OBJECTIVE: To review the application of medical imaging in diagnosis and management of fetal hepatic hemangioma. METHODS: Clinical data and imaging findings of 14 cases of fetal hepatic hemangioma, who were diagnosed prenatally and followed up in Women's Hospital of Zhejiang University School of Medicine from February 2014 to September 2018 were retrospective reviewed. RESULTS: The fetal hepatic hemangiomas were single lesions in all 14 cases, and most of them were located in the right lobe of the liver (13/14). Ultrasound images were mainly hypoechoic with heterogeneity, the honeycomb-like or grid-like anechoic regions were presented in 9 lesions and circumferential blood flow was observed with low to moderate blood flow resistance index. MRI findings showed well-defined lesions with low signal intensity on T1WI, and high or slightly high signal intensity on T2WI. Among 14 cases, there were 8 cases of induced labor and 6 cases of continuing pregnancy. In 6 cases of successful delivery, 2 were treated with propranolol, 4 cases were followed-up without treatment. The growth and development of 6 children were normal. The lesions of hepatic hemangioma showed no significant changes in 3 children and were reduced in the other 3 children, of whom the lesion was complete disappeared in 1 case. CONCLUSIONS Fetal hepatic hemangiomas present relatively typical imaging characteristics, and prenatal diagnosis can be made with ultrasound and MRI. If there are no complications, the fetus with hepatic hemangioma can be delivered at full term with a good outcome.
Female ; Fetus ; Hemangioma ; diagnostic imaging ; therapy ; Humans ; Liver Neoplasms ; diagnostic imaging ; therapy ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis ; Retrospective Studies

Infant hemangioma, the most common benign tumor in children, is characterized by rapid proliferation, followed by slower spontaneous involution. However, some patients with facial segmental hemangioma are associated with PHACE syndrome. PHACE syndrome is characterized by vascular nerve and vascular cutaneous lesions of multiple systemic systems, often resulting in structural and functional impairments. Recent studies have demonstrated that the possible pathogeneses of PHACE syndrome mainly include hypoxia, abnormality of mesodermal vascular endothelial cells, genetic abnormality, and abnormality of interstitial mesenchymal stem cells. The current medications for hemangioma with PHACE syndrome include beta blockers, glucocorticoids, and mTOR inhibitors. This review article mainly describes the pathogenesis, diagnoses and treatments of PHACE syndrome, in order to provide directions for diagnosis and treatment of this disorder.
Abnormalities, Multiple ; diagnosis ; etiology ; therapy ; Eye Abnormalities ; diagnosis ; etiology ; therapy ; Heart Defects, Congenital ; diagnosis ; etiology ; therapy ; Hemangioma ; diagnosis ; etiology ; therapy ; Humans ; Infant

Hemangiomas are the most common benign tumors of the liver. They are generally asymptomatic, but giant hemangiomas can lead to abdominal discomfort, bleeding, or obstructive symptoms. Kasabach-Merritt syndrome is a rare but life-threatening complication of hemangioma, characterized by consumptive coagulopathy with large vascular tumors. More than 80% of Kasabach-Merritt syndrome cases occur within the first year of life. However, there are few reports of Kasabach-Merritt syndrome with giant hepatic hemangioma in adults and, as far as we know, no reports of Kasabach-Merritt syndrome with hepatic hemangioma treated with first line medical treatment only. The most important treatment for this syndrome is removal of the large vascular tumor. However, surgical treatment entails risk of bleeding, and the patient's condition can mitigate against surgery. We herein present a case of unresectable giant hepatic hemangioma with disseminated intravascular coagulopathy. The patient was a 60-year-old woman who complained of hematochezia, ecchymosis, and abdominal distension. She refused all surgical management and was therefore treated with systemic glucocorticoids and beta-blockers. After two weeks of steroid therapy, she responded partially to the treatment. Her laboratory findings and hematochezia improved. She was discharged on hospital day 33 and observed without signs of bleeding for three months.
Abdomen/diagnostic imaging ; Ecchymosis/etiology ; Female ; Gastrointestinal Hemorrhage/etiology ; Hemangioma/complications/*diagnosis ; Humans ; Kasabach-Merritt Syndrome/complications/*diagnosis/drug therapy ; Middle Aged ; Prednisone/therapeutic use ; Propranolol/therapeutic use ; Tomography, X-Ray Computed

No abstract available.
Angiogenesis Inhibitors/administration & dosage/adverse effects ; Bevacizumab/administration & dosage/*adverse effects ; Follow-Up Studies ; Hemangioma, Capillary/diagnosis/*drug therapy ; Humans ; Intravitreal Injections ; Male ; Photochemotherapy/*adverse effects ; Retina/*pathology ; Retinal Detachment/*chemically induced/diagnosis ; Retinal Neoplasms/diagnosis/*drug therapy ; Time Factors ; Young Adult

OBJECTIVE: To discuss the diagnosis and treatment method in children with mass in subglottic. METHOD: There were totally 35 patients with subglottic mass who complained with dyspnea in our department. All the patients got electronic laryngoscopy examination in order to get the preliminary judgment of the mass' property. Then they accepted ultrasound and CT scan to make the definite diagnosis. The patients with subglottic hemangioma accepted oral propranolol or intralesional Pingyangmycin injection. The other type of masses got the laryngoscope CO2 laser tumor resection. RESULT: There were 31 patients with subglottic hemangiomas, 2 patients with subglottic cysts, 1 patient with subglottic fibroma, 1 patient with subglottic granuloma. The substantial follow-up time was from 1 month to 3 years. 25 patients with subglottic hemangiomas were cured, 6 patients got improvement. The patients with non-hemangiomas were all cured. CONCLUSION There was a high incidence of hemangioma in children with subglottic mass. We suggested making a diagnosis by doing electronic laryngoscopy, ultrasound and CT scan step by step. Oral propranolol was a safe and effective method in treating subglottic hemangioma. For the patients with non-hemangiomas, we considered the laryngoscope CO2 laser tumor resection as the first choice of treatment.
Child ; Glottis ; pathology ; Hemangioma ; diagnosis ; therapy ; Humans ; Laryngeal Diseases ; diagnosis ; therapy ; Laryngeal Neoplasms ; diagnosis ; therapy ; Laryngoscopy ; Larynx ; pathology ; Tomography, X-Ray Computed

Administration, Oral ; Bronchoscopy ; Female ; Glottis ; abnormalities ; diagnostic imaging ; Hemangioma ; congenital ; diagnosis ; therapy ; Humans ; Infant, Newborn ; Laryngeal Neoplasms ; congenital ; diagnosis ; therapy ; Propranolol ; administration & dosage ; therapeutic use ; Tomography, X-Ray Computed

Herein, we report a neonatal case of an extra-renal non-cranial malignant rhabdoid tumor with simultaneous tumor in the adrenal gland, which was initially diagnosed with hemangioma. The patient showed a soft tissue mass on the chin at birth which grew rapidly with invasion of lower lip. Despite multimodal treatment including surgery, chemotherapy and high dose chemotherapy followed by autologous stem cell transplantation, the patient died of disease progression at the age of 20 months finally. The clinical presentation, diagnosis, pathology, treatment, and prognosis for this case are discussed.
Adrenal Glands ; Chin ; Combined Modality Therapy ; Diagnosis ; Disease Progression ; Drug Therapy ; Hemangioma ; Humans ; Infant, Newborn ; Lip ; Neoplasm Metastasis ; Parturition ; Pathology ; Prognosis ; Rhabdoid Tumor ; Stem Cell Transplantation

Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.
Adult ; Colonoscopy ; Female ; Hemangioma/*complications ; Humans ; Iron, Dietary/therapeutic use ; Klippel-Trenaunay-Weber Syndrome/complications/*diagnosis/drug therapy ; Rectum/blood supply ; Spleen/blood supply ; Tomography, X-Ray Computed ; *Varicose Veins

We report 3 cases of circumscribed choroidal hemangioma (CCH) effectively managed with intravitreal bevacizumab. One patient (case 1) who had recurrent CCH (1.6 mm in thickness) with prior laser photocoagulation was treated with intravitreal bevacizumab alone. Two patients (case 2 and 3) who had CCH (2.4 mm and 2.2 mm in thickness, respectively) with recent visual impairment were treated with bevacizumab followed by photodynamic therapy (PDT). Ophthalmic evaluations included visual acuity, ophthalmoscopic examination, fluorescein angiography, ultrasonography, and optical coherence tomography. Patients were followed up for 6-9 months. After therapy, all patients showed improved visual acuity due to complete resorption of subretinal fluid and macular edema. Ultrasonography demonstrated a reduction of the thickness of CCH in case 1 and complete regression of the lesions in case 2 and 3. No patient showed tumor recurrence. Intravitreal bevacizumab, alone or in combination therapy with PDT, may be a useful alternative for the treatment of symptomatic CCH with subretinal fluid.
Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Choroid Neoplasms/diagnosis/*drug therapy ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioma/diagnosis/*drug therapy ; Humans ; Injections ; Male ; Middle Aged ; Ophthalmoscopy ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A ; Vitreous Body

OBJECTIVETo study the history, clinical symptoms, imaging and histology of a rare distinct infantile hemangioma.

METHODS12 patients (5 female, 7 male; aged 18 months - 26 years) diagnosed as non-involuting congenital hemangioma were retrospectively analyzed. The history, imaging, histologic examination and the treatment were collected.

RESULTSMost of the patients had only one lesion which was round or ovoid, flat or plaque-like. The average size was about 5 cm x 6 cm. The overlying skin was usually had coarse telangiectasia with central or peripheral pallor. The skin has a high skin temperature. Magnetic resonance imaging, computed tomography angiography and digital subtraction angiography findings were similar to those of common infantile hemangioma. Histologic examination revealed lobular collections of small, thin-walled vessels with a large, often stellate, central vessel. "Hobnailed" endothelial cells lined along the intralobular vessels. Small arteries were observed "shunting" directly into lobular vessels or into abnormal extralobular veins. All lesions were easily excised without recurrence.

CONCLUSIONSNon-involuting congenital hemangioma is a distinct infantile vascular tumor. It should be diagnose early and treated appropriately.

Adolescent ; Adult ; Angiography ; methods ; Angiography, Digital Subtraction ; Child ; Child, Preschool ; Female ; Hemangioma ; congenital ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Young Adult