Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.262
Filtrar
1.
Chirurgia (Bucur) ; 115(2): 267-273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32369732

RESUMO

A 52 years old woman, asymptomatic, with no significant medical history, presented to a thoracic surgery department for excision of a giant mediastinal mass that was incidentally detected during a routine abdominal ultrasound. Various imaging methods (echocardiography, chest X-ray, CT-scan, MRI) located the mediastinal mass as paracardiac and the excision using video-assisted thoracoscopic surgery (VATS) was proposed, in general thoracic surgery department. Although initially considered a paracardiac mass, intraoperatively the tumor location proved to be intrapericardial. Reaching the limits of VATS, a median sternotomy and longitudinal pericardiotomy were performed, demonstration a right atrium tumor with intrapericardial extension. At this stage, the excision was considered impossible without cardiopulmonary bypass and cardiac arrest. Having this information, the case was deferred to cardiovascular surgery, one week after and, a complete resection of the tumor was performed without incidents. Both atria were reconstructed with patches of autologous and bovine pericardium. The postoperative outcome of the patient was very good and the histopathology report showed that the tumor was a cavernous hemangioma. The literature was reviewed for this pathology. a rare case of a giant cavernous hemangioma of the heart, with diagnostic pitfalls had a successful multidisciplinary staged approach.


Assuntos
Neoplasias Cardíacas/cirurgia , Hemangioma Cavernoso/cirurgia , Procedimentos Cirúrgicos Cardíacos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Reoperação , Cirurgia Torácica Vídeoassistida
2.
Radiol Med ; 125(7): 609-617, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32072390

RESUMO

BACKGROUND: This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting. MATERIALS AND METHODS: This is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Radiation exposure (dose area product [DAP], air KERMA (AK) and fluoroscopy time [FT]), technical success, clinical success, complications and survival were analyzed. RESULTS: In total, 29 patients had CPVT and 20 patients had PC. 41/49 patients had cirrhosis. TIPS indications were refractory ascites (n = 25), variceal bleeding (n = 16) and other (n = 8). TIPS was successfully placed in 94% (46/49) of patients via a transjugular approach alone (n = 40), a transjugular/transhepatic approach (n = 5) and a transjugular/transsplenic approach (n = 1). Median DAP was 261 Gy * cm2 (range 29-950), median AK was 0.2 Gy (range 0.05-0.5), and median FT was 28.2 min (range 7.7-93.7). Mean portosystemic pressure gradient decreased from 16.8  ±  5.1 mmHg to 7.5  ±  3.3 mmHg (P <  0.01). There were no major procedural complications. Overall clinical success was achieved in 77% of patients (mean follow-up of 21.1 months). Encephalopathy was observed in 16 patients (34%), grade II-III encephalopathy in 7 patients (15%). TIPS revision was performed in 15 patients (32%). Overall survival rate was 75%. CONCLUSION: In our experience, the use of real-time ultrasound guidance allowed the majority of the TIPS to be performed via a transjugular approach alone with a reasonably low radiation exposure considering the high technical difficulties of the selected cohort of patients with CVPT or PC.


Assuntos
Hemangioma Cavernoso/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Derivação Portossistêmica Transjugular Intra-Hepática , Exposição à Radiação , Ultrassonografia de Intervenção , Trombose Venosa/diagnóstico por imagem , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Varizes Esofágicas e Gástricas/cirurgia , Feminino , Fluoroscopia , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/cirurgia , Hemangioma Cavernoso/cirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trombose Venosa/cirurgia
3.
World Neurosurg ; 133: e197-e204, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31491572

RESUMO

OBJECTIVE: To evaluate the functional connectivity (FC) and resting-state networks (RSNs) in patients under anesthesia operated for resection of intracerebral lesions. METHODS: We performed intraoperative resting-state functional magnetic resonance imaging (irs-fMRI) in 24 patients under anesthesia before and after lesion resection. Correlation matrices were established for each session (a total 48 of sessions). We analyzed the changes in overall FC and in FC of the healthy and operated hemispheres between the first and second sessions. We tested the correlation between changes in FC and clinical outcomes and the duration, rate, and total dosage of anesthesia. We also performed a group analysis to detect topographic changes in RSNs in patients under anesthesia. A single-subject analysis was performed to detect clinically relevant RSNs in each patient. RESULTS: FC decreased significantly in the second session, as did interhemispheric connectivity. The decrease in the pathological hemisphere was significant and significantly greater than the decrease in the intrahemispheric connectivity of the healthy hemisphere. The change in FC was not correlated with clinical outcome or with the duration, rate, or dosage of anesthesia. Group analysis showed topographic changes in RSNs, especially in high-level networks such as default mode and salience networks. Identification of clinically relevant networks was also possible. CONCLUSIONS: FC and RSNs could be identified under anesthesia and used for extended brain mapping. Further studies are needed to optimize the depth of hypnosis to stabilize FC between sessions.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Conectoma/métodos , Glioma/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neuronavegação/métodos , Radiografia Intervencionista/métodos , Cirurgia Assistida por Computador , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/cirurgia , Pré-Escolar , Feminino , Glioma/cirurgia , Hemangioma Cavernoso/cirurgia , Humanos , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
World J Surg Oncol ; 17(1): 205, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31801558

RESUMO

BACKGROUND: The cavernous hemangioma of mediastinum (CHM) is a rare benign lesion caused by congenital vascular dysplasia. However, its incidence is extremely low, and patients often lack relevant clinical symptoms. So we analyzed retrospectively some cases to investigate the imaging features of cavernous hemangioma of mediastinum (CHM) and improve the diagnostic accuracy. METHODS: The CT/MRI imaging features and clinical information of 19 patients with CHM were analyzed retrospectively. RESULTS: The lesions of 18 CHM patients were single. Twelve cases in the anterior mediastinum and 8 in the posterior mediastinum. The diameter of CHM ranges from 2.0 to 7.0 cm. Thirteen cases were oval-shaped or round, 4 cases were lobulated, and 2 cases were irregular. Phleboliths or nodular calcification were identified in four cases. High signal of T2WI lipid suppression in two cases and blood vessel shadows were observed in two cases. After contrast-enhanced scan, the nodular enhancement of arteries were identified in 14 cases and contrast agent was further filled of the venous phase, where "fast in and slow out" feature was performed. One case showed inhomogeneous enhancement, one case performed "fast in and slow out" feature of multiphase-enhanced MRI. Besides, aberrant veins can be seen in or around the lesion among five cases. CONCLUSIONS: CHM is more frequently located at the anterior mediastinum than at the posterior mediastinum. The performance of phleboliths, high signal on T2WI fat suppression and DWI, the nodular enhancement of the artery, venous and delayed phase filling, enhanced "fast in and slow out," and aberrant veins in the lesion are helpful for the diagnosis and differential diagnosis. Multiple period contrast-enhanced CT and MRI scan is helpful for the diagnosis of CHM.


Assuntos
Hemangioma Cavernoso/diagnóstico , Imagem por Ressonância Magnética/métodos , Neoplasias do Mediastino/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Seguimentos , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Adulto Jovem
5.
BMC Ophthalmol ; 19(1): 259, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842792

RESUMO

BACKGROUND: We report a rare case of sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage. CASE PRESENTATION: A 45-year-old woman presented decreased visual acuity in both eyes. Her best corrected visual acuity was 0.1 in the right eye and 0.15 in the left eye. Goldmann perimetry showed bilateral central scotomas and bitemporal visual field defects. MRI demonstrated a lesion with mixed hypo- and hyperintensity at the optic chiasm, which was thought to be an intratumoral hemorrhage. The patient underwent bifrontal craniotomy. The tumor was exposed via an anterior interhemispheric approach, and histological evaluation of the mass led to a diagnosis of cavernous angioma. Six months after the surgery, her best corrected visual acuity was 0.9 in the right eye and 0.9 in the left, with slight bitemporal visual field defects. CONCLUSION: Third ventricular cavernous angioma is considered in the differential diagnosis of chiasmal syndrome. Contrast-enhanced MRI and FDG-PET might be useful for differential diagnosis of cavernous angioma from other chiasmal tumors including glioblastoma.


Assuntos
Cegueira/etiologia , Neoplasias Encefálicas/complicações , Hemangioma Cavernoso/complicações , Hemorragias Intracranianas/complicações , Terceiro Ventrículo/patologia , Cegueira/diagnóstico por imagem , Cegueira/fisiopatologia , Cegueira/cirurgia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/cirurgia , Craniotomia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Lateralidade Funcional , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/fisiopatologia , Hemangioma Cavernoso/cirurgia , Humanos , Hemorragias Intracranianas/diagnóstico por imagem , Hemorragias Intracranianas/fisiopatologia , Hemorragias Intracranianas/cirurgia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/administração & dosagem , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia
6.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(5): 719-722, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31699207

RESUMO

Extracerebral cavernous hemangioma typically occurs in cavernous sinus in middle cranial fossa,showing iso-or hypointensity on T1WI,obvious hyperintensity on T2WI,and evident enhancement after contrast administration during magnetic resonance imaging(MRI).In this article we report one case of atypical cavernous hemangioma of the trigeminal nerve,with atypical MRI findings including isotense or slight long T2 signal,dotty short T1 signal,and non-enhancement on T1WI.


Assuntos
Hemangioma Cavernoso/diagnóstico por imagem , Nervo Trigêmeo/patologia , Seio Cavernoso/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética
7.
BMC Gastroenterol ; 19(1): 198, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775640

RESUMO

BACKGROUND: This case seeks to highlight to endoscopists a rare benign disorder that may be encountered during endoscopy. Clinicians may be tempted to biopsy, which could lead to a catastrophic gastrointestinal haemorrhage. CASE PRESENTATION: A 66-year-old asymptomatic Caucasian male was referred for colonoscopy with a positive faecal occult blood test as part of the UK national bowel cancer screening programme. Relevant past medical history included atrial fibrillation for which he took Dabigatran. He had a normal haemoglobin, mean cell volume, platelet and clotting function. During colonoscopy, an unusual vascular pattern encompassing the entire rectum extending to the rectosigmoid junction was noted at intubation. The lesion demonstrated confluent circumferential purple discolouration indicating venous blood supply, with heaping up of the mucosa involving the entire rectum and rectosigmoid junction. There was no corresponding history of venothromboembolic disease or liver disease. The patient proceeded to have computed tomography (CT) which revealed a considerably thickened rectosigmoid wall with multiple small rounded punctate calcifications within it, and no other visceral involvement. Subsequent magnetic resonance (MR) scan of the pelvis demonstrated extensive diffuse thickening of the rectum and lower sigmoid with intermediate to high T2 signal, and an internal architecture of multiple 'grapelike' lobulations. CONCLUSION: The findings were consistent with diffuse cavernous haemangiomatosis of the rectum (DCHR), an extremely rare benign submucosal vascular intestinal tumour originating from the dentate line. Misdiagnosis of DCHR is common and the macroscopic appearance of DCHR can mimic varices, haemorrhoids, polyps or proctitis. MR imaging is the gold standard for diagnosis. Common presentation is with haematochezia due to mucosal wall erosion. The treatment of choice for symptomatic DCHR is pull-through transection and colo-anal anastomosis. This case seeks to highlight a rare disorder that can be encountered incidentally during lower GI endoscopy. Injudicious biopsy is potentially catastrophic. In a patient who endoscopically has evidence of a DCHR, we advocate MR pelvis assessment to clarify the nature of the lesion to guide future management if required. The patient discussed remains well, asymptomatic, with no evidence of iron deficiency anaemia.


Assuntos
Hemangioma Cavernoso/diagnóstico por imagem , Neoplasias Retais/diagnóstico por imagem , Idoso , Colonoscopia , Detecção Precoce de Câncer , Humanos , Achados Incidentais , Imagem por Ressonância Magnética , Masculino , Sangue Oculto , Tomografia Computadorizada por Raios X
8.
BMC Gastroenterol ; 19(1): 197, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771513

RESUMO

BACKGROUND: Pancreatic cavernous hemangioma is an extremely rare benign tumor that is difficult to diagnose on an imaging examination, and its histopathological examination has rarely been reported. CASE PRESENTATION: Herein, we present the case of a 63-year-old man who was admitted to the hospital due to left upper abdominal pain and defecation unformed for more than 2 years. None of the positive results obtained from the physical examination could explain his symptoms. The imaging examination indicated a multilocular cyst with septa in the head of the pancreas. The patient underwent a pancreaticoduodenectomy, and the pathologic diagnosis was pancreatic cavernous hemangioma. The histopathological examination showed that the lesion was positive for benign vascular markers, such as CD31, CD34 and F8, and negative for lymphocyte markers, such as D2-40. Moreover, it was also positive for ERG and cytokeratin markers, CAM5.2 and AE1/AE3, indicating the complexity of its components, and Ki-67 negativity revealed its benign nature. CONCLUSIONS: Pancreatic cavernous hemangioma has a complex composition that may be reflected not only in the imaging examination but also in the immunohistochemical detection, and it may achieve a good outcome by surgical excision.


Assuntos
Hemangioma Cavernoso/patologia , Neoplasias Pancreáticas/patologia , Biomarcadores Tumorais/análise , Endossonografia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios X
9.
Ophthalmic Surg Lasers Imaging Retina ; 50(11): e320-e323, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31755984

RESUMO

Optical coherence tomography angiography (OCTA) is a novel imaging modality, and its role in the clinical evaluation of patients remains to be defined. In this report, the authors describe a case of a retinal cavernous hemangioma and show that OCTA of the lesion recapitulates many structural features first described in previous histopathologic studies, including aneurysmal architecture, septated blood flow, and epiretinal membrane. Thus, OCTA provides a new, noninvasive means of studying retinal cavernous hemangioma structure, a unique capability that may also be clinically relevant to the evaluation of other pathologic retinal vascular tumors, such as capillary and racemose hemangiomas. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e320-e323.].


Assuntos
Angiofluoresceinografia , Hemangioma Cavernoso/patologia , Neoplasias da Retina/patologia , Tomografia de Coerência Óptica , Adulto , Membrana Epirretiniana/patologia , Angiofluoresceinografia/métodos , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Masculino , Neoplasias da Retina/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
10.
J Radiol Case Rep ; 13(2): 15-25, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31565168

RESUMO

Primary angiosarcoma of the breast is a rare (0.04% of all malignant breast tumors) and potentially life-threatening disease. Given its variable and non-specific clinical, radiological and pathological presentation, accurate diagnosis is a challenge. Primary angiosarcoma of the breast predominantly occurs in younger patients and it is often overlooked and misdiagnosed at radiology and pathology. To ensure that this aggressive malignancy is not overlooked, radiologists need to be aware of the fact that such tumors may present with non-specific imaging features. We report a case of a 32-year-old female with primary angiosarcoma of the breast presenting with non-specific imaging features. It was initially interpreted as a capillary cavernous hemangioma at histopathology following an ultrasound-guided biopsy. This eventually turned out to be angiosarcoma after a second histopathology opinion was sought in light of the radiology-pathology discordance.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/patologia , Adulto , Mama/diagnóstico por imagem , Mama/patologia , Diagnóstico Diferencial , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Biópsia Guiada por Imagem , Imagem por Ressonância Magnética , Mamografia , Ultrassonografia
12.
Medicine (Baltimore) ; 98(37): e16986, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517817

RESUMO

RATIONALE: Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial. PATIENT CONCERNS: A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation. DIAGNOSES: Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination. INTERVENTIONS: We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times. OUTCOMES: She was cured and had no recurrence during the 3-month follow-up. LESSONS: This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.


Assuntos
Antineoplásicos/administração & dosagem , Hemangioma Cavernoso/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Triancinolona Acetonida/administração & dosagem , Nádegas , Pré-Escolar , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Humanos , Injeções Intralesionais , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
13.
Clin Lab ; 65(9)2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31532104

RESUMO

BACKGROUND: The Cavernous Angioma in Posterior Sagittal Sinus is exceedingly rare. METHODS: We report for the case of a 10-year-old male patient who was diagnosed with Cavernous Angioma in Posterior Sagittal Sinus. RESULTS: Our case is the second reported case of Cavernous Angioma in Posterior Sagittal Sinus in the world. CONCLUSIONS: It is very rare for the cavernous hemangioma to occur in the sinus, preoperative conventional MR scan lacks specificity and easily leads to misdiagnosis. Head MR enhancement, MRBTI, and SWI can provide more useful diagnostic information. The final diagnosis depends on the pathology examination.


Assuntos
Seio Cavernoso/patologia , Dura-Máter/irrigação sanguínea , Hemangioma Cavernoso/diagnóstico , Neoplasias Meníngeas/diagnóstico , Seio Cavernoso/diagnóstico por imagem , Criança , Dura-Máter/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
15.
J Comput Assist Tomogr ; 43(5): 762-769, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356526

RESUMO

OBJECTIVE: The objective of this study was to evaluate the imaging features of a hepatic sclerosed hemangioma by comparing them with those of a cavernous hemangioma using magnetic resonance imaging with gadoxetic acid enhancement. METHODS: Nine patients with hepatic sclerosed hemangiomas and 36 patients with cavernous hemangiomas (control group) who underwent gadoxetic acid-enhanced magnetic resonance imaging were included. Qualitative values (imaging findings and enhancement pattern [typical vs atypical enhancement]) and quantitative values (apparent diffusion coefficient) were evaluated. RESULTS: Patients with sclerosed hemangiomas showed significantly more irregular tumor margin on hepatobiliary phase images, peritumoral arterial enhancement, and a lower proportion of hyperintensity on heavily T2-weighted images compared with controls (all P values <0.05). In addition, the sclerosed hemangioma group had significantly more frequent atypical enhancement patterns than did the control group (88.9% vs 33.3%; P = 0.006). However, the mean apparent diffusion coefficient value of hemangiomas was not significantly different between the 2 groups (P = 0.639). CONCLUSIONS: Gadoxetic acid-enhanced magnetic resonance images can help in differentiating between hepatic sclerosed hemangiomas and cavernous hemangiomas.


Assuntos
Meios de Contraste/administração & dosagem , Gadolínio DTPA/administração & dosagem , Hemangioma/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
BMC Cardiovasc Disord ; 19(1): 179, 2019 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357944

RESUMO

BACKGROUND: Cardiac haemangiomas are exceptionally rare. They are usually solitary growths. Cardiac haemangiomas can be classified as capillary, cavernous, or arteriovenous in nature. They can occur in any chambers of the heart, but are predominantly found at the intramural or endocardial layers. CASE PRESENTATION: This is a rare case of a cardiac haemangioma located on the epicardium of a 52-year-old male patient. The patient complained of 1-year duration of chest tightness and shortness of breath. The haemangioma was removed successfully. For symptomatic lesions, surgical removal remains the preferred treatment. CONCLUSION: The pathological diagnosis was primary cardiac cavernous haemangioma. In this case, the haemangioma was successfully resected with invasive surgery. No recurrence was detected on follow up.


Assuntos
Neoplasias Cardíacas/patologia , Hemangioma Cavernoso/patologia , Pericárdio/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/diagnóstico por imagem , Pericárdio/cirurgia , Resultado do Tratamento
17.
BMJ Case Rep ; 12(7)2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31352392

RESUMO

A 53-year-old female patient known to have Cowden disease (PTEN mutation positive) was found to have a mass at the left atrium on a CT coronary angiography performed as part of a preoperative workup for an unrelated surgery. Further radiological characterisation of the lesion was achieved using MRI and positron emission tomography. Interval growth prompted surgical excision; however, surgery was expedited after the patient presented with haemopericardium and cardiac tamponade. The patient was discharged home 8 days postoperatively, and no intraoperative or postoperative complications were encountered. A diagnosis of cavernous haemangioma was made on histology.


Assuntos
Tamponamento Cardíaco/complicações , Síndrome do Hamartoma Múltiplo , Átrios do Coração/patologia , Hemangioma Cavernoso/patologia , Achados Incidentais , Angiografia Coronária , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , PTEN Fosfo-Hidrolase , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
BMJ Case Rep ; 12(7)2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31289165

RESUMO

Cowden syndrome (CS) is a rare disorder characterised by multiple non-cancerous, tumour-like growths called hamartomas. The syndrome is associated with the development of cancer of the breast, endometrium, kidneys, skin and rarely the brain. We report a rare case of symptomatic cardiac haemangioma in a patient with CS. A 54-year-old woman with CS presented with dyspnoea and orthopnoea in the setting of cardiac tamponade. Echocardiography revealed a large haemopericardium and tamponade physiology, secondary to a pericardial mass. The patient underwent urgent cardiopulmonary bypass with removal of the mass. Histopathology confirmed a benign cavernous haemangioma. We postulate that tumours involving the heart/pericardium may be an additional manifestation of CS. This case further highlights the necessity to consider pericardial/cardiac manifestations in patients with hamartomatous syndromes who present with cardiorespiratory symptoms, so that opportunistic investigation and treatment may be instituted.


Assuntos
Tamponamento Cardíaco/etiologia , Síndrome do Hamartoma Múltiplo/complicações , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/cirurgia , Tamponamento Cardíaco/diagnóstico por imagem , Ponte Cardiopulmonar/métodos , Ecocardiografia/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
19.
J Med Case Rep ; 13(1): 231, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31311579

RESUMO

BACKGROUND: Synovial hemangioma of the knee is a rare benign tumor. Very rarely, the growth of bone is affected by long-term neglect of an intra-articular tumor. Our patient had not only various clinical symptoms but also dysplasia of the femoral bone. In this report, we aimed to raise awareness to prevent various disorders arising from an unnoticed or untreated hemangioma occurring within the knee joint. CASE PRESENTATION: Our patient was a 41-year-old Japanese man who had had occasional discomfort in the right knee since elementary school. Although he had undergone radiography at several hospitals since childhood, no issues were reported; subsequently, he consulted our hospital. We performed magnetic resonance imaging and discovered a mass. The mass was homogeneous with low intensity on T1-weighted sequences and high intensity on T2-weighted sequences adjacent to the medial femoral condyle. The shape of the medial femoral condyle presented with a concavity in axial images, with irregular margins from the patellofemoral joint to the medial femoral condyle. Moreover, by using magnetic resonance angiography, we discovered a second mass. We decided to perform open surgery to achieve complete excision. Histological examination indicated a synovial hemangioma involving a cavernous hemangioma and irregular arteriovenous connections originating from the subsynovial tissue. The patient became asymptomatic after surgery, with no recurrence for more than 4 years. CONCLUSIONS: Synovial hemangioma is rare and difficult to diagnose in outpatient examinations because radiography has a limited diagnostic capacity. Magnetic resonance imaging and angiography are very useful. Nontreatment of intra-articular hemangiomas may lead to dysplasia of the bone and various clinical symptoms. Early complete excision may be instituted to reduce these risks of hemarthrosis.


Assuntos
Hemangioma Cavernoso/patologia , Artropatias/patologia , Neoplasias de Tecidos Moles/patologia , Adulto , Diagnóstico Tardio , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Artropatias/diagnóstico por imagem , Artropatias/cirurgia , Articulação do Joelho , Imagem por Ressonância Magnética , Masculino , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgia
20.
Acta Otolaryngol ; 139(8): 720-725, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31155992

RESUMO

Background: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered 'anatomically' malignant. Aims: To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome. Methods: We realised a hospital-based retrospective case review including data from 76 patient files. Results: The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) (p < .001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient r = -0.5, p < .001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA. Conclusion: Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.


Assuntos
Hemangioma Cavernoso/cirurgia , Neoplasias Orbitárias/cirurgia , Adolescente , Adulto , Criança , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Oftalmoscópios , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Acuidade Visual
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA