1/55. Popliteal vascular malformation simulating a soft tissue sarcoma.Differentiation of vascular abnormalities from soft tissue sarcomas may be difficult on clinical grounds, but is usually possible on imaging criteria. We report the MRI and digital subtraction angiography (DSA) findings in a patient presenting with a mass behind the knee. We discuss differentiating features and review the literature of similar cases.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
2/55. Congenital macroglossal angiodysplasia ("Lymphangioendotheliomatosis").A case of congenital lingual angiodysplasia with macroglossia in a 5-year-old girl is presented. A diffusely enlarged tongue was present at birth and continued to grow as the child aged. It was accompanied by impaired speech, difficulty in eating and breathing, and sleep apnea, necessitating surgical intervention. The fundamental lesion represents a complex vascular malformation of the lymphangioma-hemangioma type, involving extensively the deep musculature of the tongue. Multifocal and multicentric cavernous lymphangioma-like and hemangioma-like areas merge with benign angioendotheliomatous-like foci in a background of variable muscle degeneration and marked fibrosis. Neither a borderline nor an overtly malignant vasoformative neoplasm was present. Because of its distinctively widespread, multicentric intramuscular distribution, this lesion may be construed as a diffuse variant of lingual lymphangioma-hemangioma malformation, closely resembling a previously described case of macroglossal lymphangioendotheliomatosis.- - - - - - - - - - ranking = 0.12493947874966keywords = neoplasm (Clic here for more details about this article) |
3/55. Surgical technique for the treatment of high-flow arteriovenous malformations of the mandible.The high-flow intraosseous arteriovenous malformation is a problematic vascular lesion which may affect bone and the dentition. Variable clinical presentations of this anomaly have resulted in a gamut of treatment modalities being reported ranging from simple curettage, resection, radiotherapy, sclerosing injections, and various forms of embolization, to immediate replantation of the resected segments. Embolization techniques alone have not been universally successful and have often resulted in rapid development of collaterals from surrounding vessels. Definitive treatment has usually involved complete surgical resection (when feasible) either alone, or in combination with other modalities such as embolization. jaw resection, however, is deforming and leaves a defect often requiring subsequent reconstruction of the hard and soft tissues and replacement of any teeth lost with the resected segment. We report a surgical technique to treat mandibular arteriovenous malformations, which permits ligation of the feeding vessels and provides access allowing for complete removal of the intraosseous lesion. At the same time it not only prevents facial deformity by preserving the mandibular bone and oral soft tissue, but also, and more importantly, may preserve the dentition as well.- - - - - - - - - - ranking = 0.4keywords = soft (Clic here for more details about this article) |
4/55. Clinical study of embolization of arteriovenous malformation in the oral and maxillofacial region.OBJECTIVE: To evaluate the value of embolization on arteriovenous malformations (AVM) in the oral and maxillofacial region and to investigate the efficacy of several different embolic materials. CLINICAL MATERIALS AND methods: 10 cases with AVMs, including 5 AVMs mainly in the soft tissue and 5 intraosseous lesions, were embolized. Clinical and angiographic effects were analyzed during the 3 to 16 months follow-up. RESULTS: In the 5 cases embolized without other treatment, 1 case was embolized 3 times, 3 cases twice, and 1 case once. In these cases, postembolization angiograms revealed complete or nearly complete disappearance of the lesions. In the other 5 cases, embolized before surgery, intraoperative bleeding was significantly decreased. All these patients were free of recurrence during follow-up. Among the materials employed, NBCA seemed to offer a better result. CONCLUSIONS: Embolization may serve as the primary therapy for some AVMs in the oral and maxillofacial region, or as a routine preoperative adjunct for patients with severe intraosseous or disfiguring AVMs.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
5/55. Angioembolisation in vaginal vascular malformation.Vaginal arteriovenous malformations are rare entities and their most common presentation is vaginal haemorrhage. This case report describes a 22-year-old woman who presented at 20 weeks of gestation with slow growing soft and tender swelling at anterior vaginal wall. diagnosis was confirmed as vaginal vascular malformation on contrast enhanced magnetic resonance imaging. The mass did not subside after delivery and patient developed dyspareunia. It was successfully treated by angioembolisation using polyvinyl alcohol particles. Angioembolisation being safe and effective should be the treatment of first choice for symptomatic vaginal vascular malformation.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
6/55. Primary orbital melanoma masquerading as vascular anomalies.PURPOSE: To review two cases of primary orbital melanoma presenting like orbital vascular anomalies. methods: Retrospective review of clinical presentation, treatment, radiology and pathology for two patients under the care of the Orbital Clinic at Moorfields eye Hospital. RESULTS: Both lesions presented with the appearance and behaviour of vascular anomalies. In one case, a spindle cell melanoma appeared to be a low flow vascular anomaly with a loculated secondary haemorrhage and, in the other case, a melanoma of soft parts was considered to be an arteriovenous malformation and responded partially to embolisation. CONCLUSION: Primary malignant melanoma may present as a secondary vascular lesion of the orbit and this very rare tumour should be considered in the differential diagnosis of any vascular anomaly.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
7/55. Intraparenchymal brain hemorrhage and remote soft tissue arteriovenous malformation in a newborn infant.Congenital arteriovenous malformations (AVMs) often present with congestive heart failure. Such pathologic vascular structures typically occur in cranial, hepatic, or pulmonary locations and are usually associated with overlying external visible, tactile, or audible abnormalities. These vascular anomalies may also be associated with such complications as thromboembolic events, coagulopathy, and localized hemorrhage. We present a newborn infant with an occult but hemodynamically significant parascapular AVM who presented with an intraparenchymal brain hemorrhage, which we suspect to be a remote complication of the AVM.- - - - - - - - - - ranking = 0.8keywords = soft (Clic here for more details about this article) |
8/55. scalp arteriovenous malformation draining into the superior sagittal sinus associated with an intracranial arteriovenous malformation: just a coincidence? Case report.OBJECTIVE AND IMPORTANCE: Recent experimental and clinical evidence suggests that hemodynamic changes in the venous system can induce the formation of new arteriovenous malformations (AVMs). In a rat model, increased venous pressure induces the formation of soft tissue and dural AVMs. We report a clinical observation that may support these data. CLINICAL PRESENTATION: A 4-year-old boy with a midline scalp AVM draining into the superior sagittal sinus had an associated intracranial/parenchymal AVM. The cerebral AVM increased venous pressure in the superior sagittal sinus as revealed by angiography. INTERVENTION: The scalp AVM was resected, and the intracranial AVM was treated by use of the gamma knife. CONCLUSION: On the basis of reported experimental data and the morphological and hemodynamic characteristics in this patient's two lesions, we suggest that the scalp AVM might have been induced by hypertension in the superior sagittal sinus. This clinical observation supports the notion suggested by experimental studies that hemodynamic changes can induce the formation of associated AVMs.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
9/55. Maxillofacial rehabilitation of a large facial defect resulting from an arteriovenous malformation utilizing a two-piece prosthesis.Large facial defects involving the oral cavity can be difficult to restore prosthetically because of a lack of anatomic undercuts, limited means of retention, mobility of soft tissue margins, and the weight of the prosthesis. Use of skin adhesives may be precluded because of the presence of persistent moisture and saliva. The maxillofacial rehabilitation, including the design and fabrication of a 2-piece silicone prosthesis retained by the teeth, of a patient with a large facial defect as a result of treatment for an arteriovenous malformation is described. The pathogenesis and therapeutic alternatives for arteriovenous malformations is also discussed.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
10/55. proteus syndrome.A 34-year-old male patient was referred with a recalcitrant leg ulcer overlying an extensive vascular malformation, which had led several times to septic soft tissue infections. During his infancy he had been diagnosed to have Klippel-Trenaunay syndrome. Clinical examination revealed asymmetric hypertrophy of the lower extremities, an extensive portwine stain on the more severely affected left limb as well as prominent venous varicosities of both legs. Hands and feet showed striking cerebriform palmoplantar hypertrophy, and macrodactily with syndactily of several fingers. All toes had been amputated in early childhood due to extreme overgrowth and currently the patient walked on his forefeet in a prominent pes equinus deformity. Further symptoms consisted in several lipomas at both arms, another portwine stain at the left hemithorax and a single cafe-au-lait spot at the left scapula. Angio-magnetic resonance imaging scans of both legs showed an extensive venous-lymphatic vascular malformation involving the whole subcutis and infiltrating the muscle. The chronic wound was interpreted as venous stasis ulceration. Local percutaneous sclerotherapy of the dilated veins underneath the ulcer was discussed, but considered to carry a relevant risk of skin necrosis with consecutive progression of the wound. A conventional split-skin graft led to complete wound healing. Since, the patient consequently wears custom-made compression stockings and remained free from recurrences. The syndromatic constellation of palmoplantar overgrowth, multiple lipomas, giant fingers and toes, limb overgrowth, venous-lymphatic malformation and a cafe-au-lait spot led to the diagnosis of proteus syndrome. The possible aetiology, clinical manifestations, differential diagnosis and management of this rare disorder are discussed.- - - - - - - - - - ranking = 0.2keywords = soft (Clic here for more details about this article) |
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