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Pediatric hemangiomas are benign vascular malformations or angiodysplasias characterized by the proliferation of endothelial cells in blood vessels. Their incidence is 4%-10% in children under 1 year of age, and they most frequently occur on the head and neck [1, 2]. In addition to causing facial deformities, facial hemangiomas can lead to both functional and aesthetic issues, often resulting in significant complications. These complications negatively impact the quality of life for patients and can also affect the psychological well-being and self-esteem of their families [3]. With the expected global smartphone penetration reaching 70% [4], this case report explores the use of smartphones integrated with thermographic cameras to monitor the involution of hemangiomas during sclerosing treatment. This approach represents a promising advancement in managing and assessing hemangioma treatment through accessible, real-time monitoring technology.
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Composite hemangioendothelioma (CHE) is a rare locally aggressive vascular neoplasm of intermediate malignancy. We describe a 2-year-old patient diagnosed with this tumor. Careful documentation of patients with CHE is crucial to better define the prognosis and treatment of this entity.
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Infantile cavernous hemangioma is a benign vascular tumor in childhood. Cavernous hemangiomas have a tendency of slow enlargement with subsequent complications such as ulceration and bleeding. We report a case of a large cavernous hemangioma affecting the median upper lip in an 11-year-old girl. The lesion was growing and painful on pressure. The patient felt stigmatized. Treatment was wished for by patient and parents. After careful examination including Doppler ultrasound, we suggested a combined approach. In the first step the lesion was coagulated with an intralesional neodymium-YAG laser using a blunt tip. In the second step, immediately after the action of the laser, the lesion was removed completely by surgery. Defect closure was realized with bilateral tissue-expanding vermillion myocutaneous flaps. The patient was followed-up to 5 months. Disfigurement and functional impairment were eliminated. The result was satisfying for both patient and parents. Vascular lesions of the upper lip-particularly when close to Cupid's bow-can become disfiguring and cause functional impairment. We propose a combined approach with intralesional neodymium-YAG laser photocoagulation to avoid bleeding and to shrink the lesion before complete surgical removal. For defect closure, bilateral tissue-expanding vermillion myocutaneous flaps (Goldstein technique modified by Sawada) were used.
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BACKGROUND: Kaposiform hemangioendothelioma (KHE) is a locally aggressive and potentially lethal vascular tumor of infancy. Current consensus recommendations include the use of vincristine and/or systemic steroids as first-line treatment. Mammalian target of rapamycin (mTOR) inhibitors represent a promising therapy for patients with KHE. The goal of our study is to critically assess the existing literature on outcomes of patients with KHE treated with mTOR inhibitors. METHODS: We conducted a literature search from 1 January 2000, to 30 April 2022. Articles reporting outcomes of patients treated with mTOR inhibitors for KHE were included. Descriptive statistics were used to describe and summarize the outcomes of the treatment. RESULTS: We included 327 patients with a mean age at diagnosis of 9.1 months (SD ± 9). Patients were treated with an mTOR inhibitor for a mean of 15.2 months (SD ± 4.1). A total of 315 (96.3%) patients had positive outcomes including improvement of the tumor size, symptoms and/or laboratory parameters in 227 (85%) and complete remission in 38 (12%). Seven (2%) patients did not respond to treatment and seven (2%) died of sepsis (4), Kasabach-Merritt phenomenon complications (1), cardiac and liver failure due to ductus arteriosus (1), or metastatic disease (1). CONCLUSION: This systematic review supports the efficacy and safety of mTOR inhibitors for KHE. Their use resulted in positive outcomes in terms of decreased symptoms, reduction in tumor size and improvement in biochemical parameters with a mortality rate of 2%. According to these findings, we suggest revised consensus treatment guidelines for KHE with mTOR inhibitors potentially considered first-line therapy.
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Hemangioendotelioma , Síndrome de Kasabach-Merritt , Sarcoma de Kaposi , Humanos , Lactente , Síndrome de Kasabach-Merritt/diagnóstico , Sirolimo/uso terapêutico , Inibidores de MTOR , Hemangioendotelioma/diagnóstico , Sarcoma de Kaposi/complicações , Serina-Treonina Quinases TOR/uso terapêuticoRESUMO
Background: Hemangiosarcoma is a malignant vascular tumor commonly described in veterinary ophthalmology as emerging at the margin of the third eyelid and bulbar conjunctiva. The primary corneal attachment of the tumor is considered rare, as the cornea is an avascular structure, but there are sparse reports of primary occurrences in the cornea of dogs, cats, and horses. No reports were found in wild animals. The Tapirus terrestris, commonly known as Tapir, is a perissodactyl mammal that inhabits South America regions, being considered the largest terrestrial mammal of Brazil and one of the most popular animals in zoos in various countries. This paper aims to report the first case of primary corneal hemangiosarcoma in a 25-year-old female Tapir (Tapirus terrestris) held in captivity. Case: A 25-year-old Tapirus terrestris female presented an irregular mass in the right cornea, mucopurulent secretion, and inconclusive previous cytological evaluation. It also had a history of a milky cornea for many years, and in the last 12 months, a tissue growth was observed, as well as the occurrence of mucopurulent secretion. The menace response in the right eye was negative. In the ophthalmologic examination, a red-colored, lobed, hemorrhagic, and ulcerated mass occupying approximately 90% of the cornea was observed, and in the peripheral cornea, there was an intense discoloration. Due to the extension of the mass and visual loss, the transpalpebral enucleation was performed under general inhalation anesthesia. The histopathological analysis evidenced a vascular tumor restricted to the central peripheral cornea, composed of blood vessels of small and large caliber, showing polygonal endothelial cells with moderate atypia, anisocytosis, and anisocariasis, in addition to dense stroma and inflammatory cells. The mass occupied the anterior corneal stroma, and there was no involvement of bulbar conjunctiva, sclera, or intraocular structures. The immunohistochemical study revealed the positivity of neoplastic cells for CD31, and the proliferative index of the lesion was evaluated by the Ki-67 as inferior to 10%. Discussion: The histopathologic and immunohistochemical examinations evidenced a hypercellular lesion, and the diagnosis of primary corneal hemangiosarcoma (HSA) was possible due to the significant cellular atypia identified in the lesion. To the authors' knowledge, this is the first case of corneal hemangiosarcoma described in Tapirus terrestris. The HAS is a malignant neoplasm originating in the vascular endothelial cells. There is a significant correlation between the HSA and prolonged exposure to solar radiation. The tapir of this report lived in a high-altitude region with exposure to ultraviolet rays; therefore, it might be an important predisposing factor for the HSA emergence. The chosen treatment for vascular tumors according to the visual prognostic is the lamellar keratectomy; however, the transpalpebral enucleation was the elected treatment since the eye was not visual, the neoplasm had a great extension, the animal was in advanced age and lived in captivity, and it was difficult to handle the animal without sedation to perform adjuvant therapies. Since the mass corresponded to 90% of the cornea, total removal with free edges would not be possible as described in the literature, and, therefore, there was an increased risk of relapse. In the follow-up after 3 years of surgical excision, the animal remained free of metastasis, reinforcing the diagnosis of primary corneal hemangiosarcoma.
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Animais , Feminino , Perissodáctilos , Doenças da Córnea/veterinária , Neoplasias Oculares/veterinária , Hemangiossarcoma/veterinária , Imuno-Histoquímica/veterináriaRESUMO
Intramuscular hemangioma (IMH) represents less than 1% of all hemangiomas. In the head and neck region, it occurs mostly in the masseter, temporalis and sternocleidomastoid muscles. Despite its infiltrative growth pattern and several worrisome histological features, such as increased mitotic activity, plumpness of the nuclei, intraluminal papillary projections or perineural infiltration, the lesion is benign, and complete surgical excision is the preferred treatment for such oral lesions. Herein, we report three rare cases of IMH in the tongue and lip, discuss the clinical and histological aspects, and review the literature regarding this lesion.
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Hemangioma , Neoplasias Bucais , Neoplasias Musculares , Idoso , Feminino , Hemangioma/metabolismo , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Neoplasias Musculares/metabolismo , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgiaRESUMO
Las anomalías vasculares han sido clasificadas por primera vez en 1982, por Mulliken y Glowacki y recientemente, la Sociedad Internacional para el Estudio de las Anomalías Vasculares (ISSVA) modificó dicha clasificación, por la que hoy es aceptada mundialmente, que divide a las lesiones vasculares en tumorales y malformaciones. Dentro de la misma, encontramos una variedad de tumores, desde los más frecuentes como los hemangiomas infantiles, hasta los de menor frecuencia, integrando los síndromes clínicos y genéticos. El hemangioma hemosiderótico targetoide (HHT), también conocido como hemangioma hobnail, se encuentra dentro de dicha clasificación en el grupo de "otros" tumores vasculares, por su baja frecuencia. Fue descrito por primera vez por Santa Cruz y Aronberg en 1988, como una proliferación vascular benigna localizada con más frecuencia, en el tronco y las extremidades de los adultos jóvenes o de mediana edad. El objetivo es la presentación de un caso de hemangioma hobnail, patología vascular que se encuentra en constante revisión en la actualidad, profundizar en el conocimiento de los tumores vasculares, su clasificación y marcadores inmunohistoquímicos, revisar la bibliografía nacional e internacional y determinar bajo qué clasificación incluiríamos a esta entidad. La finalidad también es realizar un exhaustivo análisis de los diagnósticos diferenciales de esta patología, teniendo en cuenta la práctica clínica y demostrar como las nuevas tecnologías de diagnóstico, nos ayudan a aproximarnos al origen de la misma.
Vascular anomalies have been classified by Mulliken and Glowacki in 1982 and recently modified this classification by the International Society for the Study of Vascular Anomalies (ISSVA) today accepted worldwide, dividing vascular tumors and malformations. Within the same we find a variety of tumors from the more frequent as infantile hemangiomas, to the others with lower frequency, integrating clinical and genetic syndromes. Targetoid haemosiderotic haemangioma (THH), also known as hobnail haemangioma, is within that classification in the group of "other" vascular tumors due to their low frequency. It was described by Santa Cruz and Aronberg in 1988. It`s a benign vascular proliferation that arises most commonly on the trunk and limbs of young or middle-aged adults. The aim is to present a case of hobnail haemangioma, which is constantly being revised now a days, deepen of the knowledge of vascular tumors, their classification and immunohistochemical markers, review national and international literature and determine under what classification we would include this entity. The purpose is also to conduct a thorough analysis of the differential diagnosis of this disease, taking into account the clinical practice and demonstrate how new diagnostic technologies help us to approach it´s origin.
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Los corioangiomas placentarios son tumores vasculares benignos y los tumores placentarios más comunes, con una prevalencia de 1%. Raras veces sobrepasan los 4 a 5 centímetros y, cuando esto ocurre, es descrito como corioangioma gigante. Los embarazos con corioangiomas gigantes están asociados con complicaciones maternas y fetales, tales como anemia hemolítica microangiopática severa, parto pretérmino, polihidramnios, restricción del crecimiento intrauterino del feto, trombocitopenia e hidropesía. Se presenta un caso de un corioangioma gigante diagnosticado a las 22 semanas. A pesar del seguimiento estricto, el parto se produjo a las 30 semanas debido a polihidramnios y rotura prematura de membranas. Tanto la madre como el recién nacido se recuperaron sin complicaciones.
Placental chorioangiomas are benign vascular tumors and are the most common placental tumors, with a prevalence of 1%. It rarely surpasses 4 - 5 centimeters in length and, when it happens, is referred to as giant chorioangioma. Pregnancies with giant chorioangiomas are associated with maternal and fetal complications, such as severe microangiopathic haemolytic anemia, preterm labor, polyhidramnios, intrauterine growth restriction, thrombocytopenia and hydrops. A case of giant chorioangioma diagnosed at 22 weeks is presented. Despite close follow-up, delivery occurred at 30 weeks of pregnancy due to polyhidramnios and premature rupture of membranes. Both mother and newborn recovered without complications.
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El angioma en penacho es un raro tumor vascular benigno de comportamiento localmente agresivo que aparece en la infancia temprana; puede complicarse con el fenómeno de Kasabach-Merritt. Presentamos el caso de un paciente masculino de 2 años de edad con la lesión clínica característica.
Tufted angioma is a rare benign vascular tumor with a locally aggressive behavior that appears in early childhood; it may be complicated by the Kasabach - Merritt phenomenon. We report a 2 year old boy with a characteristic clinical lesion.
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El Angioma en Penacho es un raro tumor vascular de la infancia, que comparte características con el hemangioendotelioma kaposiforme, teniendo ambos posibilidad de desarrollar Síndrome de Kasabach-Merrit. Presentamos una paciente portadora de un angioma en penacho desde el nacimiento, que hemos seguido por 13 años: clínicamente, con estudios de imágenes y biopsias. El caso presenta similitudes con la literatura, con algunas interesantes peculiaridades en su evolución. Consideramos que por el comportamiento clínico e histológico, el Angioma en Penacho es parte de la misma enfermedad que el Hemangioendotelioma Kaposiforme.
Tufted angioma is a rare vascular tumor of childhood that shares features with the Kaposiform hemangioendothelioma, having both tumors the possibility of developing Kasabach-Merrit phenomenon. We report the case of a patient with a tufted angioma since birth, which we have followed for 13 years: clinically, with imaging studies and biopsies. The case presents similarities with literature, with some interesting peculiarities in its evolution. We consider that because of the clinical and histological behavior, Tufted angioma is a part of the same disease that Kaposiform hemangioendothelioma.
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Humanos , Feminino , Recém-Nascido , Neoplasias Cutâneas/patologia , Hemangioma/patologia , Neoplasias de Tecido Vascular/patologia , BiópsiaRESUMO
El Granuloma piógeno (GP), es una lesión vascular benigna común en piel y mucosas, que se incluye en la clasificación de anomalías vasculares de la “International Society for the study of vascular anomalies (ISSVA)”, dentro de “otros” tumores vasculares, a pesar de su controversial denominación y su patogenia “reaccional”. Presentamos un caso de granuloma piógeno en una paciente de 18 años de edad, en el segundo trimestre de embarazo con una presentación atípica por su gran tamaño y localización acral, con excelente respuesta al tratamiento quirúrgico.(AU)
Pyogenic Granuloma (GP) is a common vascular lesion of the skin and mucous membranes, usually presented as a solitary neoplasm with a bright red, smooth surface; usually sessile or pedunculated that grows rapidly to reach 1 to 2 inches in a few weeks and then remains stationary. It is included in the classification of vascular anomalies of the International Society for the study of vascular anomalies (ISSVA) to under "other" vascular tumors despite their controversial name and their "reactional" pathogenesis. Our goal is to present a case of pyogenic granuloma in an 18-year-old rural worker in the 2nd trimester with an atypical presentation for its size (4 x 4 cm) and acral location with excellent response to surgery and emphasize that such damage can result from repeated trauma, impaired wound healing and neovascularization and overexpression of the growth factor vascular endothelial (VEGF) at this period of life.(AU)
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El Granuloma piógeno (GP), es una lesión vascular benigna común en piel y mucosas, que se incluye en la clasificación de anomalías vasculares de la “International Society for the study of vascular anomalies (ISSVA)”, dentro de “otros” tumores vasculares, a pesar de su controversial denominación y su patogenia “reaccional”. Presentamos un caso de granuloma piógeno en una paciente de 18 años de edad, en el segundo trimestre de embarazo con una presentación atípica por su gran tamaño y localización acral, con excelente respuesta al tratamiento quirúrgico.
Pyogenic Granuloma (GP) is a common vascular lesion of the skin and mucous membranes, usually presented as a solitary neoplasm with a bright red, smooth surface; usually sessile or pedunculated that grows rapidly to reach 1 to 2 inches in a few weeks and then remains stationary. It is included in the classification of vascular anomalies of the International Society for the study of vascular anomalies (ISSVA) to under "other" vascular tumors despite their controversial name and their "reactional" pathogenesis. Our goal is to present a case of pyogenic granuloma in an 18-year-old rural worker in the 2nd trimester with an atypical presentation for its size (4 x 4 cm) and acral location with excellent response to surgery and emphasize that such damage can result from repeated trauma, impaired wound healing and neovascularization and overexpression of the growth factor vascular endothelial (VEGF) at this period of life.
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Los hemangiomas de la infancia (HI) son los tumores de partes blandas más frecuentes de la infancia. Se presentan en un 5 por ciento- 10 por ciento de la población pediátrica. El comportamiento de estos tumores es especial, ya que, a diferencia de otras neoplasias benignas, los HI tienden a regresar e involucionar espontáneamente en un 90 por ciento. Algunos pacientes con HI pueden sufrir complicaciones tales como ulceración y hemorragia. Estas complicaciones han llevado a la búsqueda de alternativas terapéuticas, donde, por mucho tiempo fueron los esteroides la primera opción de tratamiento. Esto hasta el año 2008, cuando se descubre accidentalmente el propranolol administrado por vía oral, como alternativa terapéutica para los HI severos, convirtiéndose hasta el día de hoy, en el gold standard de tratamiento. Dado la diversidad en su presentación, y las diferentes alternativas de manejo existentes, es que esta revisión pretende abordar la patogenia, clínica y enfrentamiento de estos tumores de la infancia.
Hemangiomas of infancy (HI) are the most common soft tissue tumors of childhood. They occur in up to percent-10 percent of the pediatric population and they have a special behaviour because, unlike other benign neoplasms, HI tend to regress spontaneously in up to 90 percent of the cases. Complications such as ulceration and hemorrhage can occur. These complications have led to search for new therapeutic options. Steroids were the first choice of treatment for a long time, until 2008, when oral propranolol was accidentally discovered as a potential treatment for large HI4. Today, propranolol is the gold standard for treatment. Given their variable clinical presentation and different therapeutic options available nowadays, this paper to review the pathogenesis, clinical presentation and approach of these tumors of infancy.
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Humanos , Criança , Hemangioma/diagnóstico , Hemangioma/terapia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/terapia , Diagnóstico Diferencial , Hemangioma/classificação , Hemangioma/complicações , Hemangioma/etiologia , Neoplasias de Tecidos Moles/classificação , Neoplasias de Tecidos Moles/complicações , Neoplasias de Tecidos Moles/etiologiaRESUMO
Introducción: El hemangioendotelioma kaposiforme (HEK) es un tumor vascular poco frecuente, que se asocia a coagulopatía grave, conocida como fenómeno de Kasabach-Merritt (FKM). Puede ser letal en 20 por ciento de los casos. Se han descrito múltiples tratamientos, pero a pesar de las complicaciones potencialmente severas que pueden presentar estos pacientes, no hay hasta ahora un protocolo único. Existen experiencias internacionales, en modelos experimentales, con el uso de Sirolimus (SRL), macrólido, inhibidor de mTOR, con actividad antiangiogénica. Sin embargo, la experiencia de su uso en niños en el tratamiento de anomalías vasculares como el HEK es limitada. Objetivo: Reportar la evolución de dos pacientes con HEK y FKM tratados con SRL en centros oncológicos, después de múltiples fallas con otras terapias. Casos clínicos: Reportamos dos recién nacidos con HEK profundo asociado a FKM, refractarios a terapias habituales y que evolucionaron con complicaciones amenazantes de la vida, en quienes se inicio tratamiento con SRL. El uso de SRL permitió que los dos pacientes mostraran mejoría en su estado clínico, con normalización del recuento de plaquetas y de las pruebas de coagulación, disminución del tamaño de la lesión, del dolor asociado, desaparición del riesgo vital y sin efectos adversos. Conclusión: SRL parece ser efectivo y seguro en el tratamiento de HEK, representando una nueva opción terapéutica, disponible en nuestro medio.
Introduction: Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumor, which is associated with the severe coagulopathy known as Kasabach-Merritt phenomenon (KMP). This condition has a mortality rate around 20 percent. Many treatments have been described, but despite the potentially severe complications that these patients may present, so far there is not a single protocol to follow. International experimental models have used Sirolimus (SRL), a macrolide mTOR inhibitor with antiangiogenic effect. However, its use in children against vascular anomalies, such as KHE, is limited. Objective: To report the development of two patients with KHE and KMP treated with SRL in cancer centers, after multiple failures with other therapies. Case reports: Two infants with severe KHE associated to FKM, resistant to standard therapies and who overcame life-threatening complications after treatment with SRL are presented. After SRL, the two patients showed normal platelet counts and coagulation tests, reduced lesion size and associated pain, no presence of life threatening conditions or side effects. Conclusion: SRL appears to be effective and safe in treating KHE, representing a new available therapeutic option.
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Antibióticos Antineoplásicos/uso terapêutico , Hemangioendotelioma/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Neoplasias Vasculares/tratamento farmacológico , Sirolimo/uso terapêutico , Síndrome de Kasabach-MerrittRESUMO
INTRODUCTION: Hemangioendotheliomas are locally aggressive vascular tumors with intermediate malignity and metastasis risk. The epithelioid variant, the most aggressive one, equally affects men and women at any age and it is rare in children. It occurs as a solitary tumor, which is usually painful, affecting superficial or deep soft tissues. Furthermore, it is less frequent in the liver, lung, bones, skin, lymph nodes and central nervous system. Microscopically, they present epithelioid cells with intracytoplasmic vacuoles, low mitotic activity and little or no necrosis. Additionally, its vascular nature is confirmed by immunohistochemical studies (CD31, CD34 and factor VIII). OBJECTIVE, MATERIAL AND METHODS: Through search in the archives of the Pathology Division of the National Cancer Institute (Instituto Nacional de Câncer [INCA]) from 1996 to 2011, 13 cases of epithelioid hemangioendothelioma (HEE) were identified and analyzed. RESULTS AND DISCUSSION: seven cases occurred in male patients and six in female patients, mean age 42 years, ranging from 7-66. The most common locations were: soft tissue (three patients; 23%); head and neck, mediastinum, bone and lung (two patients each; 15%); liver and lymph nodes (one patient each; 8%). There was clinical follow-up of nine patients: five were alive and disease-free (one to six years after diagnosis); three out of four patients with aggressive disease progressed to death (one month to five years after diagnosis); one relapsed two years after diagnosis and is alive with disease. CONCLUSION: This series of 13 cases of HEE, whose diagnoses were based on morphological and/or immunohistochemical analyses, demonstrates the different patterns of clinical presentation and biologic behavior of this disease.
INTRODUÇÃO: O hemangioendotelioma é um tumor vascular de malignidade intermediária, localmente agressivo e com risco de metástase. A variante epitelioide, a mais agressiva, acomete igualmente homens e mulheres em qualquer idade e é rara na infância. Apresenta-se como tumoração solitária, geralmente dolorosa, em partes moles, superficiais ou profundas; menos frequentemente, acomete fígado, pulmão, ossos, pele, linfonodos e sistema nervoso central. Microscopicamente, mostram células epitelioides com vacúolos intracitoplasmáticos, baixa atividade mitótica, pouca ou nenhuma necrose, tendo sua natureza vascular comprovada por estudos imuno-histoquímicos (CD31, CD34, Fator VIII). OBJETIVOS E MATERIAL E MÉTODOS: Por meio de busca nos arquivos da Divisão de Patologia (DIPAT) do Instituto Nacional de Câncer (INCA), de 1996 a 2011, foram encontrados e revisados 13 casos de hemangioendotelioma epitelioide (HEE). RESULTADOS E DISCUSSÃO: Sete casos ocorreram em homens e seis, em mulheres, com idade média de 42 anos, variando de 7 a 66 anos de idade. As localizações mais frequentes foram partes moles (três pacientes; 23%); cabeça-pescoço, mediastino, osso e pulmão, (dois pacientes cada; 15%); fígado e linfonodo (um paciente cada; 8%). Houve seguimento clínico de nove pacientes: cinco estavam vivos e livres de doença (de um a seis anos após o diagnóstico); dos quatro pacientes que apresentaram HEE agressiva, três evoluíram a óbito com doença (de um mês a cinco anos) e um recidivou dois anos após o diagnóstico e está vivo com a doença. CONCLUSÃO: Esta série de 13 casos de HEE, cujos diagnósticos foram firmados em bases morfológicas e/ou imuno-histoquímicas, demonstra os diferentes padrões de apresentação clínica e o comportamento biológico da doença.
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Humanos , Masculino , Feminino , Hemangioendotelioma Epitelioide , Neoplasias Vasculares , VirulênciaRESUMO
Antecedentes: Los tumores benignos de la piel se definen como el crecimiento autónomo de tejido sin relación con el patrón normal de crecimiento tisular, que persiste después del estímulo que le dio origen. Prácticamente todos los humanos presentan algún tumor benigno, pero la mayoría de las veces no se busca atención ya que no producen molestias. Son escasos los registros sobre la frecuencia de los tumores benignos. El objetivo de este estudio fue informar el número de tumores benignos en el Departamento de Dermatología de nuestro hospital. Material y métodos: Se realizó un estudio retrospectivo en el que se revisaron los registros de histopatología del periodo 2000 a 2006. Se registró año, número de biopsia, sexo, edad, topografía, diagnóstico clínico y diagnóstico histológico. Resultados: Se analizaron 9436 registros de biopsias, de las cuales 3765 fueron tumores benignos, de éstos se eliminaron 595 biopsias por falta de datos, para un total de 3170. Los tumores más frecuentes por grupo histopatológico en forma descendente fueron los tumores melanocíticos, quistes, tumores fibrosos, vasculares, de la epidermis, de tejido adiposo, del pelo, neurales, glandulares, sebáceos, de cartílago y hueso, y de músculo liso. Los tumores más frecuentes en general fueron nevos melanocíticos, quistes epidermoides, queratosis seborreicas, granulomas piógenos, lipomas y dermatofibromas. Conclusiones: Los tumores benignos más frecuentes fueron los melanocíticos constituidos por nevos de unión, intradérmicos y compuestos, y los quistes epidermoides. Esta serie proporciona información de los tumores benignos más comunes en un servicio dermatológico.
BACKGROUND: Benign skin neoplasms are defined as autonomous growing tissue unrelated to normal growing of the skin, that persist even after the originating stimulus dissapears. Almost all human beings have a certain number of benign cutaneous neoplasms and many never seek medical attention. There is a dearth of information regarding the frequency of these tumors. The aim of this study was to record the number of benign tumors studied at the Dermatology Department of a medical facility. MATERIAL AND METHODS: A retrospective study analyzed medical records between 2000 and 2006. We included year of admission, number of biopsies, sex, age, tumor location, histological and clinical diagnoses. RESULTS: We analyzed 9,436 biopsies of which 3,765 constituted benign neoplasms; 595 were not included and our total sample was 3,170 tumors. The most frequent tumors according to histopathological diagnoses in descending order were: melanocytic, cutaneous cysts, fibrous tumors, vascular tumors, epidermal tumors, fat tumors, tumors with hair differentiation, neural tumors, glandular tumors, tumors with sebaceous differentiation, cartilage and bone tumors, and smooth muscle tumors. The most common benign tumors were: Melanocytic nevi, epidermal cysts, seborrheic keratoses, pyogenic granulomas, lipomas and dermatofibromas. CONCLUSIONS: Melanocytes represented by melanocytic nevi (junctional, intradermic and compound) were the most frequent benign neoplasms, followed by epidermoid cysts. Our results illustrate the most common benign tumors observed in a dermatology department.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias/epidemiologia , Hospitais Gerais , Neoplasias/patologia , Estudos RetrospectivosRESUMO
Los sarcomas de la cabeza y cuello son raros sólo 5% de todos los sarcomas aparecen en esta región. El angiosarcoma es una neoplasia que representa 2% de todos los tumores de tejidos blandos, 60% ocurren en la piel y tejidos blandos, 50% en la región de la cabeza y cuello y entre estos últimos sólo 4% de los casos en el tracto aereodigestivo superior. Se informa el caso de una mujer de 52 años con cefalea, lagrimeo, sensación de cuerpo extraño en fosa nasal izquierda y epistaxis. En la TAC se identificó un tumor en fosa nasal izquierda que invadía hasta la lámina ósea del cráneo. El informe histopatológico fue de angiosarcoma. Se revisaron y analizaron los casos informados en la literatura desde el año 1976 al 2004. Se concluye que los angiosarcomas del tracto aereodigestivo superior tienen un mejor pronóstico con mayor supervivencia sin enfermedad, en comparación a los de la piel o tejidos blandos. La recurrencia se relaciona estrechamente con la positividad de los márgenes quirúrgicos. El tratamiento es a base de la resección quirúrgica completa con radioterapia.
Sarcomas constitute 5% of all of head and neck neoplasms. Angiosarcomas comprise 2% of all soft tissue tumors, 60% appear in skin and soft tissue, 50% in the head and neck and only 4% are present in the upper aerodigestive tract. We report a case of a 52 year old healthy woman with headache, weeping, foreign body sensation in the left nostril and epixtasis. The TAC identified a tumor in the left nostril that invaded the osseous lamina of the skull. The histopathologic diagnosis was angiosarcoma. We carried out a literature review and analysis from 1976 to 2004. Agiosarcomas of the upper aerodigestive tract have a better prognosis and long term survival free of disease than their soft tissue and skin counterparts. Recurrence is strongly correlated with positive resection margins. Complete surgery and radiotherapy are considered the optimal treatment schemes.