Objective: To present our surgical experience and technique in performing endoscopic sinus surgery for vascular sinonasal tumors without pre-operative embolization using intraoperative ligation of the external carotid artery or its distal branches. Methods: Design: Retrospective Series. Setting: Tertiary Private Teaching Hospital. Participants: Seven Patients. Results: Out of 7 patients (5 males, 2 females, aged 12 to 64 years old) with non-embolized vascular sinonasal tumors, 2 had juvenile angiofibroma, 3 had a benign vascular tumor (hemangiopericytoma, hemangioma and a vasoformative solitary fibrous tumor), and 2 had a malignancy (rhabdomyosarcoma, squamous cell carcinoma). Four (57.1%) had external carotid artery ligation, two (28.6%) had internal maxillary artery ligation and one (14.2%) had sphenopalatine artery ligation. The mean intraoperative blood loss was 2447.1 mL (range 900mL to 5,000mL) and average operation duration was 7.6 hours (range 2.9 hours to 14.5 hours). The average amount of transfused blood products was 1785.7mL (zero to 3,000mL). The average hospital stay was 7 days (range 2 to 13 days) with one post-operative complication (ICU admission for hypotension from intraoperative blood loss). Conclusion Intraoperative ligation of the ECA or its distal branches to disrupt the vascular supply of sinonasal tumors may provide a viable means of preventing excessive intraoperative blood loss in patients with non-embolized vascular sinonasal tumors.
Cardiovascular System ; Neoplasms, Vascular Tissue

Humans ; Vascular Neoplasms/pathology* ; Liver Neoplasms/pathology* ; Neoplasms, Vascular Tissue

Though leiomyosarcoma usually occurs in the gastrointestinal tract and uterus, it rarely occurs in the wall of large veins and arteries. We present a case of primary leiomyosarcoma arising in the great saphenous vein of the left inner thigh and spreading for some extent along the vein in a 54 year old female. Diagnosis was confirmed by desmin stain and electron microscopy. Postoperative course was fine. This is the first report of this in Korean literature.
Female ; Humans ; Leiomyosarcoma/*pathology ; Middle Aged ; *Saphenous Vein ; Soft Tissue Neoplasms/*pathology ; Vascular Diseases/pathology

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.
Adult ; Child ; Diagnosis ; Extremities ; Head ; Hemangioendothelioma* ; Humans ; Lymph Nodes ; Neck ; Neoplasms, Vascular Tissue ; Neuralgia ; Neurofibromatoses* ; Neurofibromatosis 1* ; Skin ; Skin Manifestations ; Ulcer ; Vascular Neoplasms

Humans ; Nerve Sheath Neoplasms ; pathology ; Nervous System Neoplasms ; pathology ; Smooth Muscle Tumor ; pathology ; Soft Tissue Neoplasms ; classification ; pathology ; Urinary Bladder Neoplasms ; classification ; pathology ; Vascular Neoplasms ; pathology

Bone Neoplasms ; pathology ; Diagnosis, Differential ; Hemangioendothelioma ; pathology ; Hemangioendothelioma, Epithelioid ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Sarcoma ; pathology ; Skin Neoplasms ; pathology ; Soft Tissue Neoplasms ; pathology ; Vascular Neoplasms ; pathology

WATER HYDROXIDES INORGANIC CHEMICALS OXYGEN COMPOUNDS OXIDES TRANSITION TEMPERATURE TEMPERATURE THERMODYNAMICS PHYSICAL PHENOMENA ANGIOFIBROMA NEOPLASMS ; VASCULAR TISSUE NEOPLASMS BY HISTOLOGIC TYPE NEOPLASMS THERAPEUTICS THERAPY

HUMANS FEMALE CHILD NEOPLASMS NEOPLASMS BY HISTOLOGIC TYPE NEOPLASMS ; VASCULAR TISSUE HEMANGIOMA CENTRAL NERVOUS SYSTEM VENOUS ANGIOMA HEMANGIOENDOTHELIOMA HEMANGIOMA ; CAPILLARY RESPIRATORY SYSTEM LARYNX

Adolescent ; Adult ; Breast Neoplasms ; pathology ; Carcinoma ; pathology ; Diagnosis, Differential ; Endothelium, Vascular ; pathology ; Fasciitis ; pathology ; Female ; Hemangiosarcoma ; pathology ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Hyperplasia ; pathology ; Leiomyoma ; pathology ; Leiomyosarcoma ; pathology ; Middle Aged ; Soft Tissue Neoplasms ; pathology ; Uterine Neoplasms ; pathology ; Vascular Diseases ; pathology

OBJECTIVETo investigate the clinicopathologic characteristics and differential diagnosis of myopericytoma.

METHODSSix cases of myopericytomas were analyzed by light microscopy and immunohistochemistry (LSAB detection method).

RESULTSTumors from 3 females and 3 males were found on the extremities and chest wall. The ages of these 6 patients ranged from 16 to 58 years. Histologically, all tumors were unencapsulated. The neoplastic cells were oval to spindle shaped with eosinophilic cytoplasm, had a myoid appearance and showd areas of concentric perivascular proliferation around lesional blood vessels which were present with focal myxoid stroma. Morphologically in some cases the tumor overlap myofibroma, hemangiopericytoma or glomus tumor. One tumor was located entirely within the lumen of a vein. In another case, the tumor displayed cellular pleomorphism, mitotic activity, necrosis should be diagnosed as malignant myopericytoma. The neoplastic cells were positive for SMA and negative for CD31, CD34, S-100, and CK.

CONCLUSIONSMyopericytoma is composed of oval to spindle shaped myoid cells with a striking tendeny for concentric perivascular growth. These cells differentiate towards perivascular myoid cells or myopericytes. Extremely rare malignant myopericytoma exist.

Actins ; metabolism ; Adolescent ; Adult ; Diagnosis, Differential ; Female ; Glomus Tumor ; metabolism ; pathology ; Hemangiopericytoma ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Myofibroma ; metabolism ; pathology ; Neoplasms, Vascular Tissue ; metabolism ; pathology ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism