Hemangioma, Cavernous

血管瘤,海绵状
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    文章类型: Case Reports
    Portal cavernoma thrombosis is a complication of portal cavernoma. We describe the case of a 74-year-old patient who presented to the emergency department with abdominal pain. The computed tomography scan showed a mass from the head of the pancreas to the hepatic hilum not enhanced after injection of iodinated contrast. There was no dilatation of the bile ducts. Abdominal magnetic resonance ruled out a tumour and confirmed a portal cavernoma thrombosis. In 50 % of cases the etiology of the portal cavernoma is unknown. It is often asymptomatic. It may be discovered in case of complications of portal hypertension. In rare cases the portal cavernoma can compress the bile ducts. To our knowledge, portal cavernoma thrombosis has only been described in one article. It is important to search for a thrombophilic disorder when such a complication is found. We share this case report in order to raise awareness in the medical community about this rare complication.
    La thrombose de cavernome portal est une complication du cavernome porte. Nous décrivons le cas d’un patient de 74 ans qui s’est présenté aux urgences pour des douleurs abdominales. La tomodensitométrie montrait un syndrome de masse de la tête du pancréas jusqu’au hile hépatique non rehaussé après injection de produit de contraste iodé. Il n’y avait pas de dilatation des voies biliaires. Une imagerie par résonance magnétique abdominale a permis d’infirmer l’hypothèse d’une masse tumorale et d’affirmer une thrombose du cavernome porte. Dans 50 % des cas, l’étiologie du cavernome portal est inconnue. Il est souvent asymptomatique. Il peut être découvert en cas de complications à la suite d’une hypertension portale. Dans de rares cas, le cavernome portal peut comprimer les voies biliaires. À notre connaissance, la thrombose de cavernome portal n’a été décrite que dans un seul article. Il est important de rechercher un désordre thrombophilique quand une telle complication est retrouvée. Nous partageons ce cas clinique afin de sensibiliser la communauté médicale à cette rare complication.
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  • 文章类型: Journal Article
    探讨3D切片器重建和3D打印定位联合经颅神经内镜在脑深部微小海绵状血管瘤手术治疗中的优缺点。方法回顾性分析我院2022年6月至2023年2月采用3D切片器重建和3D打印定位技术联合经颅内镜手术治疗的脑深部微海绵状血管瘤患者的临床资料。共收集5例资料完整,包括2名男性和3名女性,9-59岁。5例患者均为深幕上海绵状血管瘤,直径小于1.5cm,有头痛或癫痫等临床症状,并通过CT或MRI诊断。脑深部小海绵状血管瘤反复出血可导致临床症状,如反复发作的头痛和癫痫,需要手术治疗。然而,海绵状血管瘤通常有较小的病变,很难在深部定位。没有神经导航,手术可能变得极其困难。我们的团队新开发的3D切片器重建和3D打印定位技术,可以为小型海绵状血管瘤或其他脑深部小病变的手术治疗提供新的选择。但其准确性和安全性仍需进一步的临床研究验证。
    To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9-59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team\'s newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research.
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  • 文章类型: Case Reports
    血管结膜肿瘤并不常见,通常是良性病变。这里,我们报告了一名65岁的男性,他出现了鼻睑间延髓,椭圆形,和深棕色和不可移动的结膜肿块。全身和眼部检查,包括眼底镜检查和房角镜检查均在正常范围内。诊断为结膜恶性黑色素瘤(CMM),患者接受了切除活检,巩膜部分切除术,还有冷冻疗法.显微镜检查显示红细胞填充的扩张的血管通道,被纤维间质隔开,没有恶性肿瘤的迹象。因此,诊断为结膜海绵状血管瘤。我们的病例表明,结膜海绵状血管瘤可以模仿恶性结膜病变以及由于巩膜坏死引起的葡萄膜黑色素瘤或葡萄膜脱垂的巩膜外延伸。
    Vascular conjunctival tumors are uncommon, usually benign lesions. Here, we report a 65-year-old male who presented with a nasal interpalpebral bulbar firm, oval, and dark-brown and non-mobile conjunctival mass. The systemic and ocular examinations including fundoscopy and gonioscopy were within normal limits. With a diagnosis of conjunctival malignant melanoma (CMM), the patient underwent excisional biopsy, partial sclerectomy, and cryotherapy. Microscopic examination revealed dilated vascular channels filled by red blood cells, separated by fibrous interstitium and no sign of malignancy. Therefore, a diagnosis of conjunctival cavernous hemangioma was made. Our case demonstrates that the conjunctival cavernous hemangioma can mimic malignant conjunctival lesions as well as extrascleral extension of uveal melanoma or uveal prolapse due to scleral necrosis.
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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
    背景:直肠海绵状血管瘤是一种罕见的,很少引起下消化道出血的良性血管疾病,误诊率和漏诊率较高。手术治疗被认为是相对有效的;然而,它伴随着某些用于治疗浅表性血管瘤,拥有微创手术的优势,包括安全,有效性,减少创伤,和快速恢复。然而,缺乏有关泡沫硬化剂在胃肠道血管瘤中应用的文献。
    我们介绍一例60岁男性患者,住院>1年反复便血,症状恶化1周。患者的病史并不明显。
    方法:结肠镜检查后,核磁共振成像,计算机断层扫描,和其他检查,最终诊断为直肠海绵状血管瘤。
    方法:由于患者拒绝手术,在获得患者及其亲属的知情同意后,使用聚桂醇注射液进行内镜泡沫硬化治疗.
    结果:硬化治疗后,便血症状停止,未观察到不良反应。两个月后,结肠镜和核磁共振成像显示血管瘤几乎完全消失,只有少量的肿瘤残留物,取得满意的疗效。
    结论:我们的研究结果表明,内镜下注射聚桂醇泡沫硬化剂是一种安全的,有效,胃肠道海绵状血管瘤的微创治疗选择。
    BACKGROUND: Rectal cavernous hemangioma is a rare, benign vascular disease that seldom causes lower gastrointestinal bleeding, characterized by a high rate of misdiagnosis and missed diagnoses. Surgical treatment is considered to be relatively effective; however, it is accompanied by certain employed in the treatment of superficial hemangioma, boasting the advantages of minimally invasive surgery, including safety, effectiveness, reduced trauma, and rapid recovery. However, there is a lack of literature regarding the application of foam sclerosing agents for gastrointestinal hemangiomas.
    UNASSIGNED: We present a case of a 60-year-old male who was admitted to our hospital with a history of recurrent hematochezia for >1 year and worsening symptoms for 1 week. The patient\'s medical history was unremarkable.
    METHODS: Following colonoscopy, nuclear magnetic resonance imaging, computed tomography, and other examinations, the final diagnosis was rectal cavernous hemangioma.
    METHODS: Due to the patient\'s refusal of surgery, endoscopic foam sclerotherapy using a lauromacrogol injection was performed after obtaining informed consent from the patient and their relatives.
    RESULTS: Post-sclerotherapy, hematochezia symptoms ceased, and no adverse reactions were observed. Two months later, colonoscopy and nuclear magnetic resonance imaging showed that the hemangioma had almost completely disappeared, with only a small amount of tumor remnants, yielding a satisfactory curative effect.
    CONCLUSIONS: Our findings indicate that endoscopic injection of a lauromacrogol foam sclerosing agent is a safe, effective, and minimally invasive treatment option for gastrointestinal cavernous hemangiomas.
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  • 文章类型: Journal Article
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    轴外海绵状血管瘤(ECHs)是复杂的血管病变,主要见于脊柱和海绵窦。由于它们的血管分布和弥漫性,它们的移除会带来很大的风险,和他们的基因基础仍然没有完全理解。我们的方法涉及使用全外显子组测序和靶向深度测序对31个ECH组织样品进行遗传分析。我们探索了下游信号通路,基因表达变化,这些突变诱导的表型转变,在体外和体内。在我们的队列中,77.4%的样本在GNA14、GNAQ、或者GJA4.转录组分析强调了显著的途径上调,与GNAQc.626A>G(p。Gln209Arg)突变升高PI3K-AKT-mTOR和血管生成相关途径,而GNA14c.614A>T(p.Gln205Leu)突变导致MAPK和血管生成相关通路上调。使用小鼠异种移植模型,我们从这些突变中观察到增大的血管。此外,我们在一名14岁的患者中开始了雷帕霉素治疗,该患者患有GNAQc.626A>G(p。Gln209Arg)变体,导致皮肤海绵状血管瘤逐渐消退并改善运动强度,副作用最小。了解这些突变及其途径为开发对当前疗法具有抗性的ECHs疗法奠定了基础。的确,在这项研究中,在个体中使用雷帕霉素强调了靶向治疗这些复杂病变的前景。
    Extra-axial cavernous hemangiomas (ECHs) are complex vascular lesions mainly found in the spine and cavernous sinus. Their removal poses significant risk due to their vascularity and diffuse nature, and their genetic underpinnings remain incompletely understood. Our approach involved genetic analyses on 31 tissue samples of ECHs employing whole-exome sequencing and targeted deep sequencing. We explored downstream signaling pathways, gene expression changes, and resultant phenotypic shifts induced by these mutations, both in vitro and in vivo. In our cohort, 77.4% of samples had somatic missense variants in GNA14, GNAQ, or GJA4. Transcriptomic analysis highlighted significant pathway upregulation, with the GNAQ c.626A>G (p.Gln209Arg) mutation elevating PI3K-AKT-mTOR and angiogenesis-related pathways, while GNA14 c.614A>T (p.Gln205Leu) mutation led to MAPK and angiogenesis-related pathway upregulation. Using a mouse xenograft model, we observed enlarged vessels from these mutations. Additionally, we initiated rapamycin treatment in a 14-year-old individual harboring the GNAQ c.626A>G (p.Gln209Arg) variant, resulting in gradual regression of cutaneous cavernous hemangiomas and improved motor strength, with minimal side effects. Understanding these mutations and their pathways provides a foundation for developing therapies for ECHs resistant to current therapies. Indeed, the administration of rapamycin in an individual within this study highlights the promise of targeted treatments in treating these complex lesions.
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  • 文章类型: Case Reports
    心脏海绵状血管瘤是一种罕见的良性心脏肿瘤,需要与心脏黏液瘤、乳头状弹力纤维瘤、心脏肉瘤等鉴别诊断。对于症状明显的患者应首选手术治疗,术后长期预后良好。该文报道了1例心脏海绵状血管瘤患者的诊治过程。.
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