Solitary hemangioma of the small intestine: an unusual cause of bleeding diagnosed at capsule endoscopy

Solitary small intestine hemangiomas are rare and usually present with overt bleeding or chronic anemia. Diagnosis is usually difficult because traditional imaging techniques often lack accuracy. Capsule endoscopy is a new diagnostic tool that has showed greater sensitivity than other methods to reveal causes of bleeding in the small intestine. A case of hemangioma of the ileum in a 13-year-old boy is presented. Capsule endoscopy allowed diagnosis and planning of surgical treatment.     

Posterior mediastinal hemangioma

We report posterior mediastinal hemangiomas in a 4-month-old and a 6-month-old girl. The masses were identified on radiographs of the chest followed by contrast-enhanced CT. Histological evaluation of the surgical specimens established the final diagnosis. Although mediastinal hemangiomas have been described, they remain a rare entity. A diagnosis can be suggested by relatively high attenuating masses on contrast-enhanced CT. Posterior mediastinal hemangiomas sometimes mimic neuroblastomas, which is the most common posterior mediastinal in this age group.     

Six cases of children with a benign cervical tumor who required tracheostomy

Cervical tumors sometimes cause airway obstruction. We have treated six children with benign cervical tumors who required tracheostomy. Two cervical and one glossal lymphangiomata treated with local injection of OK432 after creating a tracheostomy were successfully decannulated after the treatment. One patient with a giant cervical lymphangioma needed an EXIT (ex utero intrapartum treatment) procedure. He underwent tracheostomy at 10 months of age after long-term endotracheal intubation, but he died of sepsis and hypoxic brain damage at 18 months. One patient with a subglottic hemangioma treated with steroids finally achieved closure of the tracheostomy at 2 years of age. A 7-year-old girl with a tracheal schwannoma underwent tracheostomy performed a week after admission, but she already had hypoxic brain damage resulting from problems with intubation. Most patients with a lymphangioma or hemangioma in the cervical region have required early tracheostomy before commencing treatment with OK-432 or steroids. If there is any sign of possible airway compromise, then it is vital to perform an early tracheostomy, even for benign tumors.     

海绵窦海绵状血管瘤的诊断及治疗

目的总结海绵窦海绵状血管瘤的临床特点及其治疗方法。方法分析43例海绵窦海绵状血管瘤患者的病理学流行病学影像学特点,手术及术后并发症,并对43例患者进行以额颞入路,单纯额部入路及额颞联合耳前颞下入路的手术治疗。结果手术全切除22例,近全切除11例,部分切除10例。术后主要并发症为动眼神经麻痹16例,外展神经麻痹10例,面神经麻痹3例。无手术后死亡病例。结论目前,手术仍是海绵窦海绵状血管瘤比较有效的治疗方法。     

Surgical treatment of vascular malformations of the extremities in children and adolescents

The treatment of vascular malformations (VM) of the extremities is controversial. Six patients with large, localized, symptomatic VMs of the extremities underwent surgical excision. In five cases abnormal vessels were apparent under the skin; in two of these there was also red discoloration of the skin secondary to skin involvement. Magnetic resonance imaging was the most helpful imaging modality in evaluating these patients. Subfascial resection was performed in five cases. Muscle was involved in four patients and was removed in all four cases. At follow-up, there was improvement in symptoms and function with no clinically apparent recurrence an average of 30 months following the operation. There was improvement in pain intensity from an average of 4.3 on a scale of 1 to 10 before surgery to 1.3 after surgery. Surgical excision of localized VMs that are extensive and include fascia and muscle, as appropriate, can successfully improve pain and function without evidence of recurrence at 1 to 5 years of follow-up. Accepted: 18 January 2001     

血管母细胞瘤的临床和病理学特点

目的 分析血管母细胞瘤的临床和病理学特点,提高手术疗效。方法 回顾性分析我院1970—1998年间手术和病理证实的72例血管母细胞瘤(共95个肿瘤)患者的临床资料。结果 本病的好发年龄在20—40岁,共47例(占58．3％);男性(46例)约为女性(26例)的2倍;好发于小脑半球(83个占87．4％)有遗传倾向,少数有典型家族史。本组囊壁结节型61个(67．4％)、实质型31个、囊旁结节型3个;目前诊断主要依靠CT和MR,实质性者借助于椎动脉造影鉴别。手术治疗是有效而可靠的方法。结论 血管母细胞瘤是良性肿瘤,手术切除是最好的治疗方法,彻底切除可治愈。放射治疗、化疗基本无效。初发年龄轻、有遗传倾向、探查失误和肿瘤切除不彻底是复发的关键。     

平阳霉素与地塞米松联合治疗婴幼儿面部血管瘤

目的:探索和评价平阳霉素和地塞米松联合注射治疗婴幼儿面部血管瘤的疗效。方法:用平阳霉素8 mg 地塞米松5 mg 2%利多卡因2 ml 生理盐水2 ml溶解后行瘤体内注射至肿胀发白为宜,注射剂量以0.2~0.3 mg/kg计算。2~3周注射1次,1个疗程3~5次。结果:术后随访12~18个月,有效率100%,治愈率和好转率是95.65%。结论:平阳霉素联合地塞米松注射治疗婴幼儿面部血管瘤是一种简便易行、安全可靠的治疗方法。     

Caspase-3与Clusterin在血管瘤组织中的表达及其相关性研究

目的探讨半胱氨酸天冬氨酸蛋白酶-3（Caspase-3）与Clusterin的表达及其与血管瘤消退的关系。方法采用免疫组化SP法检测Caspase-3与Clusterin在34例血管瘤和6例正常皮肤组织中的表达。结果Caspase-3与Clusterin在34例血管瘤组织中阳性表达率,增生期分别为31.3%、81.3%,消退期分别为72.2%、38.9%,而在正常皮肤均不表达,其中,Caspase-3在增生期中的表达低于消退期,差异有统计有统计学意义（P〈0.05）,Clusterin在增生期中表达高于消退期,差异有统计学意义（P〈0.05）。结论Clusterin蛋白可能通过抑制细胞凋亡在血管瘤的发生发展中发挥重要作用,且其表达与Caspase-3的异常表达密切相关。     

人血管瘤裸小鼠移植模型形态学动态观察

目的建立人血管瘤裸小鼠异种移植模型并动态观察移植物形态学变化。方法将人婴幼儿血管瘤组织切分为96个小块移植于16只裸小鼠皮下，定期测量瘤体体积，取不同时期移植瘤作HE染色和抗人CD31免疫荧光标记。结果移植瘤大部分（81／96）存活，在移植后1～2个月期间体积明显增大，继而缓慢缩小。组织学观察显示移植瘤早期出现缺血改变，瘤性内皮细胞坏死、问质纤维化，约在移植后1个月出现瘤细胞增生，血管瘤增长，继而瘤内血管扩张，瘤性内皮细胞逐渐减少，血管瘤消退，代以纤维脂肪组织。结论将快速生长的人血管瘤组织移植于裸小鼠体内，移植瘤可存活，其缺血期后生长模式与人血管瘤自然发展过程相似。     

高频电凝术治疗血管瘤和脉管畸形821例临床分析

目的探讨高频电凝治疗血管瘤和脉管畸形的疗效。方法采用高频电凝治疗血管瘤和脉管畸形患者821例,根据病变部位、大小、深度调整输出能量(10~50W)。治疗后随访6个月~3年。结果血管瘤治愈率78.64%,显效率14.08%;静脉畸形治愈率71.02%,显效率19.32%;混合型脉管畸形治愈率65.92%,显效率17.49%;动静脉畸形治愈率11.11%,显效率44.44%。其中动静脉畸形治愈率与其他3组比较差异有统计学意义(P0.05)。结论高频电凝是治疗血管瘤和脉管畸形的一种微创、安全、有效的新方法。