Home About us Contact | |||
Hemangiomas
Selected AbstractsBLUE RUBBER BLEB NEVUS SYNDROME: TREATMENT OF MULTIPLE GASTROINTESTINAL HEMANGIOMAS WITH ARGON PLASMA COAGULATORDIGESTIVE ENDOSCOPY, Issue 1 2009Enders K.W. Ng Blue rubber bleb nevus syndrome is a rare clinical entity characterized by the formation of multiple blue or purplish rubbery cavernous hemangiomas on the skin and other epithelial surfaces. Involvement of the gastrointestinal tract is common and often presents with crippling anemia as a result of chronic occult blood loss. While surgical extirpation is an option for symptomatic hemangiomas in the intestine, endoscopic therapy is more appealing for lesions found in the stomach and colon. Here we report the successful use of argon plasma coagulation in the management of an adult with multiple hemangiomas in her colon and terminal ileum. [source] Treatment of Superficial Infantile Hemangiomas of the Eyelid Using the 595-nm Pulsed Dye LaserDERMATOLOGIC SURGERY, Issue 5 2010CHRISTOPHER M. HUNZEKER MD BACKGROUND Despite the proven effectiveness of the 595-nm pulsed dye laser (PDL) in treating superficial infantile hemangiomas, many physicians are reluctant to treat such lesions involving the eyelid. OBJECTIVE To examine the safety and efficacy of the 595-nm PDL for the treatment of superficial infantile hemangiomas of the eyelid. MATERIALS & METHODS Records were reviewed for patients with superficial infantile hemangiomas of the eyelid treated with 595-nm PDL. Pre- and post-treatment photographs were compared. Reviewers rated the degree of improvement of the hemangioma as excellent (76,100%), good (51,75%), moderate (26,50%), or poor (0,25%) and indicated whether the hemangioma was 100% clear. Side effects of scarring, atrophy, hyperpigmentation, and hypopigmentation were assessed. RESULTS Twenty-two patients met the study criteria. Eight (36.4%) demonstrated complete clearance of their hemangioma, 17 (77.3%) received an improvement rating of excellent, and five (22.7%) received a rating of good. No scarring, atrophy, or hypopigmentation was noted. Two patients (9.1%) were noted to have hyperpigmentation in the treated area. CONCLUSION Early treatment with the 595-nm PDL can safely and effectively diminish proliferative growth and hasten resolution of superficial infantile hemangiomas of the eyelid. Roy G. Geronemus, MD, is on the Medical Advisory Board for Candela Laser Corp. [source] Outcomes of Childhood Hemangiomas Treated with the Pulsed-Dye Laser with Dynamic Cooling: A Retrospective Chart AnalysisDERMATOLOGIC SURGERY, Issue 12 2009CARINA RIZZO MD BACKGROUND Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes. OBJECTIVE To evaluate outcomes of hemangiomas treated with the most current laser technology. METHODS A retrospective chart analysis of 90 patients with a median age of 3.0 months and a total of 105 hemangiomas were enrolled over a 2.5-year period. All were treated with the 595-nm long-pulse pulsed-dye laser (LP-PDL) with dynamic epidermal cooling at 2- to 8-week intervals depending on the stage of growth. Exclusion criteria were previous laser, surgical, or corticosteroid treatment. Three reviewers assessed outcomes. RESULTS Near-complete or complete clearance in color were achieved for 85 (81%) and in thickness for 67 (64%) hemangiomas. There was no scarring or atrophy. Ulceration occurred in one case and resolved during treatment. Hyperpigmentation and hypopigmentation occurred in 4% and 14% of hemangiomas, respectively. CONCLUSION Early treatment of childhood hemangiomas with the 595-nm LP-PDL with dynamic cooling may reduce the proliferative phase and result in excellent rates of clearing and few adverse events. [source] Role of Intralesional Bleomycin in the Treatment of Complicated Hemangiomas: Prospective Clinical StudyDERMATOLOGIC SURGERY, Issue 5 2005Shapour Omidvari MD background. Hemangioma is the most common tumor of infancy. Although it has a basically benign nature and usually spontaneously regresses, a small percentage (5%) have complications that need treatment. Many different therapeutic modalities can be used in this tumor. objective. To investigate the effect of a new method of treatment (intralesional bleomycin injection) in complicated hemangiomas. materials and methods. In the Department of Radiation Oncology at Nemazee Hospital in Shiraz, Iran, from April 1992 to October 1998, 32 patients with complicated hemangioma were treated with four to six courses of direct injection of bleomycin into the lesion. results After a minimum follow-up of 6 years, there was 70 to 100% regression in 18 patients, 50 to 70% in 7 cases, and less than 50% reduction in 7 patients. conclusion. Intralesional injection of bleomycin is an easy, safe, and effective therapeutic modality in complicated cutaneous hemangiomas. [source] Treatment of "Cyrano" Angioma with Pulsed Dye LaserDERMATOLOGIC SURGERY, Issue 7 2001Soyun Cho MD Background. Hemangiomas of the nasal tip, the so-called Cyrano nose, are often deep, disfiguring, and persistent. Objective. To evaluate the effect of treatment with pulsed dye laser on Cyrano nose. Methods. A 3-month-old boy with hemangioma of the nasal tip of 1-months duration underwent six sessions of pulsed dye laser treatment with a 7 mm collimated beam at fluences of 5.75,6.5 J/cm2, 6 weeks apart. Results. Initial improvement was noted after two treatments, and the lesion showed a marked reduction in size and improvement in color over a total treatment period of 9 months. Conclusion. Treatment with the 585 nm pulsed dye laser should be considered in the management of infants with mild to moderate degrees of nasal tip hemangiomas since it effectively reduces the lesions with minimal adverse effects. [source] Hemangiomas: Evaluation and TreatmentDERMATOLOGIC SURGERY, Issue 5 2001Scott M. Dinehart MD Background. Hemangiomas are common skin tumors of infancy that have undergone recent changes in nomenclature, methods of evaluation, and treatment. Objective. To review the nomenclature, epidemiology, evaluation, and treatment of common hemangiomas. Methods. A literature search was conducted utilizing MEDLINE and the Cochrane library databases. Text search words used were "hemangioma" and "infancy." The clinical experience of the authors was also used to formulate the review. Results. There have been many advances in nomenclature and therapeutic options for children with hemangiomas. Hemangiomas are proliferative tumors of infancy that should be distinguished from structural malformations, such as port-wine stains and lymphangiomas. Conclusion. Natural involution remains a viable treatment option for the majority of patients with uncomplicated hemangiomas. Excisional surgery, laser, and pharmacologic remedies are indicated for a subset of complicated hemangioma patients. [source] Spindle-cell lesions of the liver: Diagnosis by fine-needle aspiration biopsyDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001Cynthia D. Guy M.D. Abstract Rarely, spindle-cell lesions in liver fine-needle aspiration biopsies (FNABs) are encountered. A retrospective review of our experience with lesions that are mesenchymal in origin or appearance was undertaken to elucidate the frequency and spectrum of these lesions. Image-guided liver FNABs performed over a 3-year period (n = 585) at our institution (1996,1998) were retrospectively evaluated. Cytologic smears, cell block preparations, and clinical follow-up of lesions with spindle-cell morphology were reviewed. Twenty-nine of 585 cases were of spindle-cell morphology (5%). Hemangiomas (n = 12, 41%) and metastatic sarcomas (n = 6, 21%) comprised the largest categories, followed by granulomatous inflammation (n = 3, 10%). Other cases included primary angiosarcoma and fibrolamellar hepatocellular carcinoma. The most frequent spindle-cell liver lesion encountered is hemangioma, followed by metastatic leiomyosarcoma and granulomatous hepatitis. Awareness of diagnostic possibilities, special attention to specimen adequacy, and use of ancillary procedures can maximize diagnostic yield. Diagn. Cytopathol. 2001;25:94,100. © 2001 Wiley-Liss, Inc. [source] Neodymium-YAG Laser for hemangiomas and vascular malformations , long term resultsJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 6 2005Die Behandlung von Hämangiomen und vaskulären Fehlbildungen mit dem Neodymium-YAG-Laser, Langzeitergebnisse Hämangiom; Lasertherapie; Nd:YAG-Laser; vaskuläre Malformation Summary Background: Hemangiomas and vascular malformations are the most common vascular lesions of infancy. Different lasers can be used for treatment. Nd:YAG laser photocoagulation is particularly effective because of its deep penetration into tissue. Patients and methods: Thirty-one patients, aged from three months to 18,years, with voluminous hemangiomas and venous malformations were treated with a cw-neodymium:YAG laser. The quartz fibre was used in percutaneous and intralesional technique. Long-term follow-up data were acquired by clinical control or a patient questionnaire for a maximal period of eight years. Twenty patients could be evaluated. Results: In the group with hemangiomas (n,=,15), three cases showed nearly complete remission (> 90 %), ten cases had a partial reduction in size (50,,,90 %), in one case there was stable disease and in one case tumor growth. In the group with venous malformations (n,=,5) two cases showed an excellent response (> 90 %), one case a moderate response (25,,,50 %) and in two cases there was no improvement. Adverse effects included scars (40 %), hyper- and hypopigmentation (23 %), mild atrophy (20 %) and a wrinkled texture (17 %). After maximal reduction in size, 30 % of the patients were not satisfied with the laser treatment outcome and elected surgical excision of the residual lesion. Conclusions: The neodymium:yttrium aluminium garnet (Nd:YAG) laser with percutaneous or intralesional application technique is a valuable tool for selected patients with hemangiomas and venous malformations. Zusammenfassung Hintergrund: Hämangiome und vaskuläre Malformationen sind die häufigsten Gefäßfehlbildungen in der Kindheit. Eine Therapieoption stellt die Laserbehandlung dar. Der Nd:YAG-Laser ist besonders effektiv aufgrund seiner hohen Eindringtiefe ins Gewebe. Patienten und Methodik: Insgesamt wurden 31,Patienten im Alter zwischen drei Monaten und achtzehn Jahren mit voluminösen Hämangiomen und venösen Malformationen mit einem cw-Neodymium:YAG-Laser behandelt. Die Laserfaser wurde in perkutaner und intraläsionaler Technik angewendet. Die Nachbeobachtung über einen Zeitraum von maximal acht Jahren erfolgte mittels klinischer Kontrollen oder einem Patientenfragebogen. Von den insgesamt 31,Patienten konnten 20 ausgewertet werden. Ergebnisse: In der Gruppe der Patienten mit Hämangiomen zeigten drei Patienten eine fast vollständige Rückbildung (> 90 %), zehn Patienten eine partielle Rückbildung (50,,,90 %), in einem Fall zeigte sich ein unveränderter Befund und bei einem Patienten beobachteten wir weiterhin Wachstum. In der Gruppe der Patienten mit venösen Malformationen zeigten zwei Patienten ein exzellentes Ansprechen (> 90 %), ein Patient ein moderates Ansprechen (25,,,50 %) und bei zwei Patienten kam es zu keiner Verbesserung. Nebenwirkungen beinhalteten Narben (40 %), Hyper- und Hypopigmentierungen (23 %), geringe Atrophie (20 %) und eine Hautfältelung. Nach vollständiger Rückbildung waren 30 % der Patienten unzufrieden mit dem Ergebnis und unterzogen sich einer operativen Entfernung der Residuen. Schlußfolgerungen: Der Nd:YAG-Laser mit perkutaner und intraläsionaler Applikationstechnik stellt eine wirksame Methode zur Behandlung ausgewählter Patienten mit Hämangiomen und venösen Malformationen dar. [source] Pain Management for Ulcerated HemangiomasPEDIATRIC DERMATOLOGY, Issue 6 2008Albert C. Yan M.D. First page of article [source] Infantile Hemangiomas: Current Knowledge, Future Directions.PEDIATRIC DERMATOLOGY, Issue 5 2005Proceedings of a Research Workshop on Infantile Hemangiomas First page of article [source] Periocular Hemangiomas: What Every Physician Should KnowPEDIATRIC DERMATOLOGY, Issue 1 2004Emily J. Ceisler M.D. Most hemangiomas remain asymptomatic and can be managed by close observation; however, immediate treatment is indicated for hemangiomas that may cause significant complications. Periocular hemangiomas warrant close evaluation and early, active treatment of those with the potential to threaten or permanently compromise vision. Herein we review the clinical features of periocular hemangiomas, differential diagnosis, possible ophthalmologic complications and sequelae, and therapeutic modalities. [source] A Study of Perceptions of Facial Hemangiomas in Professionals Involved in Child Abuse SurveillancePEDIATRIC DERMATOLOGY, Issue 1 2003Aina V. H. Greig M.A., F.R.C.S. They can mimic the appearance of bruises and parents report false accusations of child abuse by strangers. We investigated perceptions of facial hemangiomas in two professional groups involved in child abuse surveillance. Thirty health visitors and 30 primary school teachers were sent a clinical case questionnaire about a child with an involuting facial hemangioma with a color photograph of the lesion. Nineteen health visitors (63%) and 18 primary school teachers (60%) responded. Seventy-four percent of the health visitors and 11% of the teachers correctly diagnosed a hemangioma. Fifty percent of the teachers were unable to decide on a diagnosis. However, only one health visitor (5%) and one teacher (5%) thought that the lesion was a nonaccidental injury and would involve a child protection advisor. About one-third of health visitors and one-third of teachers expressed concerns that the child could suffer psychologically from teasing by peers at school and about one-third of health visitors were also concerned about the psychological effects of the lesion on the child's parents. Health visitors and teachers were most unlikely to mistake the facial hemangioma in this study for a nonaccidental injury. [source] Treatment of Superficial Infantile Hemangiomas of the Eyelid Using the 595-nm Pulsed Dye LaserDERMATOLOGIC SURGERY, Issue 5 2010CHRISTOPHER M. HUNZEKER MD BACKGROUND Despite the proven effectiveness of the 595-nm pulsed dye laser (PDL) in treating superficial infantile hemangiomas, many physicians are reluctant to treat such lesions involving the eyelid. OBJECTIVE To examine the safety and efficacy of the 595-nm PDL for the treatment of superficial infantile hemangiomas of the eyelid. MATERIALS & METHODS Records were reviewed for patients with superficial infantile hemangiomas of the eyelid treated with 595-nm PDL. Pre- and post-treatment photographs were compared. Reviewers rated the degree of improvement of the hemangioma as excellent (76,100%), good (51,75%), moderate (26,50%), or poor (0,25%) and indicated whether the hemangioma was 100% clear. Side effects of scarring, atrophy, hyperpigmentation, and hypopigmentation were assessed. RESULTS Twenty-two patients met the study criteria. Eight (36.4%) demonstrated complete clearance of their hemangioma, 17 (77.3%) received an improvement rating of excellent, and five (22.7%) received a rating of good. No scarring, atrophy, or hypopigmentation was noted. Two patients (9.1%) were noted to have hyperpigmentation in the treated area. CONCLUSION Early treatment with the 595-nm PDL can safely and effectively diminish proliferative growth and hasten resolution of superficial infantile hemangiomas of the eyelid. Roy G. Geronemus, MD, is on the Medical Advisory Board for Candela Laser Corp. [source] Utility of Intralesional Sclerotherapy with 3% Sodium Tetradecyl Sulphate in Cutaneous Vascular MalformationsDERMATOLOGIC SURGERY, Issue 3 2010MNAMS, SUJAY KHANDPUR MBBS BACKGROUND Vascular malformations have devastating cosmetic effects in addition to being associated with pain and bleeding. Sclerotherapy has been successfully used in treating complicated hemangiomas and vascular malformations. OBJECTIVES To assess the efficacy of sclerotherapy with 3% sodium tetradecyl sulphate (STS) in venous and lymphatic malformations. MATERIALS AND METHOD We performed sclerotherapy with 3% STS in 13 patients with venous malformations and microcystic lymphatic malformation, all low-flow malformations and with extent predominantly to the subcutis, confirmed using Doppler ultrasound. Lesions were located on the face, lower lip, flanks, buttocks, and extremities. Patients presented for cosmetic reasons, pain, or bleeding. Sclerotherapy was undertaken as an office procedure without any radiological guidance and therapy repeated every 3 weeks. Therapeutic efficacy was assessed subjectively clinically and photographically. RESULTS The lesions regressed by 90% to 100% in 11 cases after a mean of four injections, with no improvement in two cases (one each of venous malformation and lymphatic malformation). Complications included cutaneous blister formation, erosions, and crusting at injection site in seven cases and atrophic scarring in four patients. CONCLUSIONS Sclerotherapy with 3% STS is a simple, safe, and effective modality for venous malformations and can be undertaken as an office procedure in lesions limited to the subcutis. The authors have indicated no significant interest with commercial supporters. [source] Outcomes of Childhood Hemangiomas Treated with the Pulsed-Dye Laser with Dynamic Cooling: A Retrospective Chart AnalysisDERMATOLOGIC SURGERY, Issue 12 2009CARINA RIZZO MD BACKGROUND Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes. OBJECTIVE To evaluate outcomes of hemangiomas treated with the most current laser technology. METHODS A retrospective chart analysis of 90 patients with a median age of 3.0 months and a total of 105 hemangiomas were enrolled over a 2.5-year period. All were treated with the 595-nm long-pulse pulsed-dye laser (LP-PDL) with dynamic epidermal cooling at 2- to 8-week intervals depending on the stage of growth. Exclusion criteria were previous laser, surgical, or corticosteroid treatment. Three reviewers assessed outcomes. RESULTS Near-complete or complete clearance in color were achieved for 85 (81%) and in thickness for 67 (64%) hemangiomas. There was no scarring or atrophy. Ulceration occurred in one case and resolved during treatment. Hyperpigmentation and hypopigmentation occurred in 4% and 14% of hemangiomas, respectively. CONCLUSION Early treatment of childhood hemangiomas with the 595-nm LP-PDL with dynamic cooling may reduce the proliferative phase and result in excellent rates of clearing and few adverse events. [source] Role of Intralesional Bleomycin in the Treatment of Complicated Hemangiomas: Prospective Clinical StudyDERMATOLOGIC SURGERY, Issue 5 2005Shapour Omidvari MD background. Hemangioma is the most common tumor of infancy. Although it has a basically benign nature and usually spontaneously regresses, a small percentage (5%) have complications that need treatment. Many different therapeutic modalities can be used in this tumor. objective. To investigate the effect of a new method of treatment (intralesional bleomycin injection) in complicated hemangiomas. materials and methods. In the Department of Radiation Oncology at Nemazee Hospital in Shiraz, Iran, from April 1992 to October 1998, 32 patients with complicated hemangioma were treated with four to six courses of direct injection of bleomycin into the lesion. results After a minimum follow-up of 6 years, there was 70 to 100% regression in 18 patients, 50 to 70% in 7 cases, and less than 50% reduction in 7 patients. conclusion. Intralesional injection of bleomycin is an easy, safe, and effective therapeutic modality in complicated cutaneous hemangiomas. [source] Treatment of "Cyrano" Angioma with Pulsed Dye LaserDERMATOLOGIC SURGERY, Issue 7 2001Soyun Cho MD Background. Hemangiomas of the nasal tip, the so-called Cyrano nose, are often deep, disfiguring, and persistent. Objective. To evaluate the effect of treatment with pulsed dye laser on Cyrano nose. Methods. A 3-month-old boy with hemangioma of the nasal tip of 1-months duration underwent six sessions of pulsed dye laser treatment with a 7 mm collimated beam at fluences of 5.75,6.5 J/cm2, 6 weeks apart. Results. Initial improvement was noted after two treatments, and the lesion showed a marked reduction in size and improvement in color over a total treatment period of 9 months. Conclusion. Treatment with the 585 nm pulsed dye laser should be considered in the management of infants with mild to moderate degrees of nasal tip hemangiomas since it effectively reduces the lesions with minimal adverse effects. [source] Hemangiomas: Evaluation and TreatmentDERMATOLOGIC SURGERY, Issue 5 2001Scott M. Dinehart MD Background. Hemangiomas are common skin tumors of infancy that have undergone recent changes in nomenclature, methods of evaluation, and treatment. Objective. To review the nomenclature, epidemiology, evaluation, and treatment of common hemangiomas. Methods. A literature search was conducted utilizing MEDLINE and the Cochrane library databases. Text search words used were "hemangioma" and "infancy." The clinical experience of the authors was also used to formulate the review. Results. There have been many advances in nomenclature and therapeutic options for children with hemangiomas. Hemangiomas are proliferative tumors of infancy that should be distinguished from structural malformations, such as port-wine stains and lymphangiomas. Conclusion. Natural involution remains a viable treatment option for the majority of patients with uncomplicated hemangiomas. Excisional surgery, laser, and pharmacologic remedies are indicated for a subset of complicated hemangioma patients. [source] Treatment of hemangiomas and port-wine stains with emphasis on lasersDERMATOLOGIC THERAPY, Issue 1 2000Agneta Troilius First page of article [source] BLUE RUBBER BLEB NEVUS SYNDROME: TREATMENT OF MULTIPLE GASTROINTESTINAL HEMANGIOMAS WITH ARGON PLASMA COAGULATORDIGESTIVE ENDOSCOPY, Issue 1 2009Enders K.W. Ng Blue rubber bleb nevus syndrome is a rare clinical entity characterized by the formation of multiple blue or purplish rubbery cavernous hemangiomas on the skin and other epithelial surfaces. Involvement of the gastrointestinal tract is common and often presents with crippling anemia as a result of chronic occult blood loss. While surgical extirpation is an option for symptomatic hemangiomas in the intestine, endoscopic therapy is more appealing for lesions found in the stomach and colon. Here we report the successful use of argon plasma coagulation in the management of an adult with multiple hemangiomas in her colon and terminal ileum. [source] Management of urethral hemangiomas associated with Klippel,Trenaunay,Weber syndrome by endoscopic sclerotherapyINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2007Naoki Terada Abstract: Klippel,Trenaunay,Weber syndrome (KTS) is an unusual congenital anomaly characterized by cutaneous hemangiomas, varicosities and bony hypertrophy of the extremities. Herein the case is reported of a 24-year-old man with urethral bleeding from hemangiomas associated with KTS that were successfully managed by endoscopic sclerotherapy. A 23-G puncture needle was inserted into the bleeding vein to inject a 5% solution of monoethanolamine oleate (Oldamine), which is typically used for sclerotherapy of esophageal vasix. At a 4-month follow-up, the patient only had slightly bloodstained urethral discharge, and is doing well. This is the first case reporting endoscopic sclerotherapy for a KTS-associated urethral hemangioma. [source] Neodymium-YAG Laser for hemangiomas and vascular malformations , long term resultsJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 6 2005Die Behandlung von Hämangiomen und vaskulären Fehlbildungen mit dem Neodymium-YAG-Laser, Langzeitergebnisse Hämangiom; Lasertherapie; Nd:YAG-Laser; vaskuläre Malformation Summary Background: Hemangiomas and vascular malformations are the most common vascular lesions of infancy. Different lasers can be used for treatment. Nd:YAG laser photocoagulation is particularly effective because of its deep penetration into tissue. Patients and methods: Thirty-one patients, aged from three months to 18,years, with voluminous hemangiomas and venous malformations were treated with a cw-neodymium:YAG laser. The quartz fibre was used in percutaneous and intralesional technique. Long-term follow-up data were acquired by clinical control or a patient questionnaire for a maximal period of eight years. Twenty patients could be evaluated. Results: In the group with hemangiomas (n,=,15), three cases showed nearly complete remission (> 90 %), ten cases had a partial reduction in size (50,,,90 %), in one case there was stable disease and in one case tumor growth. In the group with venous malformations (n,=,5) two cases showed an excellent response (> 90 %), one case a moderate response (25,,,50 %) and in two cases there was no improvement. Adverse effects included scars (40 %), hyper- and hypopigmentation (23 %), mild atrophy (20 %) and a wrinkled texture (17 %). After maximal reduction in size, 30 % of the patients were not satisfied with the laser treatment outcome and elected surgical excision of the residual lesion. Conclusions: The neodymium:yttrium aluminium garnet (Nd:YAG) laser with percutaneous or intralesional application technique is a valuable tool for selected patients with hemangiomas and venous malformations. Zusammenfassung Hintergrund: Hämangiome und vaskuläre Malformationen sind die häufigsten Gefäßfehlbildungen in der Kindheit. Eine Therapieoption stellt die Laserbehandlung dar. Der Nd:YAG-Laser ist besonders effektiv aufgrund seiner hohen Eindringtiefe ins Gewebe. Patienten und Methodik: Insgesamt wurden 31,Patienten im Alter zwischen drei Monaten und achtzehn Jahren mit voluminösen Hämangiomen und venösen Malformationen mit einem cw-Neodymium:YAG-Laser behandelt. Die Laserfaser wurde in perkutaner und intraläsionaler Technik angewendet. Die Nachbeobachtung über einen Zeitraum von maximal acht Jahren erfolgte mittels klinischer Kontrollen oder einem Patientenfragebogen. Von den insgesamt 31,Patienten konnten 20 ausgewertet werden. Ergebnisse: In der Gruppe der Patienten mit Hämangiomen zeigten drei Patienten eine fast vollständige Rückbildung (> 90 %), zehn Patienten eine partielle Rückbildung (50,,,90 %), in einem Fall zeigte sich ein unveränderter Befund und bei einem Patienten beobachteten wir weiterhin Wachstum. In der Gruppe der Patienten mit venösen Malformationen zeigten zwei Patienten ein exzellentes Ansprechen (> 90 %), ein Patient ein moderates Ansprechen (25,,,50 %) und bei zwei Patienten kam es zu keiner Verbesserung. Nebenwirkungen beinhalteten Narben (40 %), Hyper- und Hypopigmentierungen (23 %), geringe Atrophie (20 %) und eine Hautfältelung. Nach vollständiger Rückbildung waren 30 % der Patienten unzufrieden mit dem Ergebnis und unterzogen sich einer operativen Entfernung der Residuen. Schlußfolgerungen: Der Nd:YAG-Laser mit perkutaner und intraläsionaler Applikationstechnik stellt eine wirksame Methode zur Behandlung ausgewählter Patienten mit Hämangiomen und venösen Malformationen dar. [source] Cutaneous composite hemangioendothelioma with satellitosis and lymph node metastasesJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2008Luis Requena The term hemangioendothelioma has been used in recent years to name a heterogeneous group of vascular neoplasms, intermediate in both biological behavior and histopathologic appearance between benign tumors (hemangiomas) and frankly malignant tumors (angiosarcomas). Thus, within the spectrum of hemangioendothelioma have been successively included epithelioid hemangioendothelioma, spindle cell hemangioendothelioma, retiform hemangioendothelioma, kaposiform hemangioendothelioma, polymorphous hemagioendothelioma of the lymph nodes, papillary intralymphatic angioendothelioma (PILA) and composite hemangioendothelioma. The latter is a vascular neoplasm showing varying combinations of benign, low-grade malignant and malignant vascular components. We herein report a case of composite hemangioendothelioma showing a combination of retiform hemangioendothelioma, epithelioid hemangioendothelioma, spindle cell hemangioma and PILA. The neoplasm showed a more aggressive behavior than other reported cases of composite hemangioendothelioma and it developed satellitosis and metastases to the inguinal lymph nodes. Neoplastic cells expressed immunoreactivity for Prox-1, supporting a lymphatic line of differentiation. [source] Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomasJOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2004Folker E. Franke Background:, Hobnail hemangioma (targetoid hemosiderotic hemangioma) is a small benign vascular tumor of the superficial and mid-dermis. In contrast to its well-characterized histology, it has been unclear whether this tumor arises from blood vessel endothelial cells (BECs) or lymphatic vessel endothelial cells (LECs). Methods:, We analyzed 10 hobnail hemangiomas by immunohistochemistry, using the recently described lymphatic endothelial cell marker, D2-40. For comparison, CD31, CD34, and ,-smooth muscle actin expression were studied in consecutive sections of the paraffin-embedded tissues. Results:, In all analyzed vessels, D2-40 labeled exclusively LECs, whereas BECs were consistently negative. In contrast to capillary BECs, either neighboring the tumors or intermingled, neoplastic endothelial cells of all 10 hobnail hemangiomas were strongly labeled by D2-40. Conclusions:, The results suggest a lymphatic origin for hobnail hemangiomas. This view is further supported by the CD34 negativity of endothelial cells and the lack of actin-labeled pericytes in hobnail hemangiomas, both characteristic of lymphatic vessels. Moreover, our analysis revealed that microshunts between neoplastic lymphatic vascular channels and small blood vessels occur, explaining some features of hobnail hemangiomas, such as aneurysmatic microstructures, erythrocytes within and beneath neoplastic vascular spaces, inflammatory changes, scarring, and interstitial hemosiderin deposits. [source] Expression of the caveolins in dermal vascular tumorsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2001Michael B. Morgan Introduction: Histopathologic criteria are usually sufficient for the accurate distinction of benign from malignant dermal vascular tumors. A minority of cases, however, pose a vexing diagnostic dilemma. Recent studies suggest that caveolin, a scaffolding cell membrane protein, may prove helpful in predicting the biologic behavior of endothelial-derived neoplasms. Methods: We analyzed a series of 30 dermal vascular tumors including 12 lobular capillary hemangiomas (LCH), 4 cases of targetoid hemosiderotic hemangiomas (TH), 4 cases of tufted angioma (TA), 12 cases of Kaposi's sarcoma (KS), 4 epithelioid (EH) and 1 spindle cell hemangioendothelioma (SH), and 4 cases of angiosarcoma (AS). The distribution of immunoreactivity was analyzed by quantifying cell membrane staining in each case. Results: There was a statistically significant difference in the expression of caveolin between LCH (mean labeling index=91.6), TH (mean labeling index=89.7), and TA (mean labeling index=87.2) and the cases of KS (mean labeling index=21.6, EH mean labeling index=23.1), and the AS ( mean labeling index=6.3). Conclusions: These results indicate that antibodies to caveolin may be useful in separating benign and malignant dermal vascular tumors and possibly implicates this peptide in their pathogenesis. [source] Contrast media-enhanced power Doppler sonography for evaluation of hemangiomas and malignant tumors in the liverJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2003AYDIN KARABACAKOGLU Abstract Aim: To evaluate the characterization of liver hemangiomas and malignant tumors using power Doppler sonography before and after intravenous injection of a sonocontrast agent. Methods: Forty-five patients with 57 liver tumors (22 hemangiomas, 24 metastases, 10 hepatocellular carcinomas (HCC) and one cholangiocellular carcinoma) were examined prospectively. The distribution (peripheral, central, mosaic) and extent (none, minimal, moderate and strong) of intratumoral flow pattern in each sonographic examination was subjectively classified. Results: The administration of the sonocontrast agent by bolus injection caused enhancement to gradually increase up to 2 min and lasted for 4,5 min. After injection of contrast agent, flow signals appeared or increased in 34 tumors. No signal enhancement was observed in 18 hemangiomas, four metastases and one HCC. The sensitivity and specificity of intratumoral vascularity for the detection of malignant liver tumors was 37.1 and 90.9% for unenhanced power Doppler sonography, and 85.7 and 81.8% for contrast-enhanced power Doppler sonography, respectively. Conclusion: Contrast-enhanced power Doppler sonography is superior to unenhanced power Doppler sonography in the demonstration of malignant tumor vascularity, and is helpful in differentiating between hemangiomas and malignant liver tumors. A specific flow pattern within the tumor is not established in primary and metastatic malignant tumors with contrast-enhanced power Doppler sonography. © 2003 Blackwell Publishing Asia Pty Ltd [source] Resovist enhanced MR imaging of the liver: Does quantitative assessment help in focal lesion classification and characterization?JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Lucia Santoro MD Abstract Purpose: To improve characterization of focal liver lesions by a prospective quantitative analysis of percentage signal intensity change, in dynamic and late phases after slow (0.5 mL/s) Resovist administration. Materials and Methods: Seventy-three patients were submitted on clinical indication to MR examination with Resovist. Signal intensity of 92 detected focal lesions (5,80 mm) were measured with regions of interest and normalized to paravertebral muscle in arterial, portal, equilibrium and T1/T2 late phases, by two observers in conference. Five values of percentage variations per patient were obtained and statistically evaluated. Results: The enhancement obtained on dynamic study is more suitable in hemangiomas and focal nodular hyperplasias than in adenomas and hepatocellular carcinomas. To discriminate benign versus malignant lesions on late-phase-T2-weighted images, a cutoff = ,26%, allowed sensitivity and specificity values of 97.4% and 97.7%, respectively. Area under the receiver operating characteristic (ROC) curve was 0.99. To differentiate hemangioma versus all other focal liver lesions, on late-phase-T1-weighted images, a cutoff = +40% permitted sensitivity and specificity values of 90.5% and 98.0%, respectively. Area under the ROC curve was 0.98. Conclusion: Late phase quantitative evaluation after slow Resovist administration, allows to differentiate malignant from benign hepatic masses and hemangiomas from all the others focal liver lesions, on T2-/T1-weighted acquisitions, respectively. J. Magn. Reson. Imaging 2009;30:1012,1020. © 2009 Wiley-Liss, Inc. [source] Infant hemangiomas: A controversy worth solvingLASERS IN SURGERY AND MEDICINE, Issue 2 2006R. Rox Anderson MD No abstract is available for this article. [source] IPL technology: A reviewLASERS IN SURGERY AND MEDICINE, Issue 2 2003Christian Raulin MD Abstract Background and Objectives Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 515,1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications. The purpose of this article was to critically review international medical publications of the many indication in which IPL technology can be used, including our own evaluations and experiences. Study Design/Materials and Methods The range of therapeutic uses for high-intensity flashlamps was reviewed, ranging from benign cavernous hemangiomas, benign venous malformations, essential telangiectasias, leg telangiectasias, poikiloderma of Civatte, and port-wine stains to pigmented lesions, cosmetically undesired hypertrichosis, and facial rhydids. The relative benefits and risks were discussed in detail and compared with other laser systems. Results Because of the wide spectrum of potential combinations of wavelengths, pulse durations, pulse frequency, and fluences, a great deal of experience is required when using IPL technology. Proper patient selection and critical diagnostics serve to keep the adverse effects of the treatment to a minimum. Conclusions The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies. Lasers Surg. Med. 32:78,87, 2003. © 2003 Wiley-Liss, Inc. [source] Lobular capillary hemangioma of the oral mucosa: Clinicopathological study of 43 cases with a special reference to immunohistochemical characterization of the vascular elementsPATHOLOGY INTERNATIONAL, Issue 1 2003Makoto Toida Clinical and histopathological features were investigated in 43 cases of oral lobular capillary hemangiomas (LCH) with a special reference to characteristics of the vascular elements. The lesions affected females more than males by a ratio of 1:1.5. Average age of the patients was 52.7 years. The lesions involved the gingiva (n = 15), the tongue (n = 13), the labial mucosa (n = 10) and other sites. The lesions appeared usually as a pedunculated mass with ulceration; size of the lesions was up to 15 mm. Histologically, a lobular area and an ulcerative area were distinguished. The density of vessels was about 1045/mm2 and 160/mm2 in the lobular and ulcerative areas, respectively. The average diameter of the vascular lumen was 9.1 5.6 mm (range: 2.8,42.0 mm) and 18.8 20.9 mm (range: 5.6,139.7 mm) in the lobular and ulcerative areas, respectively. In the lobular area, most of the vessels had an inner layer of endothelial cells showing positive reaction for von Willebrand factor (vWF) and CD34, as well as an outer layer of mesenchymal cells showing positive reaction for alpha-smooth muscle actin (ASMA). However, in the ulcerative area, there was a variety of types of vessels consisting of various proportions of both endothelial and ASMA-positive perivascular mesenchymal cells. These results indicate that most of the vascular elements in the lobular area resemble more pericapillary microvascular segments than they do capillaries. Thus, the authors propose the term ,lobular pericapillary hemangioma' to represent this type of lesion. [source] |