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Congenital hemangioma presenting as a fully developed cutaneous lesion in a newborn (a). Histologic characteristics of rapidly involuting congenital hemangioma include a prominent fibrous tissue component (b; H&E 4X), focally preserved lobules of vascular proliferation (c; H&E 10X) and residual draining vessels (d; H&E 10X). Rapidly involuting congenital hemangioma with fetal involution demonstrates similar findings (nearly involuted lesion) at birth; note the prominent feeding vessels and fibrous tissue (e; H&E 4X). Noninvoluting congenital hemangioma is characterized by lobules (f; H&E 4X) of thin walled capillaries lined by hobnailed endothelium (g; H&E 20X); endothelial cytoplasmic globules are occasionally present (h; H&E 20X)
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Vascular anomalies, further classified into vascular tumors and malformations, often involve the head and neck region of children. These entities may raise diagnostic dilemmas, as they often demonstrate heterogenous and overlapping histologic features. The aim of this paper is to provide an overview of the common vascular anomalies in the head and...
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Vascular anomalies are classified as either a vascular tumor or a vascular malformation. Precise diagnosis of vascular anomalies requires careful correlation of clinical findings, diagnostic imaging, histopathology, and genetic analysis. Pathological diagnosis, in particular, is important especially for vascular tumors and malformations, following...
Composite hemangioendothelioma (CHE) is considered a borderline malignant vascular tumor defined by an admixture of distinct vascular neoplastic components. A 21-year-old female is presented herein with a 1 cm painless mandibular vestibular mass of less than a year duration. The infiltrating tumor was characterized by dilated vascular channels line...
Introduction:
Liver transplantation (LT) is today's standard treatment for both end-stage liver disease and tumors; however, suitable grafts for LT are a scarce resource and outcome after LT is highly dependent on its underlying indication. Thus, patients must be carefully selected to optimize the number of life years gained per graft. This compre...
Citations
... Biopsy remains the gold standard diagnostic test (7). Histologically, KHE is characterized by irregular tumor margins, infiltrating rounded nodules composed of endothelial cells of spindled morphology, and slit-like vascular channels (13,14). Immunohistochemistry (IHC) shows positive staining for both lymphatic markers and vascular endothelial markers (4,7,15,16). ...
Kaposiform hemangioendothelioma (KHE), a rare form of vascular neoplasm, is typically seen in children. In this paper, we report a unique case of KHE replacing bone marrow tissue mimicking myeloproliferative neoplasm with additional involvement in the lung, liver, and brain in a 60-year-old Caucasian woman. The patient was initially seen in the hematology department for the chief complaint of epigastric pain and anemia. Abdominal magnetic resonance imaging (MRI) revealed mild splenomegaly with iron deposition secondary to extramedullary hematopoiesis. Additional workup was inconclusive. Subsequent bone marrow and lung biopsies eventually revealed bone marrow with extensive grade 3 fibrosis and multiple foci of low-grade vasoformative neoplasm in the lung suggestive of KHE. Although rare, KHE can present as an aggressive disease with indolent behavior in adults and can be distinguished from other vascular malignancies based on histopathology and imaging findings.
... Серед дитячого населення України, на відміну від дорослого, значно збільшилась частота виявлення гемангіом (ГА), які є вродженими дизонтогенетичними утвореннями, виникають із гіперплазованого ендотелію судин і зустрічаються найчастіше серед всіх інших пухлин м'яких тканин (МТ) саме у дітей [12,15,21,24,25]. ...
... Ретроспективним аналізом амбулаторних карт й історій хвороб встановлено, що в структурі доброякісних пухлин МТ ЩЛД гемангіоми займають друге місце з показником 26,0% [7, 10, 15] і локалізацією, представленою в таблиці 1. Це співпадає із даними інших дослідників, які "улюбленою" локалізацією ГА також називають щоки та бокову поверхню носа, носо-губну борозну і губи [2,13,21]. ...
... За гіпотезою P.Fries та D.Char (1988) кавернозна ГА розвивається як наслідок каналізації кровотоку в передуючих судинних аномаліях, виникаючих вторинно при патологічних змінах системної гемодинаміки, що підтверджують випадки системного ураження ангіоматозними пухлинами орбіти та хоріоідеі, орбітальної і юкстапапілярної локалізації на однойменній стороні, ангіоми орбіти та печінки [21]. Однак до теперішнього часу не знайдені специфічні генні мутації і явні ознаки спадковості, відповідальні за виникнення ГА, як невідомі й тригери ангіогенеза [18]. ...
The incidence of hemangiomas, originating from hyperplastic endothelium of the blood vessels, has notably increased among the pediatric population in Ukraine. Despite widespread awareness among doctors of various specialties, errors in the accurate identification of their type can reach up to 15%. Notably, challenges in diagnosing deep vascular lesions persist. Leveraging our substantial personal experience on this matter, we aimed to compare our findings with those presented by other researchers in scientific publications. This study is based on the examination and treatment of 46 children, ranging in age from birth to 17 years, presenting various nosological forms of hemangiomas localized on the face and neck, over a span of 6 years. All subjects underwent a comprehensive clinical examination, and in complex cases, additional specialized research methods were employed to determine the optimal course of treatment measures and their extent. Upon comparing our results, we found that investigating hemangiomas with high proliferative activity necessitates the involvement of specialists from diverse disciplines. For larger and deeply situated forms, the initial approach to treatment should involve glucocorticoid therapy or the administration of cardio-selective beta-adrenoceptor inhibitors, followed by subsequent corrective measures. It is important to consider that determining the method and extent of treatment and preventive measures during specialized care stages should be approached on an individual basis. Simultaneously, the application of general clinical diagnostic methods, along with additional and specialized research methods as needed, enables an objective assessment of the clinical situation in each case, facilitating the development of a comprehensive plan to support children throughout all periods of dynamic observation.
... Although they occur in people of all ages, VMs are often congenital 8,15) . In the orofacial region, they are most likely to occur in the lips or tongue, and only rarely in the buccal fat pad 2,5,12) . This report describes a case of a VM in the buccal fat pad. ...
... Vascular malformations are classified based on their flow dynamics as low-flow lesions (venous, lymphatic, or capillary malformations) or high-flow lesions (arteriovenous malformation, arteriovenous fistula, or arterial aneurysm/ectasia/stenosis). They can occur anywhere in the body, although almost 50% of VMs involve the head and neck region 8,12) . In the orofacial region, they are most likely to occur in the lips or tongue, and only rarely in the buccal fat pad 2,5,12) . ...
... They can occur anywhere in the body, although almost 50% of VMs involve the head and neck region 8,12) . In the orofacial region, they are most likely to occur in the lips or tongue, and only rarely in the buccal fat pad 2,5,12) . They may occur as isolated or multifocal lesions throughout the body, and the size and location are variable. ...
Vascular anomalies are categorized as vascular tumors or vascular malformations (VMs) based on the system of classification (updated in 2018) established by the International Society for the Study of Vascular Anomalies. In the orofacial region, such anomalies are most likely to occur in the lips or tongue, and only rarely in the buccal fat pad. This report describes a case of a VM in the buccal fat pad. A 47-year-old woman was referred to our hospital with a mass lesion in her left cheek. On palpation, an elastic, hard, painless, and mobile mass was found anterior to the left masseter muscle. Computed tomography, magnetic resonance imaging, and ultrasonography revealed a mass in the left buccal fat pad. The lesion was identified as a benign tumor and surgical excision performed under general anesthesia. Histopathological examination revealed that the lesion was composed of a large number of vascular structures of various sizes covered with endothelial cells. Based on the clinical and histopathological findings, a diagnosis of a venous VM was made. One year has passed since the operation and no recurrence has been observed. Long-term follow-up is planned.
... Vascular anomalies (VAs) affect any area of the human body, and the head and neck region accounts for about 60% of those diagnosed in children, showing an incidence of 1:22 pediatric patients [1]. VAs require prompt diagnosis and correct management in pediatric patients because of the risks and the long-term functional and psychological consequences depending on the number, size, localization, and extension of lesions [2]. ...
... B-Mode US shows VMs as homogenous hypoechoic lesions with irregular margins associated with phleboliths in up to 16% of cases. In addition, color and power Doppler distinguish highflow and low-flow malformations [1]. Magnetic resonance imaging (MRI), both with and without the administration of contrast, is the method used to complete the study of large intraoral and perioral VMs by defining the site, relationships with adjacent structures, and internal architecture of the lesions. ...
... From 50% to 83% of pediatric VAs occur in the head and neck region with an incidence ratio of 1:22 [1,2]. Therefore, dentists are important for the diagnosis and management of pediatric VAs [15]. ...
Background:
This study describes the management protocol for capillary-venous malformations in pediatric patients and reports the epidemiology of diagnosed and treated cases at the Unit of Odontostomatology of the Aldo Moro University of Bari from 2014 to 2022.
Methods:
The authors classified the intraoral and perioral capillary-venous malformations by superficial diameter (<1 cm, 1-3 cm, >3 cm) and ultrasonographical depth extension (≤5 mm, >5 mm). All patients underwent pulsed-mode diode laser transmucosal photocoagulation (8-12 W/cm2); those with malformations that were wide (>3 cm) and deep (>5 mm) received intralesional photocoagulation, too (13 W/cm2). The children received general anesthesia based on their compliance and lesions' extension. The follow-up lasted six months.
Results:
A total of 22 females and 14 males (age range 4-18 years) presented 63 capillary-venous malformations. Five patients with Sturge-Weber syndrome, seven with hereditary hemorrhagic telangiectasia, and five with angiomatosis showed multiple malformations. The authors found no intraoperative or postoperative complications. Seventeen patients with lesions >1 cm and >5 mm deep required multiple laser sessions to heal.
Conclusion:
The results of the current study support diode laser photocoagulation as the gold standard for the treatment of intraoral and perioral capillary-venous malformations in pediatric patients.
... 4 Orofacial clefts represent two-thirds of the birth defects in the head and neck, and vascular malformationsone of the commonest causes of birthmarkshave a preference for the head and neck region. 4,5 These birthmarks and birth defects in the head and neck region have a psychological aspect. Such areas are easily seen, and parents often fear that their child will suffer stigmatization during life. ...
Objective:
This systematic review compiles published information on subjects with head or neck birth defects or birthmarks in which past-life memories were alleged.
Data sources:
Electronic searches were done in April 2022 in the following bibliographic databases: MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and PsycINFO.
Study selection:
References of the included studies and the gray literature were searched. Our sample included six studies reporting 19 cases of birthmarks and birth defects in the head and neck region with alleged past-life memories.
Data extraction:
The features of the lesions varied, and their size ranged between 0.5 to 12 cm. All the cases had interviews with the family of the deceased person and the family of the child with the birthmarks, and nine of them included some type of verified official report.
Data synthesis:
The strength of the evidence in the cases was analyzed using the strength-of-evidence scale.
Conclusion:
This study showed that birthmarks and birth defects in the head and neck region occurred mostly in male children, with the possibility of these marks being caused by the fatal injury of the alleged personality. The literature lacks new cases with high strength of evidence, emphasizing the need for further primary studies.
... HNVM is a type of congenital disease primarily caused by abnormal angiogenesis. 16 pathways. [17][18][19] Thus, an increasing number of therapies targeting these two pathways have been developed. ...
Backgrounds:
Head and neck vascular malformation (HNVM) is a highly complex congenital condition that is difficult to diagnose, monitor, and treat. Therefore, it is critical to explore serum cytokines that may be related to its pathology and prognosis.
Methods:
An antibody-based microarray was used to examine the expression of 31 angiogenic cytokines in 11 HNVM patients relative to 11 healthy subjects. ELISA was used to verify the results. We performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses of the differentially expressed cytokines (DECs). Additionally, we explored the function of DECs in human umbilical vein endothelial cells (HUVECs) in vitro via CCK-8, wound healing, transwell, and tube formation assays.
Results:
Expression of interleukin (IL)-10, matrix metallopeptidase-9 (MMP-9), and vascular endothelial growth factor receptor 2 (VEGF-R2) in HNVM patients was significantly higher, whereas levels of IL-12p40 and angiostatin were significantly lower in HNVM patients relative to healthy controls (P<0.05). However, ELISA only verified that IL-10, MMP-9, VEGF-R2, and IL-12p40 had significant expression changes. Functional enrichment analysis revealed DECs mainly participated in the RAS signalling pathway. Functional studies demonstrated that IL-10, MMP-9, and VEGF-R2 promote cell proliferation, migration, invasion, and tube formation, while IL-12p40 inhibited these processes in HUVECs.
Conclusions:
The present study not only indicates that IL-10, MMP-9, VEGF-R2 and IL-12p40 may participate in the development of HNVMs but also provides a theoretical basis for the discovery of new targeted molecules in the treatment of HNVMs.
... Младенческие гемангиомы выявляют у 1-3% новорожденных и 10-12% детей первого года жизни [4,5], наиболее часто среди европеоидов [3,5] и в челюстнолицевой области (до 60% всех случаев) [5][6][7]. Развитие этих доброкачественных сосудистых образований связывают с гипоксическим стрессом во внутриутробном периоде [7,8]. Факторами риска развития младенческих гемангиом являются женский пол, недоношенность, семейные случаи младенческих гемангиом и низкая масса тела при рождении [9]. ...
... Младенческие гемангиомы выявляют у 1-3% новорожденных и 10-12% детей первого года жизни [4,5], наиболее часто среди европеоидов [3,5] и в челюстнолицевой области (до 60% всех случаев) [5][6][7]. Развитие этих доброкачественных сосудистых образований связывают с гипоксическим стрессом во внутриутробном периоде [7,8]. Факторами риска развития младенческих гемангиом являются женский пол, недоношенность, семейные случаи младенческих гемангиом и низкая масса тела при рождении [9]. ...
Background . Infantile hemangiomas are revealed in 1-3% of newborns and 10-12% of infants. There are only anecdotal reports on the laser therapy efficacy in this pathology management. However, there is no common approach to the use of this method in the complex treatment of infantile hemangioma in infants. Clinical Cases Description . Two clinical cases of infantile hemangioma are presented. Patients underwent complex treatment: systemic propranolol and laser therapy via pulsed dye laser. Laser exposure modes ware selected individually: laser spot sizes were 10 and 12 mm, energy levels were 5-10 J/cm ² , burst duration was short (0.45 ms) or long (10-20 ms), procedure duration was from 15 to 40 minutes, number of procedures varied from 1 to 8. Laser therapy has shown its efficacy in treatment of superficial infantile hemangioma. Conclusion . The indication for using laser therapy in management of infants with hemangiomas is especially persistent residual signs such as telangiectasias and erythema after spontaneous or drug involution phase. Laser therapy allows us to avoid aggressive methods and improves the quality of life of our patients according to this article.
Congenital cervicofacial vascular anomalies are extremely rare and present many difficulties in diagnosis and treatment requiring a multidisciplinary approach. Firstly, there is little consensus on this subject among head and neck specialists. There are two main types of vascular anomalies: vascular tumors and vascular malformations. Vascular malformations are also divided into malformations with slow blood flow (veins, lymphatics, capillaries or combined) and malformations with a fast blood flow (arteriovenous malformations and fistula). Vascular tumors like hemangiomas are known for their spontaneous involution with aging, while vascular malformations grow in dimensions with age. It is very important to choose the correct differential diagnosis between cervicofacial hemangiomas and vascular malformations for proper therapy management. Anamnesis and clinical exams help in raising suspicions about the real nature of a cervico-vascular anomaly. Furthermore, imaging brings in-depth details of the anomaly, ranging from ultrasound and contrast CT to MRI scanning and minimally invasive angiography. Angiography with selective embolization is rarely a curative procedure for arteriovenous malformations, being more suitable as a preliminary step before attempted surgical removal. Surgery is clearly necessary when there are aesthetic and functional deficits. Slow-flow vascular malformations present a reduced morbidity, and in cases without involution, the surgical ablation is reserved for the cases with aesthetic dysfunctions or psychological trauma. Lymphatic malformations must undergo surgical ablation when they are associated with mass effects and compression of great vessels or aerial viscera. The prognosis after surgical removal is good, with a low rate of recurrence or morbidity. Fast-flow vascular malformations require a combined approach, with embolization and excision in the next 48 h for safety reasons. Removal may be followed by reconstructive surgery depending on the location and dimensions of the malformation, with a possible secondary recovery of the normal microscopic vessels. Some of the masses may hinder the normal airflow and swallowing. Pathology is the gold standard for confirming the clinical and imaging diagnosis.
Vascular malformations belong to the group of vascular anomalies. They are rare congenital diseases resulting from abnormal development of vessels and can arise in any location, often in the head and neck region. Clinical symptoms are variable, functional handicaps and esthetic problems may result.
One differentiates between arteriovenous, lymphatic, venous, and capillary malformations and combinations thereof. Their classification, symptoms, diagnostics, and treatment options are discussed.
The different types of vascular malformations as well as their clinical presentation, diagnostic workup, and therapeutic options are presented, supported by clinical examples.
Interdisciplinary care of pediatric patients with vascular malformations is essential in order to generate a treatment concept after correct diagnosis and improve symptoms and quality of life.
Neuroimaging in the pregnant patient is tailored to evaluating the neuraxis of either the patients themselves or their underlying gestation(s). Imaging indications can range from outpatient follow-up and pre-scheduled gestational anatomic surveys to emergent indications affecting either the expectant patient or fetus.
