Vascular tumors of the breast are uncommon and occur, for the most part, in the form of angiosarcomas. Benign breast hemangiomas are especially rare, with few reports existing in the literature. We report a case of a subcutaneous cavernous hemangioma of the breast and describe the sonographic, MRI findings and pathologic features.
Breast ; Caves ; Hemangioma ; Hemangioma, Cavernous ; Hemangiosarcoma

PURPOSE: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. METHODS: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. RESULTS: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. CONCLUSION: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.
Anesthesia, General ; Cardiopulmonary Resuscitation ; Electrocoagulation ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Maxillary Artery ; Maxillofacial Injuries ; Polyvinyl Alcohol ; Retrospective Studies ; Rupture ; Vital Signs

Tuberous sclerosis is an autosomal dominant disorder characterized by seizure, mental retardation and harmatomatous lesions in multiple organs. The renal lesions of tuberous sclerosis are multiple angiomyolipomas often associated with cysts of various sizes. A 47-year-old man who had been on hemodialysis for 12 years was admitted to our hospital because of sudden onset of right flank pain. He had polycystic kidney disease and adenoma sebaceum. Abdominal computed tomography showed an enlarged right kidney with massive hemorrhage, and renal arteriography showed massive bleeding. Immediate transarterial embolization and radical nephrectomy on the right kidney was done. Pathologic examination revealed ruptured renal angiomyolipoma, confirming that he had contiguous gene syndrome. We experienced a case of tuberous sclerosis with spontaneous rupture of renal angiomyolipoma in a hemodialysis patient with autosomal dominant polycystic kidney disease.
Angiography ; Angiomyolipoma* ; Flank Pain ; Hemorrhage ; Humans ; Intellectual Disability ; Kidney ; Middle Aged ; Nephrectomy ; Polycystic Kidney Diseases* ; Polycystic Kidney, Autosomal Dominant ; Renal Dialysis ; Rupture, Spontaneous* ; Seizures ; Tuberous Sclerosis*

PURPOSE: We wanted to evaluate the usefulness of modified intravenous analgesia for the management of pain during uterine artery embolization for leiomyomata. MATERIALS AND METHODS: Between April 2004 and July 2004, 15 patients with symptomatic fibroids underwent uterine artery embolization and pain management. Except the three patients for whom the Visual Analogue Scale (VAS) score was not obtained, twelve patients were included in this study. For pain management, epidural PCA (Patient Controlled Analgesia) was used in two patients, intravenous PCA was used in two patients and modified intravenous analgesia injection was used in eight patients. For all the patients, we used the 2.8 Fr coaxial microcatheter and 500-710 μm PVA particles for the embolic materials. The protocol of the modified intravenous analgesia injection was as follow, 1) prior to femoral artery puncture, 30 mg of ketorolac tromethamine (Tarasyn) was injected via an intravenous route. 2) At the time that the one side uterine artery embolization was finished, normal saline mixed 150 mg meperidine (Demerol) was administered through the side port of the intravenous line that was used for hydration. 3) Additional ketorolac tromethamine 30 mg was injected after 6 hour. The VAS score and side effects were then checked. After 12 hours, the VAS score was rechecked. If the VAS score was above 4, this was considered as failure of pain management. The VAS scores, complications and side effects for the modified intravenous analgesia injection were compared with that of IV PCA and epidural PCA. RESULTS: The average VAS score of the modified intravenous analgesia injection, intravenous PCA and epidural PCA was 1.4, 1 and 0, respectively; the number of additional intramuscular injections of analgesia was 0.5, 0.5 and 0, respectively. All the patients who underwent epidural PCA had back pain at the puncture site and 1 patient who underwent modified intravenous analgesia injection experienced mild dyspnea, but they easily recovered with such conservative treatment as an oxygen supply. No serious side effects or complications developed from the modified intravenous analgesia injection. CONCLUSION: Modified intravenous analgesia injection is well tolerated for the pain management of uterine fibroid embolization and it is a relatively inexpensive, safe method as used in our radiologic practice.
Analgesia* ; Back Pain ; Dyspnea ; Femoral Artery ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Ketorolac Tromethamine ; Leiomyoma ; Meperidine ; Oxygen ; Pain Management ; Passive Cutaneous Anaphylaxis ; Punctures ; Uterine Artery Embolization* ; Uterine Artery* ; Uterine Neoplasms

Endovascular procedures are becoming the standard type of care for the management of hemodialysis vascular access dysfunction. As with any type of medical procedure, these techniques can result in procedure-related complications, although the expected number of complications is low. The clinical extent of these complications varies from case to case. Management of these cases depends on the clinical presentation. Major complications such as vein rupture, arterial embolism, remote site bleeding or hematoma, symptomatic pulmonary embolism and puncture site complications necessitating treatment require major therapy. Minor complications such as non-flow compromising small puncture site hematoma or pseudoaneurysms require little or no therapy. It is essential that the interventionist be prepared to manage these complications appropriately when they arise.
Veins ; Stents ; Rupture, Spontaneous ; Retrospective Studies ; Renal Dialysis/*methods ; Postoperative Complications/therapy ; Middle Aged ; Male ; Humans ; Female ; Extravasation of Diagnostic and Therapeutic Materials/therapy ; Embolism/therapy ; *Arteriovenous Shunt, Surgical ; Aged ; Adult

Interstitial ectopic pregnancy is a rare condition of pregnancy and may be very dangerous if not identified and treated urgently. We report a case of successful treatment of an interstitial pregnancy using selective uterine artery embolization. A 27-year-old woman with interstitial pregnancy was treated by uterine artery embolization after failure of systemic methotrexate treatment. Her serum beta-human chorionic gonadotropin (β-hCG) was undetectable one month after the therapeutic embolization and transvaginal sonography 31 days after embolization showed normal endometrium and cornu. The patient achieved a normal pregnancy eight months after embolization.
Adult ; Embolization, Therapeutic/*methods ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic/*therapy/ultrasonography ; Uterus/*blood supply

PURPOSE: To evaluate the early ultrasonographic (US) findings from the uterus and myoma after a uterine fibroid embolization (UFE). MATERIALS AND METHODS: From March 2004 to January 2006, eleven patients (27-48 years, mean: 37 years) with UFE to treat symptomatic uterine myoma, were retrospectively reviewed. A serial follow up gray-scale and color Doppler US were performed from one day to two weeks following a UFE. The US findings were evaluated for the presence and distribution pattern of air, time of air loss, and presence of fluid collection in the uterine cavity and color Doppler (SD Comment: Doppler is name. Should perhaps be upper case) signal. RESULTS: Numerous high echoes with reverberation artifacts (which suggest air), were observed within the myoma (in all cases), one day after UFE. A branching linear echo pattern was observed in 4 cases (36%), whereas scattered echoes were observed in 7 cases (64%). Progressive loss of air, within 7 days of a UFE, was observed in 9 cases (82%), whereas 2 cases (12%) were observed within 14 days of a UFE. Abnormal fluid collection in the uterine cavity and a color Doppler signal within the myoma was not observed for all cases. CONCLUSION: Branching or scattered echoes (suggesting air), are normally found within the myoma after a UFE, but these echoes disappeared within 2 weeks. These early US findings can be useful in differentiating from myoma infections after a UFE.
Artifacts ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Leiomyoma ; Myoma ; Retrospective Studies ; Ultrasonography, Interventional ; Uterine Neoplasms ; Uterus

Granular cell tumor is a rare and usually benign tumor that occasionally involves the breast. The physical examination, the mammographic and ultrasonographic findings and the pathologic findings are often suggestive of carcinoma. We report here a rare case of granular cell tumor of the breast that mimicked carcinoma on the mammography, ultrasonography and MR imaging.
Breast* ; Granular Cell Tumor* ; Magnetic Resonance Imaging ; Mammography ; Physical Examination ; Ultrasonography

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus