Optical Coherence Tomography Angiography Features of Iris Racemose Hemangioma in 4 Cases.

Importance: Optical coherence tomography angiography (OCTA) allows visualization of iris racemose hemangioma course and its relation to the normal iris microvasculature. Objective: To describe OCTA features of iris racemose hemangioma. Design, Setting, and Participants: Descriptive, noncomparative case series at a tertiary referral center (Ocular Oncology Service of Wills Eye Hospital). Patients diagnosed with unilateral iris racemose hemangioma were included in the study. Main Outcomes and Measures: Features of iris racemose hemangioma on OCTA. Results: Four eyes of 4 patients with unilateral iris racemose hemangioma were included in the study. Mean patient age was 50 years, all patients were white, and Snellen visual acuity was 20/20 in each case. All eyes had sectoral iris racemose hemangioma without associated iris or ciliary body solid tumor on clinical examination and ultrasound biomicroscopy. By anterior segment OCT, the racemose hemangioma was partially visualized in all cases. By OCTA, the hemangioma was clearly visualized as a uniform large-caliber vascular tortuous loop with intense flow characteristics superimposed over small-caliber radial iris vessels against a background of low-signal iris stroma. The vascular course on OCTA resembled a light bulb filament (filament sign), arising from the peripheral iris (base of light bulb) and forming a tortuous loop on reaching its peak (midfilament) near the pupil (n = 3) or midzonal iris (n = 1), before returning to the peripheral iris (base of light bulb). Intravenous fluorescein angiography performed in 1 eye depicted the iris hemangioma; however, small-caliber radial iris vessels were more distinct on OCTA than intravenous fluorescein angiography. Conclusions and Relevance: Optical coherence tomography angiography is a noninvasive vascular imaging modality that clearly depicts the looping course of iris racemose hemangioma. Optical coherence tomography angiography depicted fine details of radial iris vessels, not distinct on intravenous fluorescein angiography

Methods of Prediction of Infantile Hemangioma Evolution

Cutaneous hemangioma is the most frequent benign tumor for children. This blood anomaly has a frequency of 10% for children and is more common for females than males. Infantile hemangioma appears soon after birth and, in general, after a period of evolution it regresses by itself. The hemangiomas appear with a high frequency on face and neck and, if they don’t regress completely, they may have psychological effects. Sometimes, depending on the size and location of the hemangioma (mainly on the face), a quick decision should be taken to proceed (or not) with surgery, so that the lesions do not cause permanent disfigurement of the patient. Yet, doctors do not know at the moment if, at a given moment of time, how much a hemangioma will progress in the near future. Therefore, an automatic monitoring system for the detection and evaluation of the evolution of hemangiomas would be a useful tool for physicians, helping them in their decision about treatment. The present lecture presents ongoing work on developing such a system. Based on a series of images of the same hemangioma acquired periodically (typically, one month passes between two successive medical controls for a single patient), we aim at firstly assessing the way the hemangioma evolves over time, and, secondly, at predicting its evolution in the near future. This involves segmenting the hemangioma area, which is made difficult by the variety of shapes and colors the tumor may take. Then, two parameters are computed for each hemangioma, namely, size and degree of redness, as being the factors of most significant importance for assessing the state of the tumor at a given time. A fuzzy system (which incorporates knowledge from experienced physicians) is then developed based on the two aforementioned parameters to assess the evolution of the tumor in time.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Capillary hemangioma of tympanic cleft

We present an extensive capillary hemangioma of right ear in an 11-year-old child involving external auditory canal, middle ear and mastoid. Patient was presented with chronic purulent discharge and aural mass in right ear. The Computarize tomography (CT) scan revealed enhancing soft tissue filled density in external ear, middle ear and mastoid for that modified radical mastoidectomy (MRM) was done. The histopathological report of surgical specimen confirmed the diagnosis of capillary hemangiom

Bilateral diffuse choroidal hemangioma in Sturge Weber syndrome: a case report highlighting the role of multimodal imaging and a brief review of the literature

Purpose: The purpose of this paper is to present a patient with bilateral choroidal hemangioma in Sturge-Weber syndrome (SWS) and highlight multimodal imaging techniques for early detection and management of ocular alterations. Methods: A 37-year-old woman with diagnosis of SWS presented to our unit. The patient had been treated with pulsed dye laser for bilateral nevus flammeus and had right leptomeningeal angiomatosis. She had glaucoma, but ultrasound biomicroscopy did not show anterior chamber or ciliary body alterations. Results: Enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) showed bilateral diffuse choroidal hemangiomas in both eyes with choroidal thickness above 1000 μm. B-scan ultrasound examination showed diffuse choroidal hemangioma in both eyes, with a choroidal thickness of 1.53 mm and 1.94 mm in the right and left eye (RE, LE), respectively. Peripapillary retinal nerve fiber evaluation showed thinning of the retinal nerve fiber layer in both eyes. Conclusions: This report highlights multimodal imaging techniques for the critical assessment of patients with SWS, especially in rare cases with bilateral choroidal hemangioma of the choroid. Novel imaging modalities enable optimal management and follow-up of rare conditions, and our case adds further evidence to the existing literature

Cardiac hemangioma of the right atrium in a neonate : fetal management and expedited surgical resection

Cardiac hemangioma is a rare tumor with a reported incidence of 1-2%. We describe the case of a neonate with a right atrial mass that was diagnosed prenatally. The fetus developed a supraventricular tachycardia and was delivered by cesarean section in the 35th week of gestation. The infant underwent surgery after 24 hours to remove the mass which was diagnosed as a cardiac capillary-cavernous hemangioma.peer-reviewe

Excisional treatment of cavernous hemangioma of the liver

Fifteen patients had hepatic hemangiomas removed with liver resections that ranged in extent from local excision to right trisegmentectomy. There was no mortality and little morbidity. The propriety and feasibility of extirpative treatment of such liver tumors has been emphasized by this experience

Excisional therapy for benign hepatic lesions

With the recent advances in imaging techniques, increased numbers of hepatic lesions are found today, and surgeons are asked frequently for the best course of management. Benign hepatic tumors sometimes cause life-threatening complications and more often trigger disabling or annoying symptoms in otherwise healthy individuals. Although various imaging techniques are quite accurate in identifying cysts and hemangiomas, other benign hepatic lesions, such as adenomas, focal nodular hyperplasia and other benign solid tumors, cannot be differentiated from malignant lesions with a high degree of confidence

Meatal Segment of facial nerve and cavernous hemangioma

Cavernous malformations of the internal auditory canal (IAC) are a rare clinical entity. We report a rare case of cavernous hemangioma involving the internal auditory canal and the meatal segment of the facial nerve without any evident lesion to the cerebello-pontine angle and geniculate ganglion. In English language literature several studies have described cavernous malformations of the IAC, but only a few authors have described a facial nerve origin for this type of lesion. Removal of the entire lesion was achieved via the surgical resection of the facial nerve and facial nerve continuity was restored using a great auricular nerve graft. Optimal postoperative facial function recovery was reported

Ocular manifestations of Sturge–Weber syndrome: pathogenesis, diagnosis, and management

Sturge-Weber syndrome has been included in the group of phakomatoses that is characterized by hamartomas involving the brain, skin, and eyes. The characteristic facial port-wine stain, involving the first branch of the trigeminal nerve and the embryonic vasculature distribution in this area, leads to several ocular complications of the anterior segment and can involve the eyelids and conjunctiva. The posterior segment of the eyes is also affected with diffuse choroidal hemangiomas. However, the most frequent ocular comorbidity is glaucoma with a prevalence rate ranging from 30%-70%. Glaucoma is related to anterior chamber malformations, high episcleral venous pressure (EVP), and changes in ocular hemodynamics. Glaucoma can be diagnosed at birth, but the disease can also develop during childhood and in adults. The management of glaucoma in Sturge-Weber syndrome patients is particularly challenging because of early onset, frequently associated severe visual field impairment at the time of diagnosis, and unresponsiveness to standard treatment. Several surgical approaches have been proposed, but long-term prognosis for both intraocular pressure control and visual function remains unsatisfactory in these patients. Choroidal hemangiomas may also lead to visual impairment thorough exudative retinal detachment and macular edema. Treatment of exudative hemangioma complications is aimed at destructing the tumor or decreasing tumor leakage