Hemangioma, Cavernous

血管瘤,海绵状
  • 文章类型: Systematic Review
    目的:伽玛刀(GKRS)治疗眼眶海绵状血管瘤(OCH)的临床效果明显,并发症发生率低,已成为一种有前途的方法。本研究旨在评估GKRS治疗OCH的安全性和有效性。
    方法:根据PRISMA框架,我们搜索了PubMed,CochraneCentral,和Embase用于报告OCHGKRS结果的研究。报告并发症的研究,视觉改善,突增,肿瘤减少率,包括GKRS后OCH的肿瘤进展率。
    结果:六项研究,在1856个搜索结果中,包括100名患者。其中,只有5个轻微的并发症与GKRS有关,包括3例眼眶疼痛和2例眼眶周围放化疗。因此,并发症发生率为13%(95%CI,7-25%).GKRS后视力和视野改善率分别为80%(95%CI,63-96%)和71%(95%CI,47-95%)。94%的病例中,前突改善(95%CI,83-100%)。GKRS后肿瘤缩小率为77%(95%CI,69-85%)。
    结论:用于OCH的GKRS似乎是一种安全的技术,临床改善率和放射学改善率证明了这一点。然而,研究受到对照组缺失的限制.与OCH的替代手术方式相比,还需要其他研究来评估GKRS的相对疗效。
    OBJECTIVE: Gamma knife radiosurgery (GKRS) for orbital cavernous hemangioma (OCH) has emerged as a promising method due to its significant clinical improvement and low incidence of complications. This study aimed to evaluate the safety and efficacy of GKRS for the treatment of OCH.
    METHODS: In accordance with the PRISMA framework, we searched PubMed, Cochrane Central, and Embase for studies reporting outcomes of GKRS for OCH. Studies reporting complications, visual improvement, proptosis, tumor reduction rate, and tumor progression rate for OCH following GKRS were included.
    RESULTS: Six studies, out of 1856 search results, with 100 patients were included. Among them, only 5 minor complications were related to GKRS, including 3 with orbital pain and 2 with periorbital chemosis. Thus, the complication rate was 13% (95% CI, 7-25%). Visual acuity and visual field improvement rates after GKRS were 80% (95% CI, 63-96%) and 71% (95% CI, 47-95%) respectively. Proptosis improved in 94% of cases (95% CI, 83-100%). The tumor reduction rate was 77% after GKRS (95% CI, 69-85%).
    CONCLUSIONS: GKRS for OCH appears to be a safe technique, as evidenced by the rate of clinical improvement and radiological improvement. However, studies are limited by an absence of a control group. Additional studies are needed to evaluate the relative efficacy of GKRS as compared with alternative surgical modalities for OCH.
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  • 文章类型: Case Reports
    背景:单纯硬膜外脊髓海绵状血管瘤是罕见的,良性血管肿瘤,约占所有脊髓硬膜外肿瘤的4%。由于它们的哑铃形和孔侵入的倾向,他们经常被误诊和治疗不当。我们介绍了一例58岁的男性骨外海绵状血管瘤,以更好地帮助诊断和治疗这些病变。
    方法:一名58岁男性出现慢性下背痛,进行性下肢无力,T10感官水平,下肢本体感觉缺失,反射亢进,和大便失禁.成像显示T7-T10同质背侧硬膜外肿块引起索信号变化。他接受了组织病理学检查的切除术,发现单纯的硬膜外海绵状血管瘤。
    结论:脊髓硬膜外海绵状血管瘤是极为罕见的病变,常被误诊为神经鞘瘤和脑膜瘤。常见特征包括慢性疼痛和脊髓病以及T1等密度,T2高强度,和同质增强。独特的,它们呈现为分叶的,纺锤形,在硬膜外背侧间隙有锥形末端。总切除和次全切除均可产生良好的神经系统结局。
    BACKGROUND: Pure epidural spinal cavernous hemangiomas are rare, benign vascular tumors that account for approximately 4% of all spinal epidural tumors. Due to their dumbbell shape and propensity for foraminal invasion, they are often misdiagnosed and inadequately treated. We present a case of a 58-year-old male with extra-osseous cavernous hemangioma to better aid in diagnosis and management of these lesions.
    METHODS: A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. He underwent resection with histopathologic exam revealing a pure epidural cavernous hemangioma.
    CONCLUSIONS: Spinal epidural cavernous hemangiomas are exceedingly rare lesions that are often misdiagnosed as nerve sheath tumors and meningiomas. Common features include chronic pain and myelopathy as well as T1 isodensity, T2 hyperintensity, and homogenous enhancement. Uniquely, they present as a lobulated, spindled shape with tapered ends in the dorsal epidural space. Both gross and subtotal resection result in favorable neurologic outcomes.
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  • 文章类型: Journal Article
    肝血管瘤是最常见的良性肝肿瘤。通常,小型至中型血管瘤是无症状的,并且是通过广泛使用成像技术而偶然发现的。巨大血管瘤(>5cm)有更高的并发症风险。多种成像方法用于诊断。海绵状血管瘤是最常见的类型,但是放射科医生必须知道其他品种。保守的管理通常是足够的,但有些病例需要有针对性的干预措施。虽然传统上手术是主要的治疗方法,微创手术的发展现在通常推荐经肝动脉化疗栓塞作为治疗的选择.
    Hepatic hemangiomas are the most common benign liver tumors. Typically, small- to medium-sized hemangiomas are asymptomatic and discovered incidentally through the widespread use of imaging techniques. Giant hemangiomas (>5 cm) have a higher risk of complications. A variety of imaging methods are used for diagnosis. Cavernous hemangioma is the most frequent type, but radiologists must be aware of other varieties. Conservative management is often adequate, but some cases necessitate targeted interventions. Although surgery was traditionally the main treatment, the evolution of minimally invasive procedures now often recommends transarterial chemoembolization as the treatment of choice.
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  • 文章类型: Systematic Review
    海绵状瘤是在大脑不同部位发现的组织学良性血管畸形。这种海绵体瘤的罕见部位,然而,是前视路,包括视神经,chiasma,和视神经束称为视交叉海绵瘤(OCC)。这些病变通常表现为突然发作或进行性视力丧失,头痛,和模仿垂体中风的特征。在本文中,我们描述了在我们中心运营的OCC案例。我们对描述OCC病例的文献进行了更新回顾,他们的临床表现,管理,术后并发症。我们还提出了一种基于病变位置的新型分类系统,并根据所使用的手术方法和视觉结果进一步分析了这些海绵状瘤类型。一位30岁的女士有3周的进行性双侧视力丧失和头痛的病史。基于成像,她被怀疑患有交叉和左视束的海绵状血管瘤。由于进行性视力恶化,使用翼点开颅手术切除病变。术后,她的视觉症状有所改善,但她得了尿崩症.手术后18个月进行了临床和放射学随访。文献中总共描述了81例,包括本案。Chiasmal卒中是最常见的表现。手术切除是护理的标准。我们基于病变位置的分析显示,每种海绵状瘤类型的手术方法最合适。视觉结果与术前视觉状态相关。出现急性交叉中风的患者的视觉结果良好,以及完成手术切除时。发现经鼻内镜入路可提供最佳的视觉效果。除了术前视觉状态,完整的手术切除预测OCC良好的视觉结果。我们提出的分类系统指导海绵状瘤特定位置所需的适当手术方法。
    Cavernomas are histologically benign vascular malformations found at different sites in the brain. A rare site for such cavernomas, however, is the anterior optic pathway, comprising the optic nerve, chiasma, and optic tract-called optochiasmatic cavernomas (OCC). These lesions usually present with sudden onset or progressive vision loss, headache, and features mimicking pituitary apoplexy. In this paper, we describe a case of OCC operated at our center. We carry out an updated review of literature depicting cases of OCC, their clinical presentation, management, and postoperative complications. We also propose a novel classification system based on lesion location and further analyze these cavernoma types with respect to the surgical approach used and visual outcome. A 30-year-old lady had presented with a 3-week history of progressive bilateral vision loss and headache. Based on imaging, she was suspected to have a cavernous angioma of the chiasma and left optic tract. Due to progressive vision deterioration, the lesion was surgically excised using pterional craniotomy. Postoperatively, her visual symptoms improved, but she developed diabetes insipidus. Clinical and radiological follow-up has been done for 18 months after surgery. A total of 81 cases have been described in the literature, including the present case. Chiasmal apoplexy is the most common presentation. Surgical excision is the standard of care. Our analysis based on lesion location shows the most appropriate surgical approach to be used for each cavernoma type. Visual outcome correlates with the preoperative visual status. Visual outcome is good in patients presenting with acute chiasmal apoplexy, and when complete surgical excision is performed. The endonasal endoscopic approach was found to provide the best visual outcome. In addition to preoperative visual status, complete surgical excision predicts favorable visual outcomes in OCC. Our proposed classification system guides the appropriate surgical approach required for a particular location of the cavernoma.
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    文章类型: Case Reports
    海绵状血管瘤几乎可以在有血管的身体任何地方出现。甲状腺原发性血管瘤极为罕见,以前只有少数病例报道过。海绵状血管瘤的真实发生率很难估计,因为它们经常被误诊为其他静脉畸形。我们将介绍4例年龄从38岁到72岁,诊断为海绵状血管瘤.所有4例病例均为女性,通过组织病理学检查在甲状腺全切除术后确定诊断。它们在临床上表现为无症状的宫颈肿瘤,偶尔会快速增长,特别是如果存在肿瘤内出血。关键词:海绵状血管瘤,甲状腺,病理学,组织学。
    格利·海绵体海绵体波玛诺·斯维洛帕西·斯维洛普帕西·乌玛诺·乌玛诺·乌玛诺。原发性血管瘤。在非诊断性非诊断性非恶性静脉中,海绵状血管瘤难辨。Noipresentiamo4casichevarianoditrai38edi72anni,诊断为海绵体血管瘤。Tutt'e4icasieranodonneeladiagnosissifufattatramiteesameistopatologicodopotiroidectomiatotale.rapidacrescitaspecialquandoviepresente.
    Cavernous hemangiomas can arise nearly anywhere in the body where there are blood vessels. The primary hemangioma of the thyroid gland is extremely rare, and only a few cases have been previously reported. The true incidence of cavernous hemangiomas is difficult to estimate because they are frequently misdiagnosed as other venous malformations. We will present 4 cases from the age of 38 to 72 years old, diagnosed with cavernous hemangiomas. All 4 cases are women and the diagnosis was established after total thyroidectomy by histopathological examination. They clinically present as asymptomatic cervical tumors, are occasionally fast-growing, especially if intratumoral bleeding is present. KEY WORDS: Cavernous Hemangioma, Thyroid, Pathology, Histology.
    Gli emangiomi cavernosi possono svilupparsi ovunque nel corpo umano ovunque vi siano vasi sanguigni. L’emangioma primario della ghiandola tiroidea è estremamente raro e solo pochi casi sono stati precedentemente riportati. La vera incidenza dell’emangioma cavernoso e difficile da stimare in quanto sono spesso non diagnosticate così come altre malformazioni venose. Noi presentiamo 4 casi che variano di età tra i 38 ed i 72 anni, diagnosticati con emangioma cavernoso. Tutt’e 4 i casi erano donne e la diagnosi fu fatta tramite esame istopatologico dopo tiroidectomia totale. Trattasi di tumori cervicali clinicamente asintomatici ed occasionalmente di rapida crescita specialmente quando vi e presente un sanguinamento intratumorale.
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  • 文章类型: Review
    目的:有症状的发育性静脉异常(DVA)是罕见的。这里,我们说明了有症状的DVA的各种临床放射学概况,并考虑了使这些(据称)良性实体有症状的机制,并得到了文献综述的支持。
    方法:检索机构数据库以识别有症状的DVA病例。分析了9例具有11种神经血管症状的患者的临床和影像学(血管造影和横截面)数据,这些症状是由于基础DVA的战略地形而表现出的流入/流出扰动和机械阻塞。对从PubMed数据库中检索到的出版物进行了与我们的案例系列一致的有关DVA的现有文献的回顾。
    结果:由流量相关的扰动引起的静脉高压继发的症状大致分为流出受限和流入增加引起的症状。由于采集者静脉狭窄(n=2)和采集者静脉/DVA血栓形成(n=3),发生了限制性流出,而后者的病理机制是由动脉化/过渡性DVA引发的(n=2)。在1例中发现了机械/阻塞性病理机制,最终导致中度幕上脑室增宽。一名患者被诊断为与海绵体瘤相关的出血。
    结论:对潜在流量相关扰动和机械损伤的认识和情境化,使DVA对症有助于准确诊断,管理,和预测。
    OBJECTIVE: Symptomatic developmental venous anomalies (DVAs) are rare. Here, we illustrate the varied clinicoradiologic profiles of symptomatic DVAs and contemplate the mechanisms that render these (allegedly) benign entities symptomatic supported by a review of literature.
    METHODS: Institutional databases were searched to identify cases of symptomatic DVAs. Clinical and imaging (angiographic and cross-sectional) data of 9 cases with 11 neurovascular symptoms consequent to inflow/outflow perturbations and mechanical obstruction that manifested because of the strategic topography of underlying DVAs were analyzed. A review of the existing literature on DVAs in agreement with our case series was performed on publications retrieved from the PubMed database.
    RESULTS: Symptoms secondary to venous hypertension arising from flow-related perturbations were broadly divided into those arising from restricted outflow and increased inflow. Restricted outflow occurred because of collector vein stenosis (n = 2) and collector vein/DVA thrombosis (n = 3), whereas the latter pathomechanism was initiated by arterialized/transitional DVAs (n = 2). A mechanical/obstructive pathomechanism culminating in moderate supratentorial ventriculomegaly was noted in 1 case. One patient was given a diagnosis of hemorrhage associated with a cavernoma.
    CONCLUSIONS: Awareness and contextualization of potential flow-related perturbations and mechanical insults that render DVAs symptomatic aid in accurate diagnosis, management, and prognostication.
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  • 文章类型: Review
    肝血管瘤是最常见的起源于肝脏的良性肿瘤。当肿瘤超过10厘米时,在一些4或5厘米的研究中,它被认为是巨大的,占所有肝脏血管瘤的10%。组织学上,硬化性肝血管瘤,特别是,是一种极其罕见的血管瘤亚型.临床上,Bornman-Terblanche-Blumgart综合征是肝血管瘤的一种非常罕见的并发症。
    本病例介绍的目的是通过记录一例巨大的硬化性血管瘤病例,该病例诊断为一名36岁女性,患有Bornman-Terblanche-Blumgart综合征,以及对文献的简要回顾。
    本论文记录了两种罕见的肝血管瘤的临床和组织学特征。Bornman-Terblanche-Blumgart综合征是一种复杂的巨大肝血管瘤,在组织学上被发现具有硬化性。了解肝脏血管瘤的罕见并发症,可以及时实施适当的干预措施,反过来,可以提高患者的生活质量和降低相关死亡率。
    UNASSIGNED: Hepatic hemangioma represents the most frequent benign tumor originating from the liver. When the tumor exceeds 10 cm, and in some studies 4 or 5 cm, it is considered giant, which accounts for 10% of all hemangiomas arising from the liver. Histologically, Sclerosing hepatic hemangioma, in particular, is an exceedingly rare subtype of hemangioma. Clinically Bornman-Terblanche-Blumgart syndrome is a very rare complication of hepatic hemangioma.
    UNASSIGNED: The aim of this case presentation was to contribute to the literature by documenting a case of giant sclerosing hemangioma diagnosed in a 36-year-old female presenting with Bornman-Terblanche-Blumgart syndrome, along with a brief review of the literature.
    UNASSIGNED: The current paper documents two rare clinical and histological features of hepatic hemangioma. Bornman-Terblanche-Blumgart syndrome is complicated a giant hepatic hemangioma found histologically to be sclerosing in nature. Knowledge about the uncommon complications of liver hemangioma permits the implementation of appropriate interventions in a timely manner and, in turn, can enhance the patient\'s quality of life and minimize rates of associated mortality.
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  • 文章类型: Case Reports
    背景:视网膜海绵状血管瘤(RCH)是一种罕见的视网膜血管疾病,其特征是囊状动脉瘤的葡萄样簇,通常是单方面的,无症状和非进行性。诊断是通过包括常规荧光素血管造影(FA)在内的多模态成像进行的。最近引入的扫频源光学相干断层扫描血管造影(SS-OCTA)使人们对血管疾病有了新的认识,允许非侵入性,更精确的视网膜和脉络膜血流可视化,并且代表了FA的可能替代方案。
    方法:我们在此描述了两种具有多模态成像的RCH病例,包括SS-OCTA,并将我们的发现与之前描述的结果进行比较。
    结果:关于OCTA,一艘排水船的存在,SCP和DCP中的流量信号减少,可以观察到液位。
    结论:这些OCTA征象与常规荧光素血管造影术中描述的征象一致,允许在典型情况下避免这种侵入性检查。
    BACKGROUND: Retinal cavernous hemangioma (RCH) is a rare retinal vascular disease characterized by grape-like clusters of saccular aneurysms, usually unilateral, asymptomatic and non-progressive. The diagnosis is made by multimodal imaging including conventional fluorescein angiography (FA). The recent introduction of swept source optical coherence tomography angiography (SS-OCTA) has allowed new insight into vascular diseases, allowing non-invasive, more precise visualization of retinal and choroidal blood flow, and represents a possible alternative to FA.
    METHODS: We herein describe two cases of RCH with multimodal imaging, including SS-OCTA, and compare our findings with those previously described.
    RESULTS: On OCTA, the presence of a draining vessel, a reduction in flow signal in the SCP and DCP, and a fluid level can be observed.
    CONCLUSIONS: These OCTA signs are in accordance with those described on conventional fluorescein angiography, allowing this invasive exam to be avoided in typical cases.
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    文章类型: Review
    目的:探讨睾丸海绵状血管瘤(TCH)的临床诊断和治疗方法。
    方法:回顾性分析我院收治的1例TCH合并睾丸扭转患者的临床资料,并复习相关文献。
    结果:患者在术前检查后接受了“右睾丸切除术”。术中病理提示睾丸实质梗死,术后病理显示海绵状血管瘤伴出血和梗死。术后随访3年无复发。
    结论:睾丸海绵状血管瘤是一种极其罕见的睾丸良性肿瘤,很少与睾丸扭转有关。术前和术中病理为选择合理的治疗方法提供了依据。
    OBJECTIVE: To explore the clinical diagnosis and treatment of testicular cavernous hemangioma (TCH).
    METHODS: We retrospectively analyzed the clinical data on a case of TCH associated with testicular torsion treated in our hospital and reviewed the relevant literature.
    RESULTS: The patient underwent \"right orchiectomy\" after preoperative examinations. Intraoperative pathology indicated testicular parenchyma infarction, and postoperative pathology showed cavernous hemangioma with hemorrhage and infarction. No recurrence was observed during 3 years of postoperative follow-up.
    CONCLUSIONS: Testicular cavernous hemangioma is an extremely rare benign tumor of the testis, and rarely associated with testicular torsion. Preoperative and intraoperative pathology provides a basis for the selection of reasonable treatment.
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  • 文章类型: Review
    木村病(KD)是一种免疫介导的疾病,主要影响亚洲男性。它表现为头颈部皮下肿块,伴有炎症浸润和血清免疫球蛋白E水平升高。KD的临床表现类似于各种疾病。这里,我们报道了一名30岁的菲律宾男子,患有KD,模仿海绵状血管瘤,接受手术治疗。仔细调查可能的KD病例至关重要。误诊容易导致徒劳的干预和不必要的影响。辅助治疗的手术优于其他形式的KD治疗。
    Kimura\'s disease (KD) is an immune-mediated disorder which mainly affects Asian men. It appears as head and neck subcutaneous masses, with inflammatory infiltrate and elevated serum immunoglobulin E levels. The clinical presentation of KD resembles that of various diseases. Here, we report the case of a 30-year-old Filipino man with KD mimicking cavernous hemangioma who was treated by surgery. Careful survey for possible KD cases is crucial. Misdiagnoses are prone to futile interventions and unwanted effects. Surgery with adjuvant therapy is superior to other forms of KD treatment.
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