PHACE syndrome describes the association of large segmental haemangioma with extracutaneous features (posterior fossa anomalies, arterial, cardiac, eye and endocrine anomalies). We report a case of segmental facial infantile haemangioma with PHACE syndrome treated successfully with oral propranolol without neurological sequelae.
We present a rare case of a multifocal sclerosing haemangioma of the lung in a 49-year-old lady. A left pneumonectomy with complete excision of the tumour seems to be the curative treatment. The recent literature on this unusual presentation is reviewed.
Hemangiomas are the most common congenital lesions in man and occur predominantly in the head and neck region. Massive hemangioma especially near vital organs or structures pose a challenge to surgeons. With the availability of expertise in embolization of feeding vessel of the hemangioma and reconstructive techniques we were able to manage successfully a complicated case of massive facial hemangioma.
The mangement of vascular lesions such as haemangiomas frequently present difficult choices between various treatment modalities. Circumstances may limit the,number of options available for the surgeon. This article describes the circumstances, investigations, difficult choices, and eventual treatment of a case of a mandibular haemangioma. It is concluded that for a medium sized haemangioma such as in this case,in the absence of facilities to embolize it, surgical excision may be safely carned out provided that proper investigations and precautions have been conducted. An angiogram is of utmost important in determining the feeding vessels and is very important before any surgical procedure is attempted.
Infantile haemangioma represents a congenital vascular anomaly commonly observed in the head and neck region. Such an occurrence over the postcricoid region, however, is rather unusual. Herein, the authors report a case of a synchronous postcricoid haemangioma in a 7-week-old newborn diagnosed with severe laryngomalacia. In addition to the floppy redundant arytenoid mucosa, flexible laryngoscopy revealed a lobulated bluish mass at the postcricoid. The lesion was hyperintense on T1-weighted sequence and was enhanced with contrast, supporting the diagnosis of a haemangioma. She underwent surgical excision of the haemangioma with intralesional steroid injection. Surveillance at 6-month postoperation did not show disease recurrence.
Laryngeal hemangiomas are relatively rare. Laryngeal hemangiomas occur in two main forms--infantile and adult laryngeal hemangiomas. While infantile hemangiomas are usually found to occur in the subglottis, adult hemangiomas occur commonly in the supraglottic regions of the larynx. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present a case of hemangioma of the right vocal cord in an adult, which was managed successfully in our center.
Intranasal haemangioma is quite rare. This tumor may be confused with other intranasal vascular tumor such as juvenile nasopharyngeal angiofibroma (JNA), glomus tumors as well as other tumor such as angiosarcoma and leiomyoma. Juvenile nasopharyngeal angiofibroma is the most common vascular tumor encountered in nasal cavity. A definitive histology diagnosis pre-operatively is difficult to be obtained as the biopsy may lead into severe uncontrolled bleeding. The final diagnosis very much depends on histology after the tumor excision. Complete surgical resection of the tumor is the standard approach. In this report we describe our surgical management in approaching intranasal haemangioma endoscopically and this pathology can be considered as one of differential diagnosis for unilateral nasal mass.
Tuberous sclerosis is a disease with a well known association with renal masses, both cysts and angiomyolipomas. Reported here is a case of a 26 year old woman who had, in addition to angiomyolipomas of the kidneys, adenoma sebaceum, paraungual fibromas, shagreen patches and cerebral tubers.
A neck mass with soft consistency suggests the diagnosis of a cyst which is usually congenital in origin. Needle aspiration yielding blood should alert the physician the possibility of hemangioma although it is very rare. Ultrasonography and computed tomography will delineate the extent and nature of the lesion and provide the roadmap for surgical excision. We report a case of a girl who presented with a painless neck mass which was later found to be a hemangioma originating from the sternohyoid muscle. The morphology and immunohistochemical stain were consistent with hemangioma.
Cavernous hemangioma is a vascular tumor composed of large dilated blood vessels and containing large blood-filled spaces. The formation is due to dilation and thickening of the walls of the capillary loops. Most cavernous hemangiomas present at birth or soon after. On the other hand, jugular phlebectasia is an abnormal benign sacculofusiform dilatation of jugular veins. It should be considered as one of the differential diagnosis of neck swelling. Majority of the reported cases occurred in a young child. We reported a case of an elderly woman who was diagnosed clinically as anterior jugular vein phlebectesia. Histologically the mass turned out to be a cavernous hemangioma.
Adrenal tumours are either functioning or non-functioning. Non-functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.
The majority of infantile hemangiomas are benign and will resolve on their own. We report a 4-month-old infant with an ulcerated giant segmental infantile hemangioma involving the left upper limb who developed a contracture of the left elbow despite treatment with oral propranolol, proper wound care, and regular intense physiotherapy. To our knowledge, contracture resulting from an infantile hemangioma has not been reported previously.
The authors report a case of a 6-year-old girl who developed subacute intestinal obstruction after a trivial blunt trauma to her abdomen. Her normal vital signs masked the presence of intestinal bleeding. An incidental finding at surgery of a haematomatous polypoid vascular growth of the ileum was subsequently confirmed to be cavernous haemangioma of the small bowel. Surgical resection was curative in this patient.
We report two cases of uncommon vascular lesions (Littoral cell angioma and liver haemangioma) mimicking traumatic organ injuries. The patients' histories and clinical findings of trauma were well demonstrated. Both patients had interesting CT scan features that were suggestive of solid organ injuries. However, both conditions were subsequently found to be benign incidental lesions.
A 29 year old Chinese female who presented with spontaneous purpura, was found to have gross hepatomegaly and thrombocytopenia. The thrombocytopenia responded to steroid therapy but relapsed when the dose of steroid was tapered down. Subsequent investigations revealed that the hepatomegaly was due to a large haemangioma of her liver. For symptomatic hepatic haemangioma, surgical excision is the treatment of choice; this was refused by the patient.