Giant Frontotemporal Cavernous Malformation in a 2-Month-Old Infant: A Case Report and Review of the Literature

2021 ◽  
pp. 1-7
Author(s):  
Olivia E. Gilbert ◽  
John M. Wilson ◽  
Jerome M. Volk

<b><i>Introduction:</i></b> Cavernous malformations in the pediatric population are exceedingly rare, especially in infants. Giant cavernous malformations (GCM) are even more rare and have a diameter &#x3e;4 cm. The onset of symptoms predominantly occurs in adulthood, but the rate of hemorrhage is significantly higher in the pediatric population. Similar to non-GCM, GCM can be misidentified as tumors on imaging due to their tumefactive pattern with edema. Here, we present a rare case of a right frontotemporal GCM in a 2-month-old girl, the youngest recorded case in the existing literature. <b><i>Case Presentation:</i></b> A previously healthy 2-month-old girl presented to the emergency department following an increasing frequency of seizure-like activity that began 3 days prior to presentation. Magnetic resonance imaging of the brain with and without contrast characterized a large (5.8 × 4.3 × 4.2 cm) heterogeneous lesion of the right temporal lobe with diffuse scattered blood products of various ages seen throughout the lesion. She underwent a right-sided craniotomy where a gross total excision was achieved. Pathology confirmed the diagnoses of a GCM. The patient’s seizures subsequently resolved, and she continues to do well postoperatively. <b><i>Discussion/Conclusion:</i></b> GCM can be mistaken for tumors due to their large size, cystic nature, and surrounding edema, but a vascular lesion should always remain in the differential diagnosis before operating, even in infants. Surgery is generally recommended in patients that present with a symptomatic hemorrhage, recurrent hemorrhages, persistent seizures despite medical management, or progressively worsening neurological deficits if the GCM is in a safe location. It has been shown that 70–99% of patients undergoing surgery with successful removal of the GCM can achieve seizure freedom 2 years postoperatively. Complete surgical excision of this infant’s GCM was successful in treating her neurologic symptoms; therefore, pathological confirmation of this lesion is critical and should prompt a complete surgical excision.

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Claire J. Wiggins ◽  
Rami P. Dibbs ◽  
Erica L. Bartlett ◽  
Daniel J. Ashton ◽  
Renata S. Maricevich

Abstract Background Epithelioid hemangioma is a rare, benign vascular lesion classically presenting with painless nodules in the head and neck region. Hemangioma lesions are typically small, located within the dermis and subcutaneous tissue, and rarely exceed 10 cm in size. Complete surgical excision, with negative margins, is the recommended treatment as local recurrence is common. We describe an unusual presentation of epithelioid hemangioma that, to our knowledge, has not been previously described in the literature, epithelioid. Case presentation We report an atypical case of a large epithelioid hemangioma lesion with deep intramuscular involvement in a 16-year-old male. Ultrasound and MRI showed a hypervascular mass on the patient’s left upper back, and biopsy confirmed the diagnosis. Treatment consisted of preoperative embolization followed by excision and local tissue rearrangement. Conclusions Epithelioid hemangiomas are considered uncommon in the pediatric population. Moreover, it is challenging to diagnose these lesions due to their similarities to other vascular anomalies. We aim to increase awareness of this condition and obtain more precision in diagnosis, thus standardizing the approach for those treating individuals with vascular anomalies.


2020 ◽  
Vol 49 (2) ◽  
pp. 44-47
Author(s):  
Md Hasanul Haque ◽  
Belayat Hossain Siddique ◽  
Abirvab Naha ◽  
Abdus Sattar ◽  
Nigar Sultana ◽  
...  

Solitary papilloma in the respiratory tract is a rare benign epithelial tumor which is complete surgical excision of the current standard treatment for this type of tumor. Here a case of solitary tracheal papilloma treated by surgical resection is reported. Due to rarity and non-specific symptoms, tracheal papilloma always subjected to misdiagnosed and suffer from delayed treatment. In this case, a forty two years male has been presented with a recurrent non-productive irritative cough, a progressive shortness of breath, expiratory stridor and occasional hemoptysis. The patient was previously diagnosed as a case of bronchial asthma by a Pulmonologist and wrongly treated as well. CT scan revealed an intraluminal tracheal mass arises from the right side of the tracheal wall opposite c6-c7 vertebrae. The tumour was removed by endoscopic excision. The histopathological result confirms the diagnosis of squamous cell papilloma. No complications occur during surgery and no recurrence was observed in six months after surgery on followup. Bangladesh Med J. 2020 May; 49(2) : 44-47


2018 ◽  
Vol 15 (4) ◽  
pp. 404-411 ◽  
Author(s):  
Justin Mascitelli ◽  
Jan-Karl Burkhardt ◽  
Sirin Gandhi ◽  
Michael T Lawton

Abstract BACKGROUND Surgical resection of cavernous malformations (CM) in the posterior thalamus, pineal region, and midbrain tectum is technically challenging owing to the presence of adjacent eloquent cortex and critical neurovascular structures. Various supracerebellar infratentorial (SCIT) approaches have been used in the surgical armamentarium targeting lesions in this region, including the median, paramedian, and extreme lateral variants. Surgical view of a posterior thalamic CM from the traditional ipsilateral vantage point may be obscured by occipital lobe and tentorium. OBJECTIVE To describe a novel surgical approach via a contralateral SCIT (cSCIT) trajectory for resecting posterior thalamic CMs. METHODS From 1997 to 2017, 75 patients underwent the SCIT approach for cerebrovascular/oncologic pathology by the senior author. Of these, 30 patients underwent the SCIT approach for CM resection, and 3 patients underwent the cSCIT approach. Historical patient data, radiographic features, surgical technique, and postoperative neurological outcomes were evaluated in each patient. RESULTS All 3 patients presented with symptomatic CMs within the right posterior thalamus with radiographic evidence of hemorrhage. All surgeries were performed in the sitting position. There were no intraoperative complications. Neuroimaging demonstrated complete CM resection in all cases. There were no new or worsening neurological deficits or evidence of rebleeding/recurrence noted postoperatively. CONCLUSION This study establishes the surgical feasibility of a contralateral SCIT approach in resection of symptomatic thalamic CMs It demonstrates the application for this procedure in extending the surgical trajectory superiorly and laterally and maximizing safe resectability of these deep CMs with gravity-assisted brain retraction.


2019 ◽  
Vol 3 (12) ◽  
pp. 2224-2235 ◽  
Author(s):  
Aditya Dutta ◽  
Rimesh Pal ◽  
Nimisha Jain ◽  
Pinaki Dutta ◽  
Ashutosh Rai ◽  
...  

Abstract Primary hyperparathyroidism (PHPT) is a rare endocrine disease in the pediatric population. Sporadic parathyroid adenomas remain the most common cause of pediatric PHPT. Parathyroid carcinoma (PC) is an extremely rare cause of pediatric PHPT. We report a 16-year-old boy presenting with a nonhealing fragility fracture of the right leg along with florid features of rickets. Examination revealed a neck mass, mimicking a goiter. Biochemical findings were consistent with PHPT. Imaging was suggestive of a right inferior parathyroid mass infiltrating the right lobe of thyroid. The patient underwent en bloc surgical excision of the parathyroid mass along with the right lobe of thyroid. Histopathology was suggestive of a PC. He achieved biochemical remission with normalization of serum calcium and parathyroid hormone levels. At follow-up, there was no biochemical or imaging evidence of recurrence or metastasis. Genetic analysis revealed heterozygous germline deletion of CDC73. An extensive literature search on PC was conducted, with an emphasis on the pediatric population. Thirteen cases of pediatric PC were identified. The median age of presentation was 13 years; there was no sex predilection. All cases were symptomatic; 31% had a visible neck mass. The median serum calcium and intact parathyroid hormone levels were 14.3 mg/dL and 2000 pg/mL, respectively. All patients underwent surgical excision, with 27% showing metastatic relapse. Our findings indicate that the preoperative features that could point toward a diagnosis of PC in a child with PHPT are a tumor size of >3 cm, thyroid infiltration on imaging, and severe hypercalcemia at presentation.


1970 ◽  
Vol 20 (1) ◽  
pp. 78-81
Author(s):  
NK Sinha ◽  
MH Rashid ◽  
MM Shaheen ◽  
DC Talukder ◽  
MAY Fakir ◽  
...  

Juvenile angiofibroma is a rare hypervascular, locally aggressive benign tumour which is exclusively found in the nose and paranasal sinuses of male adolescents. The definitive treatment for this tumour is complete surgical excision. Different surgical approaches are used for complete excision. Most recent development is excision of the tumour using endoscopes. But in certain cases with large size and different extensions, open transfacial approaches are the choice for complete removal and for less operative bleeding, which are the main challenges for surgical excision of this tumour. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8587 J Dhaka Med Coll. 2011; 20(1) :78-81


2020 ◽  
pp. 112067212097361
Author(s):  
Manpreet Singh ◽  
Manu Saini ◽  
Debajyoti Chatterjee ◽  
Aditi Mehta ◽  
Manpreet Kaur ◽  
...  

A 63-year-male had painless, progressive, yellowish-pink, immobile conjunctival mass with prominent feeder vessels in the right eye of 1-year duration. The rest of the ophthalmic examination was unremarkable. MRI showed no extension into orbit or extraocular muscles. An excision biopsy with the amniotic membrane patch was performed. Histopathology confirmed inflammatory myofibroblastic tumour (IMT) with SMA and calponin positivity on immunohistochemistry. Complete surgical excision, amniotic membrane, and oral steroids provided long-term relief from recurrence. The conjunctiva is a rare site for IMT, and IMT should be kept in the differentials for atypical cases of ocular surface neoplasia.


2017 ◽  
Vol 5 (4) ◽  
pp. 497-500
Author(s):  
Cristiana Voicu ◽  
Mara Mihai ◽  
Mihai Lupu ◽  
James W. Patterson ◽  
Nely Koleva ◽  
...  

BACKGROUND: Basal cell carcinoma (BCC) is the most frequently encountered neoplasm worldwide. While nodular BCC is the most frequent clinical subtype, other forms of BCC, such as superficial, cystic, morpheiform, infiltrative, and pigmented may also be encountered.CASE PRESENTATION: We present the case of a 67-year-old male with a relatively well-defined infiltrative, pigmented plaque with multiple colours and peripheral growth situated in the right axillary region. The histopathologic examination performed after complete surgical excision of the tumour revealed a complex pigmented BCC with macronodular, fibroepithelioma-like, cystic, focally infiltrative and basosquamous features.CONCLUSION: Uncommon locations of BCCs in sun-protected areas such as the axillary region require a higher degree of suspicion for diagnosis. The complex histology of the presented case, including subtypes with differing biologic attributes, emphasises the importance of histopathological examination in the diagnosis and therapeutic management of BCC.


2019 ◽  
Vol 12 ◽  
pp. 117955061988656
Author(s):  
Amina Mouzali ◽  
Samia Lameche ◽  
Assia Slimani ◽  
Omar Zemirli

Objectives: Pleomorphic adenomas are benign tumors that rarely involve nonsalivary glands. We report an uncommon case of ala nasi pleomorphic adenoma. We discuss the clinical and histopathologic characteristics, and review the literature on nasal pleomorphic adenoma. Method: A 20-year-old man presented with a painless slow growing lobulated mass located on the right ala nasi extending into the nasal vestibule. Results: Complete surgical excision was performed. Histologic examination found a mixed cellular component: epithelial and myoepithelial cells with chondromyxoid stroma. This was consistent with the diagnosis of a typical pleomorphic adenoma. There was no evidence of recurrence at 18 months after the surgery. Conclusions: Pleomorphic adenomas located in the external nose are extremely rare. In such case, pleomorphic adenoma could originate from ectopic minor salivary gland. Complete surgical excision with long-term follow-up is recommended due to the potential risk of recurrence and malignant transformation.


2017 ◽  
Vol 10 (1) ◽  
pp. 136-142 ◽  
Author(s):  
Marcelo Di Gregorio ◽  
Lionel  D’Hondt ◽  
Francis  Lorge ◽  
Marie-Cécile Nollevaux

Objective: To describe a rare pathology, the liposarcoma of the spermatic cord (LSC), and discuss its diagnosis and treatment. Materials and Methods: We report a case of well-differentiated LSC in a 61-year-old man. The main complaint was painless enlargement in the right inguinoscrotal area that appeared 6 months prior to presentation. Ultrasonography showed a heterogeneous and hyperechogenic mass of the right spermatic cord that was highly suspicious of malignancy. Computed tomography confirmed a heterogeneous supratesticular mass. The mass was surgically removed. Results: Pathological examination showed a well-differentiated LSC. The patient did not receive any additional treatment. The follow-up did not present complications or further symptoms and, at present, the patient is in complete remission. Conclusion: LCSs are a very rare entity. The diagnosis is difficult and often mistaken with common scrotal swelling associated with a hernia, hydrocele, or other tumour. Treatment should include complete surgical excision, usually by radical inguinal orchiectomy. A long follow-up period is necessary.


2020 ◽  
Vol 9 ◽  
pp. 9
Author(s):  
Ahmed Raza ◽  
Asma Mushtaq ◽  
Seema Qayyum ◽  
Fiza Azhar ◽  
Ahmad Imran ◽  
...  

Background: Teratoma originates from all three germinal layers and commonly found at the sacrococcygeal region. The orbit is an unusual site of occurrence, but they grow rapidly and cause massive proptosis. Case Presentation: A 9-day-old female neonate presented with marked unilateral proptosis of the right eye. Imaging workup gave a suspicion of a complex mass with internal hemorrhage or a teratoma. Modified exenteration was performed. Histopathological examination revealed mature cystic teratoma. Conclusion: Orbital teratoma presents with marked disfiguring proptosis in neonatal life. Prompt complete surgical excision is curative in the case of mature lesions.


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