肾脏交织状血管瘤1例报告并文献复习

目的 探讨肾脏交织状血管瘤的临床特点、诊断及治疗方法. 方法 回顾性分析1例肾脏交织状血管瘤的临床资料,结合相关文献复习,总结该病的诊断和治疗特点. 结果 术前误诊为恶性肿瘤,于全麻下行后腹腔镜右肾根治性切除术,术后病理提示肾脏交织状血管瘤.随访3个月,未见肿瘤复发. 结论 肾脏交织状血管瘤是一种罕见的变异的肾脏毛细血管良性肿瘤.临床及影像学表现无特异性,术前易误诊为恶性肿瘤,确诊有赖于病理,宜行保留肾单位肾部分切除术治疗.     

Epithelioid hemangioma of the spine: a case series of six patients and review of the literature

Background contextEpithelioid hemangioma (EH) of bone is a benign vascular tumor that can be locally aggressive. It rarely arises in the spine, and the optimum management of EH of the vertebrae is not well delineated.PurposeThe report describes our experience treating six patients with EH of the spine in an effort to document the treatment of the rare spinal presentation.Study designThis study is designed as a retrospective cohort study.Patient sampleA continuous series of patients with the diagnosis of EH of the spine who presented at our institution.Outcome measuresThe clinical and radiographic follow-up of the patient population is documented.MethodsThe Bone Sarcoma Registry at our institution was used to obtain a list of all patients diagnosed with EH of the spine. Medical records, radiographs, and pathology reports were retrospectively reviewed in all cases. Only biopsy-proven cases were included.ResultsThe six patients included five men and one woman who ranged in age from 20 to 58 years (with an average age of 40 years). The follow-up available for all six patients ranged from 6 to 115 (average 46.8) months. All patients presented with lytic vertebral body lesions. Five patients presented with pain secondary to their tumor, and the tumor in the sixth patient was found incidentally during the workup for a herniated disc. Three patients required surgical management for instability secondary to the destructive nature of their tumors, and two other patients required emergent decompression secondary to spinal cord compression by the tumor. The sixth patient was treated expectantly after biopsy confirmation. Three patients received postoperative radiation therapy as gross tumor remained after surgery. Three patients had gross total resections and did not receive postoperative radiation. Preoperative embolization was used in four patients. One patient continued to have back pain after surgery and radiation and another continued to have ataxia after surgery and radiation. No tumor locally recurred or progressed.ConclusionsOur data suggest that EH of the spine can be locally aggressive and lead to instability and cord compression. Surgery is required in such instances; however, observation should be considered in patients without instability or cord compression.     

Primary yolk sac (endodermal sinus) tumor of the prostate: case report and review of the literature.

A primary yolk sac (endodermal sinus) tumor of the prostate is described in a 40-year-old male. This is the second documented case of a yolk sac tumor occurring in the prostate gland. Treatment included surgical removal and subsequent combination chemotherapy. Four months following diagnosis, the patient died of complications. At autopsy, no residual tumor was detected. The role of combination chemotherapy as potentially curative therapy in the treatment of extragonadal yolk sac tumors is discussed.     

Renal sinus hemangioma simulating renal mass: A diagnostic challenge

A 47-year-old female presenting with right flank pain and renal mass on ultrasonography was evaluated for renal malignancy. Based on the CT findings and blood aspiration on repeated fine needle aspiration biopsy the patient underwent radical nephrectomy. Histopathology revealed renal sinus hemangioma with normal kidney, perirenal fat and the hilar structures.     

Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature

Context

Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture.

Findings

We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful.

Conclusion

In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended.     

Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature

Abstract

Context

Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture.

Findings

We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful.

Conclusion

In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended.     

Cavernous sinus chondroma. Case report and review of the literature

Chondromas of the base of the skull are most commonly found in the parasellar and sellar regions, and present varying degrees of involvment of the cavernous sinus.However, those confined mainly to the cavernous sinus are rare, and only a few cases have been reported. A 50 year old man experienced left hemifacial pain followed by left abducens nerve palsy. Computerized tomography and magnetic resonance image depicted a well circumscribed mass in the left cavernous sinus. A pterional craniotomy was performed to approach this lesion intradurally. The tumour was subtotally removed Histologically the mass was diagnosed as a mature chondroma. Postoperatively, the left hemifacial pain disappeared and the diplopia improved from the first postoperative day. Successfull removal of lesions in the cavernous sinus requires individualisation of the case as well as choosing the correct surgical approach for the certain patient.     

Sphenoid sinus lymphoma. Case report and review of the literature

A 64-year-old man presented to his general practitioner with an history of headaches and recent diplopia. Neuroradiological investigation showed a sphenoid sinus mass involving the sella and the clivus. Diagnosis of non-Hodgkin lymphoma was made via a transsphenoidal approach. The patient subsequently underwent a 6-month course of chemotherapy (M COPPA protocol) followed by 50 Gy locoregional radiotherapy. At three years follow-up the patient was in complete clinical and radiological remission. This case underscores the importance of thorough radiological work-up for accurate identification of tumor masses involving the pituitary fossa and provides an opportunity to review the literature on the management of this rare entity.     

Renal cavernous hemangioma: robot-assisted partial nephrectomy with selective warm ischemia. Case report and review of the literature

Renal hemangioma is a relatively rare benign tumor with a wide range of clinical and radiological presentation, not easy to differentiate preoperatively from a renal cancer. Due to its benign nature complete surgical resection is the recommended therapy and is considered curative.A 73-year old male patient followed-up for a lung carcinoma and a chronic renal failure underwent a CT scan showing a 35-mm mass of the inferior pole of the left kidney.The patient underwent robot-assisted partial nephrectomy with left inferior pole selective warm ischemia. The outcome was favorable and no repercussions on the renal reserve were observed postoperatively.Histopathological characteristics of the surgical specimen were consistent with renal cavernous hemangioma.A robot-assisted operation allows the fine dissection required to carry out a bloodless nephron-sparing surgery without a complete warm ischemia. The use of robot could be noteworthy for nephron-sparing surgery in cases of concomitant chronic renal failure.     

上颌窦海绵状血管瘤动脉栓塞后切除1例

患者女,24岁,主因“右侧鼻腔通气差,间断流黄水1个月”入院。查体：外鼻无畸形,右侧上颌窦区、筛窦区压痛,右鼻腔外侧壁凸出一白色新生物,鼻中隔受压轻度左偏,肿物下方可见下鼻甲。鼻与鼻窦CT显示右侧上颌窦肿物,右鼻腔外侧壁骨质受压移位;增强扫描肿物明显不均匀强化（图1）。术前穿刺抽出新鲜血液,穿刺处渗血较多。患者于术前经右股动脉插管,接受双侧颌内动脉、面动脉造影及栓塞治疗。     

Multiple meningiomas. Case report and review of the literature

A case of multiple meningiomas without the stigmata of von Recklinghausen's disease is reported. The patient was followed up with serial computed tomography scanning over a 3-year period. The literature on multiple meningiomas is reviewed.     

Ectopic meningioma of the ethmoid sinus: case report and a review of the literature

A rare case of ectopic meningioma of the ethmoid sinus is reported. A 57 year-old male patient was admitted with complaints of anosmia and headache. Computed tomography revealed a relatively high-density mass in the bilateral ethmoid and sphenoid sinuses. The mass was markedly enhanced after intravenous administration of contrast medium. The cerebral angiography showed tumor stains fed by bilateral internal and external carotid arteries with right side dominance. The tumor in the ethmoidal sinus was removed by otolaryngologists at first and then the tumor in the sphenoid sinus was removed using sublabial transseptal sphenotomy. The histological examination resulted in a diagnosis of transitional meningioma with psammoma bodies. The tumor in this case is suspected to have originated from heterotopic meningocytes or meningocytes accompanying the perineural sheath of the olfactory nerve.     

Cavernous hemangioma of the parietal bone. Case report and review of the literature

Intraosseous cavernous hemangiomas are a rare finding in the calvarium. It is a benign tumor arising from the intrinsic vasculature of the bone. We report one case observed in a 20 year-old male. The diagnostic peculiarities and therapeutic implications of this lesion are discussed and the available literature on this subject is reviewed. These tumors do not recur once a radical surgical removal is performed.     

Penile schwannoma mistaken for hemangioma: a rare case report and literature review

Penile neoplasm is uncommon. Schwannomas of the penis are especially rare. For this reason, it is difficult to get an accurate impression to enable decision making. This report primarily deals with the mistaken diagnosis of hemangioma, to the surgery, and the follow-up in real-world. A 38-year-old male patient presented with a palpable mass in the penile root that increased in size with erection. One year after the mass had been found, the patient visited the hospital and complained that the mass was growing. Moreover, the patient explained that the mass seemed to increase during penile erection. On physical examinations, a 2 cm mass without tenderness was palpated in the left penoscrotal junction. About 2.1 cm in size, an isoechoic mass was observed next to the corpus cavernosum on ultrasonography. There was high vascularity inside of the mass. Excision and biopsy were decided upon. Following surgery, a schwannoma was confirmed by pathology. After three months, the patient did not complain of any symptoms and had normal erectile function. Most of these tumors are benign. By December 2020, 40 cases were reported, of which 6 were diagnosed as malignant. The most frequent occurrence site is the penile shaft. In all cases, surgical resection was performed and no recurrence was found. The aim of this case report is to assist clinicians in choosing the best treatment option when faced with this rare condition by discussing the radiological, pathological, and clinical course.     

Schwannoma of the cavernous sinus. Case report and review of the literature.

A patient operated on for a schwannoma entirely developed into the cavernous sinus is described. Abducens nerve is supposed to be the origin of the tumor, although it could not be identified during the operation. Schwannomas of the cavernous sinus are exceedingly rare lesions. Only four reports exist in the literature. In three cases the tumor arose from the abducens nerve, in one case probably from the trochlear nerve. Direct approach to the cavernous sinus has become possible in recent years, but preoperatively impaired cranial nerve function shows a slim chance of postoperative recovery.     

Paraganglioma of the cavernous sinus. Case report

A case of paraganglioma arising from the cavernous area is presented. A 51-year-old woman presented with a parasellar mass causing decreased visual acuity, oculomotor nerve paresis and retro-orbital headaches without endocrinological dysfunction. Diagnosis was confirmed by histological appearance and electron microscopy. The patient was treated with surgery followed by radiation therapy consisting of 45 Gy. The clinicopathological features and the possible pathogenesis are discussed.     

Cavernous hemangioma of the sphenoid sinus: case report and review of the literature

BACKGROUND: Few cases of paranasal sinus cavernous hemangiomas have been reported in the literature. We report the first case of cavernous hemangioma of the sphenoid sinus and discuss therapeutic considerations and differential diagnosis. CASE DESCRIPTION: A case of sphenoid sinus tumor in a 67-year-old woman is reported. The initial symptoms were a horizontal diplopia, a left facial dysesthesia, and a recent history of unusual headache. Physical examination revealed a left VIth nerve paresis. A CT scan was performed showing a hypodense homogeneous mass in the sphenoid sinus that was not enhanced after administration of contrast medium. MR study demonstrated on T1-weighted image an isointense nonenhancing homogeneous mass filling the sphenoid sinus. On T2-weighted images the tumor mass displayed a mild hyperintense signal. The patient was operated on via a transsphenoidal approach with total removal of the tumor. Pathological findings were consistent with a nonosseous cavernous hemangioma. MR imaging performed 5 years later was still normal. CONCLUSION: The clinicoradiological and pathological features of this entity are described, and the literature reviewed.