Cavernous hemangiomas are benign neoplasms of endothelial cells. Although this neoplasm has the potential to develop in all parts of the body, it rarely develops in the axilla; in fact, there are only two case reports of axillary cavernous hemangiomas in the literature. Here, we describe a third case, which occurred in a 30-year-old Korean woman. The patient presented with a palpable mass in the left axilla that was initially thought to be either a phyllodes tumor or a lymphoma based on imaging studies. However, the results of an excisional biopsy led to a diagnosis of cavernous hemangioma. Although uncommon, a cavernous hemangioma can be encountered unexpectedly, presenting as a mass in axilla. Although usually curative, surgery may be challenging not only because of the rarity of the condition, but also because of inconsistent preoperative findings and the involvement of large vessels.
Adult ; Axilla ; Biopsy ; Diagnosis ; Endothelial Cells ; Female ; Hemangioma, Cavernous ; Humans ; Lymphoma ; Phyllodes Tumor ; Ultrasonography ; Vascular Neoplasms

We report a case of multiple hemangiomas involving the urinary bladder in a 4-year-old boy who presented with recurrent episodes of gross hematuria. On ultrasonography, compared with the bladder wall, the lesions presented as multiple isoechoic polypoid intraluminal masses with mildly increased vascularity on color Doppler exam. Cavernous hemangioma was confirmed by cold-cup biopsy, and the all lesions were coagulated with a Holmium laser. Despite their rarity, bladder hemangiomas should be included in the differential diagnosis of multiple intravesical masses in children with gross hematuria.
Biopsy ; Child* ; Child, Preschool ; Diagnosis, Differential ; Hemangioma* ; Hemangioma, Cavernous ; Hematuria* ; Humans ; Lasers, Solid-State ; Male ; Ultrasonography ; Urinary Bladder*

A combination of giant hepatic hemangioma and diffuse hemangiomatosis is extremely rare in adults. Even when they are large, hemangiomas are soft and rarely compress adjacent structures. A 78-year-old man presented with abdominal pain and distension. Ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a large expansile mass replacing the medial segment and caudate lobe with diffusely scattered nodules in the entire liver. The large hilar mass contained a central nonenhancing area and had a mass effect, leading to left portal vein occlusion. The image findings also revealed two unprecedented findings: left lateral segmental atrophy of the liver and recent portomesenteric vein thrombosis. The hepatic lesions were confirmed with hemangiomas by ultrasonography-guided biopsy. We diagnosed intrahepatic portal vein obstruction caused by a mass effect of giant hepatic hemangioma coexistent with diffuse hemangiomatosis, resulting in hepatic segmental atrophy and extrahepatic portal vein thrombosis.
Abdominal Pain ; Adult ; Aged ; Atrophy* ; Biopsy ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Liver ; Magnetic Resonance Imaging ; Portal Vein* ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis*

Vascular tumors of the breast are uncommon and most are angiosarcomas. Breast hemangioma, a rare benign vascular tumor, is usually found as a superficially located mass. We present an unusual case of breast hemangioma located in parenchyma with atypical imaging features.
Breast* ; Hemangioma ; Hemangioma, Cavernous* ; Hemangiosarcoma ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography, Mammary

OBJECTIVETo determine the safety and efficacy of the enhanced radiofrequency ablation (RFA) new technology for treatment of giant hepatic hemangiomas.

METHODSFrom August 2010 to September 2011, 30 patients with giant hepatic hemangiomas (average diameter: 7.7+/-1.9 cm, range: 5.0 to 12.8 cm) were treated with enhanced RFA. The original lesion diameter, enhanced radiofrequency duration, and cases of RFA-induced burning were recorded. Cases requiring a second RFA treatment were also recorded. Correlation analysis was carried out to determine the association of enhanced RFA with adverse events and change in lesion diameter.

RESULTSThe rate of completely destroyed lesions by enhanced RFA was 70.96%, and the total rate of reduced lesions was 87.1%. No severe adverse events occurred. The duration of enhanced radiofrequency correlated positively with the original lesion diameter (r=0.687, P less than 0.01). The enhanced RFA treatment significantly reduced the average lesion diameter (follow-up: 6.2+/-1.8 cm; t=6.417, P less than 0.01).

CONCLUSIONThe new minimally-invasive technology of enhanced radiofrequency ablation is effective and safe for treating giant hepatic hemangiomas and produces an obvious, short-term curative effect.

Adult ; Catheter Ablation ; methods ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Ultrasonography, Interventional

OBJECTIVE: We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. MATERIALS AND METHODS: Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. RESULTS: All the lesions were located in the cortex and their mean size was 1.3 +/- 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. CONCLUSION: Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.
Adolescent ; Adult ; Aged ; Brain Diseases/*surgery/ultrasonography ; Brain Neoplasms/surgery/ultrasonography ; Female ; Glioma/surgery/ultrasonography ; Hemangioma, Cavernous, Central Nervous System/surgery/ultrasonography ; Humans ; Male ; *Microsurgery ; Middle Aged ; *Ultrasonography, Interventional ; Young Adult

Adolescent ; Adult ; Carcinoma, Embryonal ; diagnosis ; diagnostic imaging ; Child ; Child, Preschool ; Diagnosis, Differential ; Hemangioma, Cavernous ; diagnosis ; diagnostic imaging ; Humans ; Infant ; Lymphoma ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Orchitis ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Seminoma ; diagnosis ; diagnostic imaging ; Teratoma ; diagnosis ; diagnostic imaging ; Testicular Neoplasms ; diagnosis ; diagnostic imaging ; Ultrasonography, Doppler, Color ; Young Adult

OBJECTIVESTo analyze the reliability and clinical value of intraoperative ultrasound combined with neuronavigation for resection of intracranial cavernous malformations.

METHODSFrom January 2007 to December 2009, 40 cases of intracranial cavernous malformations were operated under the application of intraoperative ultrasound combined with neuronavigation. There were 18 male and 22 female, aged 18 to 58 years, with a mean age of 34.5 years. Neuronavigation was used for all patients before operation to display the three-dimensional model of nervous system and lesions, so to design the operative approach and determine the scope of the incision. Lesions were allocated by real-time neuronavigation in order to continuously verify the accuracy of operative approach during the operation, supplemented by real-time monitoring of intraoperative ultrasound to guide the process of surgery and determine the extent of resection of lesions.

RESULTSThe registration error of neuronavigation was 1.3 - 3.2 mm, with an average of 2.0 mm. All the patients' three-dimensional model of nervous system and lesions were satisfactorily displayed, and the area of lesions were all accurately located. Structural brain-shifts occurred in 4 cases in the remove process of the lesion, with shift degree 5.0 - 10.0 mm, and were corrected by intraoperative ultrasound. All lesions were well displayed by intraoperative ultrasound. Gross total resection was achieved in all patients, with no patient infected or dead. Neurological deterioration was seen in 2 patients, the morbidity was 5.0%.

CONCLUSIONSThe combination of neuronavigation and intraoperative ultrasound for resection of intracranial cavernous malformations can provide valuable intraoperative informations of the location and resection level of the lesion, thereby maximize the accuracy of lesion localization and the extent of resection, with less complications and enhanced efficacy of the surgery.

Adolescent ; Adult ; Female ; Hemangioma, Cavernous, Central Nervous System ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Neuronavigation ; Neurosurgery ; methods ; Ultrasonography ; Young Adult

OBJECTIVETo investigate the clinical manifestations, pathologic features and laboratory findings in two Proteus syndrome patients with giant hemangiomas in the spleen and chronic DIC.

METHODSUltrasound imaging and magnetic resonance imaging (MRI) were used for analysing the characteristics of the giant hemangiomas in the spleen. The spleen specimen was examined pathologically for the feature of the hemangioma. Homostatic tests were performed by routine laboratory methods.

RESULTSTwo Proteus syndrome patients with giant hemangiomas in the spleen causing chronic DIC (Kasabach-Merritt syndrome) were first reported. They were recovered after splenectomy.

CONCLUSIONProteus syndrome when accompanied giant hemangioma could cause chronic DIC. Significantly decreased plasma fibrinogen level in this case might be helpful for the differential diagnosis from DIC caused by other diseases.

Adolescent ; Disseminated Intravascular Coagulation ; etiology ; Female ; Hemangioma, Cavernous ; complications ; diagnostic imaging ; surgery ; Humans ; Proteus Syndrome ; complications ; Splenectomy ; Splenic Neoplasms ; complications ; diagnostic imaging ; surgery ; Ultrasonography

The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.
Alcoholism/complications ; Diagnosis, Differential ; Esophageal Neoplasms/pathology* ; Esophageal Neoplasms/radiography ; Esophageal Neoplasms/ultrasonography ; Esophagoscopy ; Gastritis/complications ; Helicobacter Infections/complications ; Hemangioma, Cavernous/diagnosis ; Human ; Incidental Findings ; Lymphoma, Mucosa-Associated Lymphoid Tissue/pathology* ; Lymphoma, Mucosa-Associated Lymphoid Tissue/radiography ; Lymphoma, Mucosa-Associated Lymphoid Tissue/ultrasonography ; Male ; Middle Aged ; Mucous Membrane/pathology ; Neoplasm Invasiveness ; Smoking ; Thyroiditis, Autoimmune/complications