PDF(Pubmed)
Abstract：
An epithelioid hemangioma (EH) is a rare benign vascular lesion that is usually seen in superficial small vessels within the dermis and subcutaneous tissue. Intravascular epithelioid hemangiomas of large and medium-sized vessels are rare, and only a handful of cases have been reported in the literature. Intravascular epithelioid hemangiomas are biologically benign and best treated by complete surgical excision. On occasion, lesions have been associated with aneurysmal changes in the affected vessel. Local recurrence may occur, and close clinical follow-up is advised. Herein, we report the second case in the literature of an EH originating from the popliteal artery. A 57-year-old male patient presented with a one-month history of knee pain without claudication. Imaging highlighted a right popliteal aneurysm, 5x5 cm, with partial distal thrombosis and inadequate outflow. The patient subsequently underwent popliteal artery ligation above and below the aneurysm, reconstructed with a superficial femoral artery (SFA) to distal anterior tibial artery (ATA) reverse saphenous vein bypass graft. Patient recovery was complicated by the development of a 5x5 cm right-sided mid-thigh hematoma, requiring evacuation under anesthesia. A post-one-year arterial duplex of the affected limb demonstrated a recurrent enlarging popliteal aneurysm measuring 5.7x4.8x9.1 cm. The aneurysm was reported to be mostly thrombosed with noted vascularity, but patency of the original bypass was noted. The patient underwent excision of the recurrent aneurysm with subsequent ligation of the feeding arteries. Pathology and histology confirmed the final diagnosis of EH of the popliteal artery. An 18-month follow-up after the excision procedure demonstrated no recurrence of vascular lesion and patency of the original bypass graft.
摘要：
上皮样血管瘤（EH）是一种罕见的良性血管病变，通常见于真皮和皮下组织内的浅表小血管。大型和中型血管的血管内上皮样血管瘤很少见，文献中只报道了少数病例。血管内上皮样血管瘤是生物学良性的，最好通过完全手术切除治疗。有时,病变与受影响血管的动脉瘤改变有关。可能发生局部复发，建议密切临床随访。在这里，我们报告了文献中的第二例EH源自the动脉。一名57岁的男性患者有一个月的膝关节疼痛史，但没有跛行。成像突出显示了右动脉动脉瘤,5x5厘米，部分远端血栓形成和流出不足。患者随后在动脉瘤上方和下方进行了动脉结扎术，重建股浅动脉（SFA）至远端胫骨前动脉（ATA）反向隐静脉旁路移植。患者的恢复因5x5厘米右侧大腿中部血肿的发展而复杂化，需要在麻醉下撤离.患肢一年后的动脉双工显示出复发性扩大的the动脉瘤，尺寸为5.7x4.8x9.1cm。据报道，动脉瘤主要是血栓形成的血管，但注意到原始旁路的通畅性。患者接受了复发性动脉瘤的切除，随后结扎了喂养动脉。病理和组织学证实了the动脉EH的最终诊断。切除手术后18个月的随访表明，没有复发血管病变和原始旁路移植物的通畅。
