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

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

Primary adrenal lymphoma is extremely rare with only 65 cases reported in the worldwide literature until 1998. The presenting symptom may be related to the lymphoma itself or to adrenal insufficiency. Most of the lymphomas were of B cell diffuse large cell type with only two seemed to be T-cell in origin. The therapeutic modalities include surgery, combination chemotherapy, surgery followed by chemotherapy and/or radiation therapy, in addition to corticosteroid replacement. A 65 year old man with chronic hepatitis C and hemangioma of liver presented with general weakness. Abdominal ultrasonography showed bilateral adrenal masses. The adrenal masses were diagnosed as a primary adrenal non-Hodgkin's lymphoma by open biopsy. The histologic findings were consistent with B cell diffuse large cell lymphoma. After three cycles of CHOP chemotherapy, the adrenal mass disappeared on follow up abdominal CT scan, but the patient died 4 months after diagnosis due to sepsis.
Adrenal Glands ; Adrenal Insufficiency ; Aged ; Biopsy ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Hemangioma ; Hepatitis C, Chronic ; Humans ; Liver ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Sepsis ; T-Lymphocytes ; Tomography, X-Ray Computed ; Ultrasonography

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

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

A clinical observation was made on 20 patients with renal tumor who had been admitted to Department of Urology, Jeonbug National University Hospital during the period from January 1978 to March 1983. The following results were obtained. 1. The incidence of renal tumor among total 1892 inpatients was 1.1% and 5.1% among the 389 genitourinary tumors. The most prevalent age group was fifth decade. The sex ratio, male to female was 1.5:1. 2. Histopathological analysis showed renal cell carcinoma in 11 cases, transitional cell carcinoma in 2 cases, squamous cell carcinoma in I case, Wilms' tumor in 1 case, neuroblastoma in 1 case, hemangioma in I case and simple cyst in 3 cases. 3. The most frequent symptoms and signs were gross hematuria in 11 cases(55%), flank pain in 11 cases(55%) and palpable mass in 6 cases (30%), and these classical symptom triad were seen in 3 cases of renal cell carcinoma. 4. Renal angiography was performed in 9 patients with 6 cases of renal cell carcinoma, 1 case of transitional cell carcinoma, 1 case of hemangioma and 1 case of renal cyst. 5. At the time of diagnosis, distant metastasis were found in 2 cases with renal cell carcinoma to lung, spine and Virchow's node. 6. Treatment of renal tumors consisted of surgery, radiation and/or chemotherapy. Radical nephrectomy was performed in 10 cases, simple nephrectomy in 2 cases, nephroureterectomy with bladder cuff resection in 3 cases, renal cystectomy with marsupialization in 3 cases and only diagnosis in 2 cases.
Angiography ; Carcinoma, Renal Cell ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Drug Therapy ; Female ; Flank Pain ; Hemangioma ; Hematuria ; Humans ; Incidence ; Inpatients ; Jeollabuk-do ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Neuroblastoma ; Sex Ratio ; Spine ; Urinary Bladder ; Urology ; Wilms Tumor

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

PURPOSE: To report a case of retinal capillary hemangioma treated with verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide. METHODS: A 15-year-old female presented with metamorphopsia in the left eye for 7 days. Examination showed peripheral endophytic retinal capillary hemangioma, macular edema, and a best-corrected visual acuity of 20/50. The hemangioma and macular edema were treated with verteporfin photodynamic therapy and intravitreal triamcinolone acetonide. RESULTS: After 5 months of follow-up, involution of the hemangioma, reduction of macular edema, decrease of the feeder and draining vessel diameter, and improvement of best-corrected visual acuity to 20/25 was seen. CONCLUSIONS: This verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide appeared to cause involution of the hemangioma with reduction in macular edema and improvement in visual acuity.
Adolescent ; Female ; Fundus Oculi ; Glucocorticoids/*administration & dosage/therapeutic use ; Hemangioma, Capillary/diagnosis/*drug therapy ; Humans ; Injections ; *Photochemotherapy ; Photosensitizing Agents/*therapeutic use ; Porphyrins/*therapeutic use ; Retinal Neoplasms/diagnosis/*drug therapy ; Tomography, Optical Coherence ; Triamcinolone Acetonide/*administration & dosage/therapeutic use ; Ultrasonography ; Vitreous Body