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Purpose: To report a case of retinal cavernous hemangioma with intralesional phleboliths, simulating retinoblastoma., Methods: A healthy 5-month-old girl developed left esotropia and was noted to have atraumatic vitreous hemorrhage with underlying partially calcified mass, suspicious for retinoblastoma., Results: On examination, the visual acuity was fix and follow in the right eye and absent fixation in the left eye. Evaluation of the right eye revealed normal findings. The left eye demonstrated healthy anterior segment and dense vitreous hemorrhage with no view of the postequatorial structures, but with hazy view of the flat peripheral retina and a superonasal retinal mass, covered with fresh hemorrhage. Three white intralesional flecks, consistent with calcification, each measuring 300 μm, were visualized. B-scan ultrasonography confirmed the dense mass with several foci of calcification, suspicious for retinoblastoma, despite poor visualization on funduscopy. Prophylactic intravenous chemotherapy was delivered for globe salvage and systemic protection. At 12-month follow-up, the hemorrhage showed resolution, revealing a superonasal dark blue multilobulated mass with saccular aneurysms, measuring 16 mm in diameter, and with 3 phleboliths (intralesional calcification). Fluorescein angiography demonstrated early and midphase hypofluorescence with late-phase filling and with plasma-erythrocyte separation in some larger aneurysms, characteristic of retinal cavernous hemangioma., Conclusion: Retinal cavernous hemangioma can be associated with intralesional calcification (phleboliths).

Cavernous angioma (CA) is a vascular pathology caused by loss of function in one of the 3 CA genes (CCM1, CCM2, and CCM3) that result in rho kinase (ROCK) activation. We investigated a novel ROCK2 selective inhibitor for the ability to reduce brain lesion formation, growth, and maturation. We used genetic methods to explore the use of a ROCK2-selective kinase inhibitor to reduce growth and hemorrhage of CAs. The role of ROCK2 in CA was investigated by crossing Rock1 or Rock2 hemizygous mice with Ccm1 or Ccm3 hemizygous mice, and we found reduced lesions in the Rock2 hemizygous mice. A ROCK2-selective inhibitor, BA-1049 was used to investigate efficacy in reducing CA lesions after oral administration to Ccm1 +/- and Ccm3 +/- mice that were bred into a mutator background. After assessing the dose range effective to target brain endothelial cells in an ischemic brain model, Ccm1 +/- and Ccm3 +/- transgenic mice were treated for 3 (Ccm3 +/- ) or 4 months (Ccm1 +/- ), concurrently, randomized to receive one of three doses of BA-1049 in drinking water, or placebo. Lesion volumes were assessed by micro-computed tomography. BA-1049 reduced activation of ROCK2 in Ccm3 +/- Trp53 -/- lesions. Ccm1 +/- Msh2 -/- (n=68) and Ccm3 +/- Trp53 -/- (n=71) mice treated with BA-1049 or placebo showed a significant dose-dependent reduction in lesion volume after treatment with BA-1049, and a reduction in hemorrhage (iron deposition) near lesions at all doses. These translational studies show that BA-1049 is a promising therapeutic agent for the treatment of CA, a disease with no current treatment except surgical removal of the brain lesions.

Background: Cavernous angiomas (CAs) are vascular malformations that may result in stroke., Case Description: Herein, we evaluate a CA patient with chronic migraine who experienced 2 documented symptomatic hemorrhages after receiving respective high doses of botulinum toxin (Btx)., Conclusions: Recently, bacterial lipopolysaccharide has been reported to contribute to CA development through Toll-like receptor signaling, causing hemorrhagic angiogenic proliferation. Lipopolysaccharide and Btx share a common intracellular signaling pathway driving CA development and hemorrhage. Significance of these observations is demonstrated by previous works on plasma molecules showing prognostic associations with symptomatic hemorrhages in human CA, related to the same canonical pathways. Authors suggest careful tracking of the association of Btx and hemorrhage in CA patients., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Diffuse cavernous haemangioma is a rare disease of the rectum. It usually presents with a history of rectal bleeding in children and young adults. When conservative methods fail to control bleeding, traditionally resection is recommended. A 50-year-old man presented with per rectal bleeding and was diagnosed with diffuse cavernous haemangioma of the sigmoid and rectum extending up to 40 cm in the left colon through endoscopy, magnetic resonance imaging and computed tomography. The diagnosis was confirmed by biopsy. This patient was successful managed conservatively with tranexamic acid as needed, avoiding the need for resection.

Background: More than a million Americans harbor a cerebral cavernous angioma (CA), and those who suffer a prior symptomatic hemorrhage have an exceptionally high rebleeding risk. Preclinical studies show that atorvastatin blunts CA lesion development and hemorrhage through inhibiting RhoA kinase (ROCK), suggesting it may confer a therapeutic benefit., Objective: To evaluate whether atorvastatin produces a difference compared to placebo in lesional iron deposition as assessed by quantitative susceptibility mapping (QSM) on magnetic resonance imaging in CAs that have demonstrated a symptomatic hemorrhage in the prior year. Secondary aims shall assess effects on vascular permeability, ROCK activity in peripheral leukocytes, signal effects on clinical outcomes, adverse events, and prespecified subgroups., Methods: The phase I/IIa placebo-controlled, double-blinded, single-site clinical trial aims to enroll 80 subjects randomized 1-1 to atorvastatin (starting dose 80 mg PO daily) or placebo. Dosing shall continue for 24-mo or until reaching a safety endpoint., Expected Outcomes: The trial is powered to detect an absolute difference of 20% in the mean percent change in lesional QSM per year (2-tailed, power 0.9, alpha 0.05). A decrease in QSM change would be a signal of potential benefit, and an increase would signal a safety concern with the drug., Discussion: With firm mechanistic rationale, rigorous preclinical discoveries, and biomarker validations, the trial shall explore a proof of concept effect of a widely used repurposed drug in stabilizing CAs after a symptomatic hemorrhage. This will be the first clinical trial of a drug aimed at altering rebleeding in CA., (Copyright © 2018 by the Congress of Neurological Surgeons.)

Rationale: Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial., Patient Concerns: A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation., Diagnoses: Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination., Interventions: We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times., Outcomes: She was cured and had no recurrence during the 3-month follow-up., Lessons: This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.

Introduction: Parotid haemangiomas account for the majority of salivary gland tumours in children. This articles highlights the use of medical treatment for the treatment of parotid haemangioma., Case Summary: A 4 year old male underwent a superficial parotidectomy for a parotid mass that was found to be a a parotid haemangioma on histology. At the age of 14 years he presented again with a parotid mass. He had imaging which aided the diagnosis of a parotid haemangioma being made. He was treated with successfully propranolol over a period of 6 months., Discussion: There are no clear guidelines for treatment of parotid haemangiomas. These lesions can represent a clinical challenge and optimal management is controversial. It was proposed that propranolol be used for treatment in this particular case. This is a non-invasive form of treatment with minimal side effects., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objectives: The authors describe a case of congenital calvarial hemangioma successfully managed using propranolol therapy. Presenting symptoms, radiological and pathological features, differential diagnosis, and management of this rare congenital mass are described., Case Presentation: A 2-year-old boy presented with a 1-year history of a growing right parietal skull mass. No obvious etiology was apparent. No focal neurological deficits or associated craniofacial anomalies were identified. Plain film imaging demonstrated focal thickening of the right parietal bone with internal trabeculations in a sunburst appearance. Computed tomography (CT) scan showed bone thickening with coarsening of the bony trabeculae, minor irregularity of the outer table, unaffected inner table, and no evidence of aggressive features. A diagnostic biopsy of the lesion was performed in the operating room. Microscopic examination was consistent with hemangioma. Based on histological and radiological features of the lesion, it was identified as a cavernous hemangioma. Medical treatment utilizing propranolol was initiated for over 3 years with interval reduction in the lesion size. MRI head following treatment with propranolol demonstrated reduction of the mass compared to preoperative imaging., Conclusions: Although a rare entity, it is important to consider congenital calvarial hemangioma in the differential diagnosis of slow growing skull lesions due to the possibility of complications as a result of the hemangioma's intracranial extension, and the potential for treatment. En bloc resection has classically been described as a treatment for such lesions, although our case demonstrates that medical treatment with propranolol therapy may be appropriate in certain situations.

Purpose: To report the response of cavernous haemangioma of the disc to PDT., Methods and Patients: A 32 years old lady presented to us with complaints of sudden onset of blurry vision in her right eye. What seemed initially as polypoidal choroidal vasculopathy turned out as cavernous haemangioma of the disc after pneumatic displacement of the sub-retinal haeme. She was treated with PDT as she was prone to recurrent haemorrhage from the lesion due to her low platelet count., Results: Complete regression of the cavernous haemangioma was noted as early as the second week itself and remained regressed for 4 months., Conclusion: PDT can be safe option for patients presenting with symptomatic cavernous haemangioma of the disc or retina.

Objective: To evaluate the efficacy and safety of 2% topical propranolol cream in the treatment of proliferating infantile strawberry hemangiomas., Methods: A total of 40 infants were enrolled; 2% propranolol cream was applied three times daily. In the subsequent monthly visit, dynamic changes in tumor size, texture, and color were recorded. The adverse events (AEs) were observed. Treatment outcomes were scored on a four-point scale. All patients were followed up for 12 mo after treatment., Results: The overall response was graded Scale 1 (poor response) in 2 patients, Scale 2 (moderate response) in 15 patients, Scale 3 (good response) in 17 patients, and Scale 4 (excellent response) in 6 patients. No significant differences were seen in treatment outcomes between female and male patients, among lesion locations/size, or in the age at the start of the treatment. No obvious AEs were reported., Conclusions: 2% topical propranolol cream is safe and effective for the treatment of proliferating infantile strawberry hemangiomas.

The hydatid cyst is a parasitic infection included within the category of zoonoses, in which there exists a direct or indirect relation with animals, particularly with dogs. We report a clinical case of a patient who has undergone surgery of hydatid cyst in the right hepatic lobe. Seven years later the patient presents hydatid cyst in portal vein with secondary cavernomatosis, which is a rare complication. There are few cases described in the literature. The symtomatology presented by hydatid cyst is variable and the diagnosis is made by ultrasonography, TC and/or RNM. The treatment of choice is the surgical removal of the cyst, prior to surgery Albendazol must be administered for 1-2 weeks and be maintained for 4 more weeks after surgery.

A 10-month-old infant with the diagnosis of retinal cavernous hemangioma involving the macula presented with an outward deviation of the right eye that has been noticed by her parents. Examination revealed a clearing vitreous hemorrhage, and grape-like clusters filled with blood in the posterior pole. After 4 cycles of intravenous infliximab over the period of 3 months, no evident change was noted on the size of the cavernous hemangioma.

Idiopathic non-cirrhotic portal hypertension is a rare disease of unknown etiology. Patients with idiopathic non-cirrhotic portal hypertension have an increased risk of developing portal vein thrombosis and this is especially prevalent when HIV is also present. We describe a unique case of a patient with idiopathic non-cirrhotic portal hypertension associated to HIV, who developed acute portal vein thrombosis that despite anticoagulation transformed in portal cavernoma and disappeared completely after five years of follow-up on continuous anticoagulation., (Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Background: The current survey aimed to describe the clinical features of critical infantile hepatic hemangioma (IHH) and the implications of recent treatments., Materials and Methods: A nationwide survey of critical IHH patients treated between 2005 and 2010 was performed in all 117 registered pediatric surgical hospitals in Japan. As a result, 19 patients were identified and reviewed using a statistical analysis., Results: Abdominal distention (47.4%), high-output cardiac failure (47.4%), coagulopathy (42.1%), and respiratory distress (31.6%) were the major symptoms. Three patients died (1 of coagulopathy, 1 of cardiac failure, and 1 of both). An accompanying portovenous shunt was also highlighted. Infantile hepatic hemangioma was totally insensitive to steroid treatment in 3 (23.1%) of the 13 patients, and 9 (47.4%) of the 19 patients required other treatments. Surgical resection and β-blocker improved the hematologic data, whereas hepatic arterial ligation and embolization seemed to produce a limited effect. Among the dead patients, several hematologic parameters were significantly worse: the thrombocyte count (pretherapeutic: 73,000 vs 300,000/mm(3), dead vs survivor, respectively [P < .03]; posttherapeutic: 66,000 vs 388,700/mm(3) [P < .003]) and the prothrombin time (posttherapeutic, 35.0 vs 12.1 seconds [P < .0001], dead vs survivor, respectively)., Conclusion: For critical IHH cases with steroid-insensitive hematologic disorders, alternative treatments including β-blocker therapy, surgery, and liver transplantation should be considered., (Copyright © 2011 Elsevier Inc. All rights reserved.)

The therapeutic arsenal for hemangiomas in early childhood can now be considered to include oral β-blockers, mainly propranolol. These drugs are thought to act as vasoconstrictors, regulating angiogenic pathways and inducing apoptosis of vascular endothelial cells. Although infantile hemangioma is not among the approved indications for β-blockers, many specialized clinics will prescribe propranolol before resorting to corticosteroids. A dosage of 2 mg/kg/d, is usually employed with a dosing interval of 8 hours. Propranolol is safe, causing few side effects, although cases of hypoglycemia, hypotension, diarrhea, reflux, cold hands and feet, bronchospasm, and hyperkalemia have been described. Generally, these adverse effects have not had serious consequences. Prescription in PHACE syndrome is controversial. In all cases, a cardiologist should assess the patient before treatment begins, blood pressure should be monitored, and pediatric follow-up should be scheduled. This review covers our current understanding of the indications, clinical response, and adverse effects of propranolol, a drug has revolutionized our attitude toward infantile hemangioma and the way we approach therapy. Clinical trials under way are also reviewed., (Copyright © 2011 Elsevier España, S.L. y AEDV. All rights reserved.)

Kaposiform hemangioendothelioma is a rare vascular tumor in children. Especially, in association with the Kasabach-Merritt Phenomenon it can be life threatening. The management of these patients is very difficult and an aggressive treatment regime is required. Several multimodality and chemotherapeutic regimens have been described but with variable success and many side effects. We present a 6-week-old boy with Kaposiform hemangioendothelioma and Kasabach-Merritt Phenomenon. Ongoing propranolol treatment with only 4 initial courses of vincristine resulted in a remission that lasted at least 1 year.

Kaposiform hemangioendothelioma (KHE) is a rare tumor that occurs nearly exclusively during infancy and childhood. It has features common to both capillary hemangioma and Kaposi sarcoma and for that reason many terms have been used for these tumors including "Kaposi-like infantile hemangioendothelioma" and "hemangioma with Kaposi sarcoma-like features." KHE typically presents as an ill-defined, red to purple, indurated plaque and is often complicated by the Kasabach-Merritt phenomenon (KMP), a condition of severe thrombocytopenia and consumptive coagulopathy. Knowledge of the radiological findings of this uncommon tumor might be helpful for diagnosis. We present the MRI features of a case of KHE with neither typical skin lesions nor the Kasabach-Merritt phenomenon.

Cavernous malformations are vascular lesions of the central nervous system. They are very rare in childhood. We report the case of sporadic cavernous cerebral angioma in a 1-year-old girl without pathologic antecedents revealed by a partial seizure. With this case and a review of the literature, we show the clinical and therapeutic characteristics of cerebral cavernomatosis in childhood., (Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.)

Radiation-induced cavernous hemangiomas (RICH) are a known complication of radiation exposure, especially in young children. The current treatment approaches to these lesions include observation and surgical resection. We report the case of a 4-year-old male with recurrent medulloblastoma who had resolution of an incidental RICH lesion while being treated with bevacizumab for his recurrent brain tumor. There was no evidence of worsening hemorrhage with this therapy and the RICH did not recur upon discontinuation of the chemotherapy regimen. This is the first documented case of a RICH lesion responding to antiangiogenic therapy, suggesting the possible use of this class of agents in the treatment of symptomatic patients who are not considered appropriate candidates for surgical resection. Although the risk of bleeding must be taken into consideration, antiangiogenic therapies have the potential to be a novel treatment modality for symptomatic RICH lesions., (Copyright © 2010 S. Karger AG, Basel.)

Giant hemangiomas are rare in newborn babies and may cause some life-threatening complications such as congestive heart failure and coagulopathies including severe thrombocytopenia, microangiopathic hemolytic anemia and bleeding such as Kasabach-Merritt syndrome. We have presented here one infant case with a right lower brachial plexus paralysis due to giant hemangioma treated successfully with interferon alpha and have discussed the treatment. This is the first case of Kasabach-Merritt syndrome associated with a right lower brachial plexus paralysis treated with interferon in the literature to our knowledge. The administration of interferon-alpha might be indicated as a therapy for severe, life-threatening and giant hemangiomas such as Kasabach-Merritt syndrome, especially when there is resistance to steroid. However, more extensive data and new patients are needed to clarify this issue.

Background: Literature consistently mentions that pregnancy and hormonal therapy probably increase the bleeding rate and seizure expression of cerebral cavernomas. Either increased hormonal activity or embryogenesis related abundant expression of some growth factors such as VEGF, bFGF, and placental growth factor during pregnancy were proposed to initiate angiogenic process and vascular proliferation in cavernomas, thereby increasing their bleeding rate and seizure expression., Methods: To reveal whether estrogen and/or progesterone have direct effect on cerebral cavernomas, their receptor expressions were studied immunohistochemically in recently excised 12 cerebral cavernomas., Results: Study showed no expression of either estrogen or progesterone receptors in cerebral cavernomas even the staining worked well in positive control tissues of infiltrative ductal carcinoma., Conclusions: Aggressive behavior of cerebral cavernomas during pregnancy is a commonly proven observation and attributed to some hormonal effects. However, this effect seems not related to effect of estrogen or progesterone on cavernoma tissue via receptor binding.

The authors report a 7-day-old girl born with a hemangioma involving the right side of the scalp and neck who developed ipsilateral brachial plexus palsy at 5 days of age. Imaging studies confirmed the presence of a cavernous hemangioma in the vicinity of the brachial plexus. She was treated with intravenous corticosteroids and her palsy resolved in 5 days. Only 1 prior case of hemangioma producing brachial plexus palsy has been reported; this patient was not treated with corticosteroids and had a partial recovery. The authors believe that the quick recovery after initiating systemic steroids was due to relief of nerve compression (neuropraxia) resulting from shrinkage of the cavernous hemangioma. The purpose of this article is to describe an uncommon cause of neonatal brachial plexus palsy and to report the effectiveness of early intravenous corticosteroid treatment in a patient with brachial plexus palsy due to a cavernous hemangioma.

Hemangiomas are the most common benign tumors of infancy. Capillary hemangioma generally is presented as a spot or well-defined purple lesion. The diagnosis of these tumors is based on physical examination. Giant hemangioma is a rare and extensive variation of capillary hemangioma, that generally occurs in newborns and suckling infants. There are several therapeutical modalities, as the intralesional injection of steroids, laser therapy, intralesional injection of sclerosing solutions, surgery, radiotherapy and embolization. New therapeutical modalities have been developed, with the objective of getting better results and to make possible the treatment of the lesions of difficult surgical access or refractory cases to the used therapeutical modalities. The best results have been observed with interferon-alpha. This is a case of a patient with three months of age, that presented since birth, a purplish tumor in the superior eyelid of the right eye, plain and purplish cutaneous lesions in the temporal and parietal right region. On computed tomography of the skull, an orbital expansive vascularized process with intracranial extension could be observed. Systemic therapy with steroids was the initial treatment, during forty days, with gradual reduction for four weeks. With the practically unchanged clinical findings, the treatment with interferon-alpha was indicated, in the dose of subcutaneous 3.000.000 U/m(2), three times a week. After 9 months of treatment, a small residual orbital lesion was observed. In this case, interferon-alpha is presented as a good option for the treatment of craniofacial giant hemangioma.

Background: The aim of this study was to establish a treatment strategy for patients with cavernous angiomas and have seizures., Methods: We analyzed retrospectively 31 patients with cavernous angiomas presenting with seizures. Of the 31 patients, 15 (11 men, 4 women) had been treated medically (the medical group) and 16 (11 men, 5 women) had been treated surgically (the surgical group). The percentage of patients who became seizure-free and the number of anticonvulsants used were compared between these 2 groups. The mean follow-up period was 5.3 years (range, 7 months-10 years). There was no statistically significant difference between the 2 groups with regard to the number of patients, sex, age, and follow-up period., Results: The percentage of patients who became seizure-free was higher in the surgical group than in the medical group (80% vs 19%, P < .01). The number of anticonvulsants required was reduced in the surgical group after surgery (from 1.5 +/- 0.7 to 1.1 +/- 0.8, P < .01) and was not reduced after in the medical group., Conclusions: Surgical intervention may have greater benefits than medical intervention for patients with cavernous angiomas presenting with epileptic seizures.

Systemic corticosteroid treatment is reported as effective for problematic cutaneous hemangiomas occuring in infancy, and depend on the dose, the duration of treatment, and the age at which the course of drugs is initiated. A 7-month-old female infant with extended cavernous hemangioma on the left part of forehead, face,and neck which appeared 15 days after birth is presented. She was successfully treated with oral methylprednisolone (initial doses of 3 mg/kg/daily and reduced in steps over 6 months) with significant involution of the lesions and with good aesthetic results. The oral corticosteroid treatment is an efficient medical therapy for common extended cavernous infantile hemangiomas with accelerated growth if initiated early in the proliferative phase.

The authors describe their experience with systemic therapy of cavernous haemangiomas making use of interferon alpha. They have successfully used the method in treating two female patients with cavernous haemangiomas in the orbit. In the first patient, the IFN therapy was followed by surgical removal of the tumour. In the second patient, surgical operation was not suitable. After the IFN therapy, the patient's state improved both subjectively and objectively. Decreased level of bFGF in urine prove to be the criterion for successful treatment by IFN. The authors also stress the risk of complications in sucklings. When choosing the method of treatment, they emphasize the necessity of interdisciplinary cooperation.

Objectives: To prepare the magnetic pingyangmycine-bearing microspheres (MPMs), test its characteristics, and evaluate the target ability of MPMs., Methods: MPMs were prepared by a cold-condensation method at first. Then the scan electron microscope, high performance liquid chromatography (HPLC) and atomic absorption spectrometry were used to measure the diameter of MPMs and the contents of PYM and Fe3O4 in MPMs. Drug-releasing instrument was used to test the quantity of PYM released from MPMs. The distribution of intravenously injected MPMs in SD rat liver was investigated under an externally magnetic field., Results: MPMs are spherical with the mean diameter of 32.23 microns. The content of pingyangmycine in MPMs was 3.8% and Fe3O4 was 11.7% (w/w). The quantity of PYM released from MPMs in 3 hours was 63.1%. The content of Fe3O4 in the targeting sites of rats was obviously higher than that in the non-targeting sites (P < 0.01)., Conclusion: MPMs have good properties of drug-targeting and drug sustain releasing. MPMs may be ideal for the use of the treatment of cavernous hemangioma.

A 45-day-old patient was admitted with dyspnea, hepatomegaly, tachycardia, holosystolic murmur in the precordial region, and continuous murmur at the right hypochondrium. Four cutaneous angiomas were noted. Instrumental examinations revealed congestive heart failure and multiple focal lesions in the liver with typical features of hemangiomas. The therapy with subcutaneous interferon-alfa-2a (IFN-alpha) was administered for 12 months with progressive regression of cutaneous hemangiomas, liver lesions, and cardiological alterations. IFN-alpha therapy was effective without any significant adverse effects.

Objective: To investigate the probability and mechanism magnetic pingyangmycine-bearing microspheres(MPMs) in the treatment of cavernous hemangioma., Methods: Twenty rabbits were divided into four groups. MPMs, pingyangmycine and magnetic nonpingyangmycine-bearing microspheres were injected into marginal ear veins respectively. All animals were killed after 21 days and histological varations of the veins were observed under the light microscope and transmission electron microscope., Results: The occlusion of the veins in the group of MPMs with the external magnetic field was more prominent than that in the other groups., Conclusion: MPMs can occlude veins by means of its embolized effect and PYM drug effect. MPMs may be better used in the therapy of cavernous hemangioma.

Objective: The effect of Pinyangmycin, Dexamethasonum and Sodium Morrhuate injected concomitantly to treat cavernous hemangioma in oral and maxillofacial regions was evaluated., Methods: The medical records of 350 patients with cavernous hemangioma in oral and maxillofacial regions between January 1998 and January 2002 were reviewed. One hundred and sixty-five of the patients were men, and 185 were women, the sex ratio was 1:1.12. The patients' ages were between 4 months and 55 years. Two hundred and Twenty-six hemangiomas were located in the maxillofacial regions, and 124 located in the oral cavity. The size of the lesions varied from 1 cm x 1 cm to 6 cm x 9 cm. Pinyangmycin, Dexamethasonum and Sodium Morrhuate were injected simultaneously into the lesions or in the vicinity of the cavernous hemangiomas, and the injection might be repeated every 5 to 7 days when necessary, and this process could be repeated 3 to 5 times., Results: Three hundred and fifty patients were followed up for 6-48 months. The cure and essentially cured rates were 95.48%, the total efficiency rate was 100%., Conclusion: This method was a safe, simple and effective therapy to manage cavernous hemangioma in the oral and maxillofacial regions.

Kaposiform hemangioendothelioma and tufted angioma are viewed as two separate disease entities in the current classification of vascular tumors. However, the concurrence of features of both vascular tumors in the same specimen of some patients raises the question whether these tumors exist on a continuum. Herein, we report a dynamic transformation between both tumors within a single patient, which suggests they are two variants of the same vascular tumor., (Copyright 2003 S. Karger AG, Basel)

In a previous report, we showed the efficacy of the submucous sclerosant therapy with Etoxiesclerol (Polidocanol) in two patients with Rendu-Osler-Weber disease. We confirm, in this present study, the advantages of Etoxiesclerol in the treatment of the epistaxis in the Rendu-Osler disease, in six patients, 3 males and 3 females and likewise in two patients with non-specific granuloma of nasal septum and another patient with cavernous hemangioma of soft palate.

Unlabelled: We report the case of a 4-month-old boy presenting with a giant cutaneous haemangioma complicated by Kasabach-Merritt syndrome (KMS) with severe thrombocytopenia. After poor response to corticosteroid therapy and subsequent treatment with interferon alpha-2a, radiotherapy led to tumour regression and resolution of the disseminated intravascular coagulopathy over a 14-month period of follow up. Whereas the various available treatment options are reviewed and discussed in this article, the therapy of choice should be chosen individually., Conclusion: to date prospective randomised and controlled trials are required to investigate the optimal management of patients with Kasabach-Merritt syndrome.

Objective: The objective of this study is to investigate the mechanism of acute trauma of endothelium after injection of Pingyangmycin., Methods: A total of 42 adult Wistar rats were divided randomly into experimental groups (24), positive control groups (12) and normal control group (6), and the rats in the experimental or the positive control groups were injected with Pingyangmycin or sodium morrhuate into the mesenteric veins respectively, and then the enzyme activity of hepatic endothelial cells and hepatocytes was examined histochemically 0.5, 1, 2, 4, 8 and 24 hours after injection., Results: After injection, the activity of 5'-nucleinase(5'-N) in hepatic endothelial cells and that of lactic dehydrogenase (LDH) and succinodehydrogenase (SDH) in hepatocytes decreased gradually, but that injected Pingyangmycin was less than that injected sodium morrhuate., Conclusion: The trauma caused by Pingyangmycin is less than that caused by sodium morrhuate, but the reaction of trauma caused by both is nonspecific.

Objective: The aim of this study was to investigate the mechanism of Pingyangmycin sclerotherapy for cavernous hemangiomas., Methods: Totally 9 rabbits (one as the control) were selected to be injected with Pingyangmycin and sodium morrhuate into the auricularis posterior vein, and then these veins were examined histologically 2, 7, 14 and 21 days after injection respectively., Results: After injection, Pingyangmycin nonspecifically made the endothelia and veins defective, and induced proliferation of endothelial cells and smooth muscle cells after 7 days. Further, the veins became sclerostenosis 21 days after injection. On the other hand, sodium morrhuate caused thrombosis quickly and the vascular cavity disappeared. Finally, the thrombus became fibrogenesis. The local skin could be observed swollen and necrosis., Conclusion: Pingyangmycin is a better sclerosant for the therapy of cavernous hemangioma.

Objective: To investigate the indication and result in hemangioma in oral and maxillofacial region with Pingyangmycin injection., Methods: 1282 patients (554 males and 728 females) with hemangioma in oral and maxillofacial region have been treated in our hospital during the 10-year period from May 1990 to March 1999. The patients range between 0.5-84 years old. Lip, cheek and tongue were usually involved. 1211 patients were treated with injection of Pingyangmycin(about 0.89 mg/ml) and dexamethasone (about 0.55 mg/ml), 1 time/1-2 weeks., Results: The curative rates of cavernous hemangioma and strawberry hemangioma were 93.87% and 84.90%, but that of plexiform hemangioma was 22.22% and those of portwine stain and central hemangioma of the jaws were 0%, respectively. Serious complications associated with Pingyangmycin injection, such as pulmonary fibrosis were not seen., Conclusion: Injection of Pingyangmycin is selective primary method for cavernous and strawberry hemangioma treatment.

Characteristics and outcomes of recent portal or mesenteric venous thrombosis are ill-known. We intended to compare these features with those of patients with portal cavernoma, and also to assess the incidence of recanalization of recent thrombosis on anticoagulation therapy. All patients seen between 1983 and 1999 were enrolled into this retrospective study if recent portal or mesenteric venous thrombosis or portal cavernoma had been documented, and if cancer of the liver, pancreas, or bile duct, intrahepatic block including cirrhosis, and obstruction of the hepatic veins had been ruled out. The proportion of recent thrombosis was 7% in patients seen before 1990 and 56% after 1994 (P <.05). Patients with recent thrombosis (n = 33) or cavernoma (n = 108) did not differ with regard to age, sex ratio, or prevalence of prothrombotic states and of previous thrombotic events. In patients with recent thrombosis, septic pylephlebitis was more common and the incidence of gastrointestinal bleeding was lower (2.4 vs. 12.7/100 patient-years). Recanalization occurred in 25 of 27 patients given anticoagulation and 0 of 2 patients not given anticoagulation. The probability of recanalization was related to the extent of thrombosis (P =.003). In conclusion, mesenteric or portal venous thrombosis is increasingly recognized at an early stage. The features differentiating recent thrombosis and cavernoma are related to silent onset precluding early recognition and therapy in the latter. Frequent association with prothrombotic states and frequent recanalization on anticoagulation support the recommendation of early anticoagulation therapy in all patients with recent portal vein thrombosis.

Objective: To provide a simple and safe surgical approach in treating cavernous and racemose hemangioma., Methods: First cross-ligate the hemangioma, as to divide the tumor into independent compartments, them inject pingyangmycin into the compartments respectively., Results: There are 30 cases in this group (35 hemangiomas). Twenty-four cases (28 hemangiomas) were totally cured, accounting for 80%; Six cases were improved (7 hemangiomas) for 20%; There was no ineffective case., Conclusion: "Inner-hemangioma ligation and injection of pingyangmycin" has broad surgical indications, with desirable outcome in treating cavernous and racemose hemangioma, especially those unsuitable for surgery, or ineffective simply by inner-hemangioma injection.

Objective: To evaluate the effects of Pinyangmycin, Dexamethasonum and Sodium morrhuate injected homochronouly on treatment of cavernous hemangioma in maxillofacial regions., Methods: The medical records of 115 patients with cavernous hemangioma in maxillofacial regions between September, 1996 and September, 1998 were reviewed. Fifty of the patients were men, and 65 were women, with a ratio of 1:1.3. The age of the patients was from 4 months old to 45 years old. 73 of the hemangioma bodies were sited in maxillofacial regions, 42 were sited in oral cavity. The sizes of the lesions varied from 1 cm x 1 cm to 5 cm x 8 cm. Treatment procedure: 1. Preparation: 8 mg Pinyangmycin was dissolved in 5 mg/ml Dexamethasonum and in 4 ml of 1% procain which were ready for use; 2. Injection: 1-5 ml (Pinyangmycin 1.6-8.0 mg) of mixed solution was first injected to the hemangioma, then followed by an injection of 0.5-2.0 ml Sodium morrhuate according to local appearance, size of the tumor and patient's age. Generally, the amount of each injection should not be over 8 mg Pinyangmycin. If the tumor did not subside after an injection, another injection might be repeated every 5-7 days, and this process might be repeated 3-5 times. The total dose of Pinyangmycin should not be over 40 mg., Results: 115 patients were followed up for 6-24 months. 81 of 115 (70.43%) cases were recovered, and 30 (26.09%) cases were basically recovered. 4 (3.48%) cases got improvement. The recovery rate were 96.52%, and the total efficiency was 100%., Conclusion: This method may be a safe, simple and effective therapy to cavernous hemangioma in maxillofacial regions.

A 49 years old man in good physical condition suffering from abdominal pain in the right hypochondrium was hospitalized and CT scan revealed an hemoperitoneum, an enlargement of the liver and a rupture of an heterogeneous spleen. The patient was operated on and spleen removed. Pathological examination of the spleen concluded to a splenic cavernous hemangioma. In the postoperative course, an increase of liver nodules occurred within two weeks. A localized splenic angiosarcoma was recognized by reexamination of the specimen. The patient treated by chemotherapy was still alive after 5 months. Prognosis of splenic angiosarcoma is very poor; there is no curative treatment.

A 75-year-old man with a recent history of pulmonary embolism, presented with collapse followed by a gran mal seizure and right-sided non-pulsatile proptosis. On recovery, he had diplopia on lateral and upward gaze and signs of congestive cardiac failure. Further pulmonary embolism was proven by lung scintigraphy. Computed tomography of his orbits confirmed a contrast-enhancing space-occupying lesion of the medial wall of the right orbit, with no intracranial abnormality. The patient was investigated for metastatic tumour as a possible cause of the space-occupying lesion and the unprovoked thromboembolic event, but no evidence of malignancy was found. The orbital lesion was not biopsied because of the risk of bleeding from anticoagulation. Three weeks later, the patient represented with recurrent cardiac failure, proptosis, and diplopia. A transorbital ultrasound confirmed an encapsulated, well-defined vascular lesion, with typical appearances and Doppler flow characteristics of a cavernous haemangioma. Diuretic therapy abolished the proptosis and diplopia in tandem with relief of the cardiac failure. This is the first description of recurrent proptosis with diplopia due to recurrent congestive expansion of an orbital cavernous haemangioma.

Objective: To evaluate the distribution of magnetic-bearing microspheres (MPMs) in rabbits., Methods: The distribution of intravenously injected 99mTc-labelled MPMs in rabbits at different intervals of magnetic field applied and different magnetic field intensity was investigated by using an externally applied magnetic field and measuring the radio-activity at the rabbit head and other organs., Results: MPMs have the properties of targeted distribution, as positive correlation between targetic radio-activity and times and intensity of magnetic field., Conclusion: MPMs may be better used in the therapy of cavernous hemangiomas.