INTRODUCTIONMetastatic orbital tumour from gastric cancer is rare. Patients with metastatic disease may present initially to the ophthalmologist with symptoms from metastases instead of from the primary cancer.

CLINICAL PICTUREWe report a case, with clinicopathological correlation, of metastatic gastric adenocarcinoma presenting first in the orbit with diplopia. Computed tomography and magnetic resonance imaging of the orbit showed a well-defined enhancing right intraconal tumour.

TREATMENT AND RESULTSExcisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Focused gastrointestinal screening revealed an otherwise asymptomatic Stage IV gastric adenocarcinoma. Chemotherapy was initiated with good tumour response.

CONCLUSIONEarly biopsy of unusual orbital tumours is critical as orbital metastases may be the initial manifestation of an asymptomatic primary. Histopathological diagnosis can aid localisation of the primary tumour and allow prompt treatment to be instituted.

Biopsy ; Diplopia ; pathology ; Hemangioma, Cavernous ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Orbital Neoplasms ; secondary ; surgery ; Stomach Neoplasms ; pathology ; Time Factors

Diffuse hepatic hemangiomatosis without extrahepatic lesions is extremely rare in adults. A case of diffuse hepatic hemangiomatosis involving right lobe in a 50-year-old woman was presented. The hemangiomatosis was demonstrated by ultrasonography, computerized tomography (CT) and magnetic resonance image (MRI), and was confirmed histopathologically. Although diffuse hepatic hemangiomatosis is a rare disease in adults, its diagnosis should be considered in patients with diffuse tumor growth in one or both hepatic lobes and distinguished from malignant tumors. The present case is the first documented case of diffuse hepatic hemangiomatosis in an adult in Korea.
Case Report ; Female ; Hemangioma, Cavernous/ultrasonography ; Hemangioma, Cavernous/surgery ; Hemangioma, Cavernous/radiography ; Hemangioma, Cavernous/pathology+ACo- ; Human ; Liver Neoplasms/ultrasonography ; Liver Neoplasms/surgery ; Liver Neoplasms/radiography ; Liver Neoplasms/pathology+ACo- ; Magnetic Resonance Imaging ; Middle Age ; Neoplasms, Multiple Primary/ultrasonography ; Neoplasms, Multiple Primary/surgery ; Neoplasms, Multiple Primary/radiography ; Neoplasms, Multiple Primary/pathology+ACo- ; Tomography, X-Ray Computed

Diffuse hepatic hemangiomatosis without extrahepatic lesions is extremely rare in adults. A case of diffuse hepatic hemangiomatosis involving right lobe in a 50-year-old woman was presented. The hemangiomatosis was demonstrated by ultrasonography, computerized tomography (CT) and magnetic resonance image (MRI), and was confirmed histopathologically. Although diffuse hepatic hemangiomatosis is a rare disease in adults, its diagnosis should be considered in patients with diffuse tumor growth in one or both hepatic lobes and distinguished from malignant tumors. The present case is the first documented case of diffuse hepatic hemangiomatosis in an adult in Korea.
Case Report ; Female ; Hemangioma, Cavernous/ultrasonography ; Hemangioma, Cavernous/surgery ; Hemangioma, Cavernous/radiography ; Hemangioma, Cavernous/pathology+ACo- ; Human ; Liver Neoplasms/ultrasonography ; Liver Neoplasms/surgery ; Liver Neoplasms/radiography ; Liver Neoplasms/pathology+ACo- ; Magnetic Resonance Imaging ; Middle Age ; Neoplasms, Multiple Primary/ultrasonography ; Neoplasms, Multiple Primary/surgery ; Neoplasms, Multiple Primary/radiography ; Neoplasms, Multiple Primary/pathology+ACo- ; Tomography, X-Ray Computed

Adult ; Brain Stem Neoplasms ; complications ; pathology ; surgery ; Female ; Hemangioma, Cavernous ; complications ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Tremor ; etiology

Cervical Vertebrae ; Hemangioma, Cavernous ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Rupture, Spontaneous ; Spinal Canal ; pathology ; Spinal Neoplasms ; diagnosis ; surgery

Cavernous hemangiomas are one of the most common benign tumors of the orbit in adults. We report a case of a longstanding retrobulbar hemangioma that was removed successfully through a temporal transconjunctival approach combined with lateral canthotomy. A 45-year-old female patient, with a 15-year history of slowly progressive proptosis and decreased visual acuity of the left eye, had a corrected visual acuity of finger count at 50 cm OS, compared with 1.0 OD. Exophthalmometry by the Nagle's method measured 15 mm OD by 26 mm OS. Magnetic resonance imaging (MRI) revealed a well-encapsulated retrobulbar main mass, 2.3 x 3.0 x 3.7 cm in size along with multiple small satellite nodules that were displacing the optic nerve and globe superiorly. The tumors were removed through a superotemporal transconjunctival approach combined with lateral canthotomy. Pathological examination revealed an intraorbital cavernous hemangioma. The patient was free of visible scars, proptosis and any other noticeable complications at her last follow-up, 6 months after surgery.
Case Report ; Conjunctiva/surgery ; Female ; Hemangioma, Cavernous/pathology/*surgery ; Human ; Magnetic Resonance Imaging ; Middle Age ; Ophthalmologic Surgical Procedures/*methods ; Orbital Neoplasms/pathology/*surgery ; Treatment Outcome

PURPOSE: We aimed to evaluate the histologic and radiologic findings of vascular lesions after stereotactic radiosurgery (SRS) categorized as radiation-induced cavernous hemangioma (RICH). MATERIALS AND METHODS: Among 89 patients who underwent neurosurgery for cavernous hemangioma, eight RICHs from 7 patients and 10 de novo CHs from 10 patients were selected for histopathological and radiological comparison. RESULTS: Histologically, RICHs showed hematoma-like gross appearance. Microscopically, RICH exhibited a hematoma-like area accompanied by proliferation of thin-walled vasculature with fibrin deposits and infiltrating foamy macrophages. In contrast, CHs demonstrated localized malformed vasculature containing fresh and old clotted blood on gross examination. Typically, CHs consisted of thick, ectatic hyalinized vessels lined by endothelium under a light microscope. Magnetic resonance imaging of RICHs revealed some overlapping but distinct features with CHs, including enhancing cystic and solid components with absence or incomplete popcorn-like appearance and partial hemosiderin rims. CONCLUSION: Together with histologic and radiologic findings, RICH may result from blood-filled space after tissue destruction by SRS, accompanied with radiation-induced reactive changes rather than vascular malformation. Thus, the term "RICH" would be inappropriate, because it is more likely to be an inactive organizing hematoma rather than proliferation of malformed vasculature.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*pathology ; Female ; Hemangioma, Cavernous/complications/*pathology/surgery ; Hematoma/surgery ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiosurgery/adverse effects ; Treatment Outcome

Intracranial cavernous angiomas are benign vascular malformations and can be divided into intra-axial and extra-axial lesions. Extra-axial cavernous angiomas are relatively rare and usually arise in relation to the dura mater and mimick meningiomas. We report a case of cavernous angioma that occured in the falx cerebri of a 22-yr-old female patient with the special focus on neuroradiologic findings. This is the fourth case of cavernous angioma in the falx cerebri reported in the literature to our knowledge.
Tomography, X-Ray Computed ; Meningeal Neoplasms/pathology/*radiography/surgery ; Magnetic Resonance Imaging ; Humans ; Hemangioma, Cavernous/pathology/*radiography/surgery ; Female ; Dura Mater/*pathology ; Adult

BACKGROUNDThe aim of this study is to explore the treatment and outcome of epileptogenic temporal lobe cavernous malformations (CMs).

METHODSWe analyzed retrospectively the profiles of 52 patients diagnosed as temporal lobe CMs associated with epilepsy. Among the 52 cases, 11 underwent a direct resection of CM along with the adjacent zone of hemosiderin rim without electrocorticogram (ECoG) monitoring while the other 41 cases had operations under the guidance of ECoG. Forty-six patients were treated by lesionectomy + hemosiderin rim while the other six were treated by lesionectomy + hemosiderin rim along with extended epileptogenic zone resection. The locations of lesions, the duration of illness, the manifestation, the excision ranges and the outcomes of postoperative follow-up were analyzed, respectively.

RESULTSAll of the 52 patients were treated by microsurgery. There was no neurological deficit through the long-term follow-up. Outcomes of seizure control are as follows: 42 patients (80.8%) belong to Engel Class I, 5 patients (9.6%) belong to Engel Class II, 3 patients (5.8%) belong to Engel Class III and 2 patients (3.8%) belong to Engel Class IV.

CONCLUSIONPatients with epilepsy caused by temporal CMs should be treated as early as possible. Resection of the lesion and the surrounding hemosiderin zone is necessary. Moreover, an extended excision of epileptogenic cortex or cerebral lobes is needed to achieve a better prognosis if the ECoG indicates the existence of an extra epilepsy onset origin outside the lesion itself.

Adolescent ; Adult ; Child ; Electroencephalography ; Epilepsy ; surgery ; Female ; Hemangioma, Cavernous, Central Nervous System ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Temporal Lobe ; pathology ; surgery ; Treatment Outcome ; Young Adult

Adult ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Frontal Bone ; Hemangioma ; metabolism ; pathology ; surgery ; Hemangioma, Cavernous ; pathology ; Humans ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; metabolism ; pathology ; Skull Neoplasms ; metabolism ; pathology ; surgery