio de um diagnóstico preciso e uma conduta terapêutica adequada, o caso apresenta-se com um acompanhamento de um ano, sem sinais de recidiva, e com um resultado estético funcional satisfatório, com regressão total da lesão...

Hemangiopericitoma de órbita / Orbital hemangiopericytoma

Hemangiopericitomas são tumores raros originados a partir da proliferação de pericitos, ou seja, células que envolvem os capilares. São encontrados em ossos, pulmões, crânio, partes moles profundas ou membros inferiores, principalmente na coxa. É considerado um tumor com potencial de malignidade incerto e quando afeta a região orbitária pode apresentar um comportamento biológico agressivo, com grande chance de recidiva. O objetivo deste trabalho é relatar um caso de hemangiopericitoma orbital e destacar suas características clínicas, cirúrgicas e histopatológicas. Usualmente, os hemangiopericitomas da órbita são tumores sólidos, únicos e de crescimento lento. Devem ser lembrados no diagnóstico diferencial dos tumores orbitários bem delimitados, como cistos epidermoides, schwannomas, neurofibromas, fibro-histiocitomas, lipomas e malformações vasculares. A confirmação diagnóstica é realizada pelo exame anatomopatológico e, por vezes, complementada pelo estudo imuno-histoquímico. O tratamento deve ser realizado com exérese completa do tumor, com margens amplas, sendo a radioterapia e a quimioterapia reservadas para casos de lesões reincidentes.

Hemangiopericytomas are rare tumors arising from the proliferation of pericytes. They may be found in the lungs, bones, skull, deep soft tissue or limbs. The tumor has an unpredictable prognosis and when it affects the orbital region, may have an aggressive behavior, with high incidence of recurrence. We report a case of orbital hemangiopericytoma and highlight clinical, surgical, and histopathological features of these tumors. Orbital hemangiopericytomas usually are solid, slow-growing tumors. They should be considered in the differential diagnosis of well-defined orbital masses along with epidermoid cysts, schwannomas, neurofibromas, fibrous histiocytomas, lipomas, and vascular malformations. The diagnosis is confirmed by anatomopathologic examination and sometimes complemented by immunohistochemistry. Complete excision of the tumor with wide margins is usually curative; however, radiotherapy and chemotherapy may be required for recurrent lesions.

Primary pulmonary artery sarcoma extending retrograde into the superior vena cava.

Primary pulmonary artery sarcoma is a rare tumor that is highly fatal. It can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. Herein, we report the case of a 22-year-old woman with a preoperative diagnosis of pulmonary embolism and superior vena caval thrombosis. Intraoperatively, an extensive sarcoma was seen to extend retrograde from the pulmonary artery, past the right ventricle and right atrium, and into the superior vena cava. Surgical resection of the tumor and reconstruction of the central pulmonary arteries, followed by adjuvant chemotherapy, relieved the clinical symptoms. The patient remained free of cancer at 14 months postoperatively. We believe that this is the 1st report of a primary pulmonary artery sarcoma that extended retrograde into the superior vena cava.

Tumor glômico: um diagnóstico fácil ou difícil? / Glomus tumor: an easy or a difficult diagnosis?

Introdução: O tumor glômico é uma lesão neoplásica benigna, geralmente única, quese forma no glomo terminal. Esta estrutura é uma anastomose arteriovenosa subcutâneadistribuída por toda a superfície corporal, em particular nos leitos ungueais, polpas digitais,palmas das mãos e plantas dos pés. Apesar da sua raridade, recebe atenção especialpor seus sintomas caracterizados por dor paroxística, sensibilidade à pressão do local, aofrio e por sua localização típica na ponta do dedo. O diagnóstico inicial é raramente feito,levando os pacientes a apresentarem os sintomas por meses e até anos, sem o diagnósticoe tratamento adequados. Objetivo: O objetivo desse trabalho é evidenciar o método diagnósticoclínico e histopatológico do tumor glômico, e a utilização da microscopia em seutratamento cirúrgico. Resultados: Observou-se grande diminuição nos casos de recidiva,com retorno funcional do órgão acometido e melhora da saúde física, funcional e psicossocialdo paciente. Conclusão: A exérese do tumor mostrou-se eficaz e os resultados foramplenamente satisfatórios, não havendo complicações pós-operatórias significativas, nemrecidivas até o momento.

Introduction: The glomus tumor is rare subungueal pathology that consists of a neuromyoarterial.Glomus bodies sensible to temperature oscillations, that regulate arteriolarflow, located at the arteriolar-venula anastomosis. The main symptom of this pathology isan excruciating pain leading to functional limitation of the Lyme. Objective: The purposethis study is to highlight its clinical and histopathological diagnosis, as well as the use ofmicrocopy on its surgical treatment. Results: The treatment resulted in a great reduction ofrecurrence, with functional recovery of the limb and improvement of apaticutp’s physical,social and psycosocial health. Conclusion: The surgical resection of the tumor was efficientand the results were very satisfactory, with no significant post operative complications andno recurrence.

Diagnóstico e tratamento do hemangioma infantil: [revisão] / Diagnosis and treatment of infantile hemangioma: [review]

O hemangioma infantil é o tumor vascular benigno mais frequente nas crianças. Apresenta incidência de 2,5 a 5% em recém-nascidos vivos caucasianos, com predominância no sexo feminino. Durante um longo período não havia uma classificação diagnóstica aceita internacionalmente, dificultando a criação de condutas, bem como comparações entre os diversos tratamentos. Em 1996, a International Society for the Study of Vascular Anomalies dividiu as anomalias vasculares em duas categorias: tumores vasculares e malformações vasculares. O hemangioma a partir deste momento passou a significar um tumor benigno com características peculiares. A sua origem ainda é incerta e diversas hipóteses são formuladas para explicá-la. O quadro clínico apresenta três fases bem definidas: proliferativa, involutiva e involuída. O diagnóstico é realizado por meio da anamnese e do exame físico; quando indicados, ressonância magnética, ultrassom e métodos angiográficos podem ser auxiliares. A maioria dos hemangiomas infantis tem resolução favorável para regressão completa, sem complicações. No entanto, alguns deles podem levar ao comprometimento funcional ou apresentar complicações como ulcerações, infecções, sangramentos ou complicações sistêmicas durante sua evolução. Estes são os casos em que há indicação terapêutica. Entretanto, outras indicações relativas de tratamento podem ser consideradas, devido à localização e às dimensões do tumor. Diversas opções de tratamentos estão disponíveis além do cirúrgico: os tratamentos clínicos, com corticoesteróides (o mais utilizado), o alfa-interferon, com suas indicações um pouco restritas pelos seus efeitos colaterais e, mais recentemente, os beta-bloqueadores, com boa resposta e poucos efeitos colaterais, mas ainda em fase de pesquisa em protocolos clínicos.

Infantile hemangioma is the most common benign tumor of infancy. Incidence is around 2.5 to 5% in caucasian newborns, with predominance in females. For a long period of time, the lack of a single classification accepted worlwide impaired treatment, management and comparisons between treatment groups. In 1996, The International Society for the Study of Vascular Anomalies proposed a classification for vascular anomalies, dividing vascular anomalies in two main groups: vascular tumors and vascular malformations. Infantile hemangioma is the most frequent vascular tumor. There are still several hypothesis for the explanation hemangioma development. Clinically there are three distinct phases, named proliferative, involutive and involuted. Diagnosis is clinically based and imaging methods like magnetic ressonance, ultra sound and interventional radiology may be useful in some cases. The majority of infantile hemangiomas have favorable resolution due to spontaneous regression. However, in some cases complications are present, like ulceration, bleeding, infection or systemic complications. In these cases, active treatment is indicated, as well as in cases of relative indication, depending on size and tumor location. Surgical resection and medical treatment are used. Medications more frequently used are oral corticosteroids, alfa-interferon - with more side effects and now a days beta-blockers, with good response, less side effects, but still under research protocols.

Clinicopathological study on primary malignant vascular tumors of liver / 第二军医大学学报

Objective:To study the clinicopathological and immunohistochemical features of hepatic malignant vascular tumors. Methods:H E and immunohistochemistry were used to study 6 angiosarcoma and 5 epithelioid hemangioendothelioma (EHE) of the liver. Patients were aged 0.5 68 years, 7 were females and 4 were males. Results:Patients presented with nonspecific symptoms. Macroscopically,the tumors were usually multiple (3 13.7 cm in diameter) and were frequently hemorrhagic and multinodular. Histologically,there was a wide morphologic spectrum among cases. Six angiosarcoma included areas similar to cavernous and capillary hemangioma,spindle cell and epithelioid sarcoma. In the hepatic EHE,the tumor were comprised of dendritic and epithelioid cells that often contained vacuoles representing intracellular lumina. The stroma was fibrous with myxohyaline areas. Immunohistochemically,all tumors were positive for at least one endothelial marker(factor Ⅷ related antigen and /or CD 34 ). Conclusion:Hepatic malignant vascular tumor is very rare, the angiosarcoma of the liver is highly malignant with short survival. The prognosis of EHE is usually much better than that of angiosarcoma, surgical resection can obtain prolonged survival. The diagnosis can be made based on histological and immunohistochemical features of the tumor.

Nitric oxide synthases expression in human bladder cancer and their relationship with angiogenesis / 中华泌尿外科杂志

Objective Evaluated NOS expression in bladder tissue from the patients with transitional cell carcinoma (TCC) of the bladder and studied its relationship with angiogenesis. Methods Bladder carcinoma tissue specimens were procured from 58 patients with TCC and 14 cases of benign bladder tissue as contrast group. NOS immunohistochemistry was performed on all tissue specimens and microvessal density (MVD) was counted by endothelial cells immunostained. Results Inducible NOS specific proteins were found in 47 of 58 bladder cancer specimens but not in control bladder tissue. The malignant cells and inflammatory cells within the carcinomas were highly iNOS positive whereas specimens of bladder mucosa outside the malignant regions showed only a weak positive iNOS immunostaining. The endothelial cells in both normal urothlium and tumor tissue showed a highly positive eNOS immunostaining but its immunoreaction was not detected in either malignant or benign epithelium. MVD was (39.3?19.5)/HP and (29.3?10.5)/HP in iNOS positive and negative tissues respectively (P