Separation of vascular lesions into one of the two groups, namely, hemangioma and vascular malformations can be of considerable significance relative to the treatment of patients. They pose serious bleeding risks. A case report is presented here where a patient with a vascular malformation is treated with fixed orthodontic appliances. A coordinated, interdisciplinary approach can result in enhanced patient satisfaction and successful treatment outcomes.
Hemangioma ; Port-Wine Stain

Infantile hemangiomas are known to be the most common tumors of childhood. These vascular tumors have a distinctive clinical course characterized by a proliferation phase (early and late), followed by a plateau phase and lastly the involution phase. Despite the ability to involute, certain complications, ulcerations being the most common, indicate prompt treatment. Early intervention during the proliferative phase with oral propranolol has been emphasized to achieve an optimum outcome. In this case, a 7-month-old infant presented with a 4.4cm by 3.2cm infantile hemangioma (IH) with ulceration on the left intergluteal area during the late proliferative phase. Prior to propranolol treatment, routine laboratory workup, 21-lead electrocardiogram and ultrasound of the kidneys, ureter and bladder were done, revealing unremarkable results. The patient was referred to a Pediatric Cardiologist and assessment deemed no contraindications for beta-blocker treatment. That patient was placed on a 12-hour day admission for the initiation of oral propranolol at a starting dose of l.0mg/kg/dose and was later discharged, stable, at 1.5mg/kg/dose. Escalation of doses were done by 0.5 every 2 weeks under close supervision on subsequent follow-ups via telemedicine. Four months following the initiation of propranolol treatment regression of the size of the lesion with residual fibrosis were observed. Oral propranolol appears to be an effective and safe therapeutic approach for ulcerated infantile hemangiomas, even during the late proliferative phase. Results achieved significant contraction and resolution of the ulceration and rapid involution of the lesion.

Humans ; Hemangioendothelioma, Epithelioid/pathology* ; Trans-Activators ; Transcription Factors ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; Hemangioendothelioma

Glottic hemangioma is a benign vascular tumor that is rarely seen in the adult population. We report a rare Filipino case of glottic hemangioma in a 65-year-old female presenting with 2 weeks history of hoarseness and a smooth, pedunculated, bluish mass at the anterior one-third of the right vocal cord in flexible laryngoscopy. Direct suspension laryngoscopy showed a pedunculated mass that was paler-looking, similar to the color of the surrounding mucosa, exhibiting the Phonation sign of Menzel. The patient underwent microlaryngeal excision and histopathology showed findings consistent with cavernous hemangioma.
Vocal Cords ; Hemangioma ; Adult

Humans ; Hemangioma, Cavernous/diagnostic imaging* ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging

Humans ; Hemangioblastoma/complications* ; Von Hippel-Lindau Tumor Suppressor Protein

Humans ; Hemangioma/pathology* ; Hemangioma, Capillary/pathology*

Humans ; Granuloma, Pyogenic/pathology* ; Hemangioma, Capillary

Humans ; Hemangioma ; Liver Neoplasms ; Fever

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.
Humans ; Hemangioendothelioma, Epithelioid/pathology* ; Contrast Media ; Retrospective Studies ; Liver Neoplasms/pathology* ; Portal Vein/pathology* ; Ultrasonography