Combined Therapy for Vascular Lesions of the Head and Neck with Intra-Arterial Embolization and Surgical Excision

1982 ◽  
Vol 90 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hugh F. Biller ◽  
Yosef P. Krespi ◽  
Peter M. Som
Keyword(s):  
Soft Tissue ◽  
Arteriovenous Malformations ◽  
Combined Therapy ◽  
Arterial Embolization ◽  
Surgical Excision ◽  
Vascular Lesions ◽  
Tumor Site ◽  
Carotid Angiography ◽  
Selective Angiography ◽  
Soft Tissue Masses

Large extracranial arteriovenous malformations (AVM) are considered rare. Most of these lesions appear as soft tissue masses or as bleeding. Symptoms relate to the tumor site. The clinical diagnosis of AVM should be confirmed by selective angiography. The preferred technique for carotid angiography is selective catheterization by the retrograde femoral approach based on Seldinger's method.

scholarly journals Elastofibroma dorsi: The clunking tumour that need not cause alarm

2016 ◽  
Vol 98 (03) ◽  
pp. 208-211 ◽  
Author(s):  
HG Smith ◽  
JAF Hannay ◽  
K Thway ◽  
C Messiou ◽  
MJF Smith ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Percutaneous Biopsy ◽  
Surgical Excision ◽  
Electronic Patient Records ◽  
Cross Sectional ◽  
Female Ratio ◽  
Cross Sectional Imaging ◽  
Soft Tissue Masses ◽  
Pathology Reports

Introduction Elastofibromas are rare, pseudo-tumours arising at the inferior pole of the scapula that have a characteristic presentation. Due to their tissue of origin and size, they may often be mistaken for soft tissue sarcomas. We present the management of patients diagnosed with elastofibroma at a single institution. Methods Patients diagnosed with elastofibroma between January 1995 and January 2015 were identified from a prospectively maintained histopathology database. Electronic patient records, imaging and pathology reports were retrieved and reviewed. Results Thirty seven patients were identified, with a median age of 66 years and a male-to-female ratio of 1:1.6. All tumours occurred in the characteristic subscapular location. The median maximum tumour diameter was 8.2cm. A synchronous contralateral lesion (15.8%) was found in six patients. Cross-sectional imaging was performed in 29 patients, with magnetic resonance imaging the most common modality (59.5%). Diagnosis was confirmed with percutaneous biopsy in all but one patient, who proceeded directly to surgery. Eighteen patients were managed non-operatively; 19 opted for surgical excision due to significant symptoms. Excision was performed in a marginal fashion and, at a median follow-up of 5 months, no functional impairment or local recurrences were observed. Conclusions Soft tissue masses greater than 5cm in diameter should prompt the clinician to exclude soft tissue sarcoma. The diagnosis of elastofibroma may be alluded to by its typical presentation and can be confirmed by percutaneous biopsy. After excluding malignancy, these lesions can be safely managed non-operatively, with surgery reserved for symptomatic patients.

scholarly journals Giant scalp arteriovenous malformation

2016 ◽  
Vol 62 (9) ◽  
pp. 828-830 ◽  
Author(s):  
PAULO VALDECI WORM ◽  
LEONARDO GILMONE RUSCHEL ◽  
MARCELO ROSA ROXO ◽  
RAFAEL CAMELO
Keyword(s):  
Literature Review ◽  
Physical Examination ◽  
Arteriovenous Malformations ◽  
Surgical Excision ◽  
Computed Tomographic Angiography ◽  
External Carotid ◽  
Carotid Angiography ◽  
Computed Tomographic ◽  
The Subject ◽  
Tomographic Angiography

SUMMARY Arteriovenous malformations (AVMs) of the scalp are rare lesions. The clinical picture presents with complaints of increased scalp, scalp disfigurement, pain and neurological symptoms. Its origin can be congenital or traumatic. We present a case of giant scalp AVMs and its management, followed by a brief literature review on the subject. The diagnosis of scalp AVMs is based on physical examination and confirmed by internal and external carotid angiography or computed tomographic angiography (CTA). Surgical excision is especially effective in scalp AVMs, and is the most frequently used treatment modality.

Intraoperative color-flow Doppler imaging of AVM's and aneurysms

1988 ◽  
Vol 68 (4) ◽  
pp. 635-639 ◽  
Author(s):  
Keith L. Black ◽  
Jonathan M. Rubin ◽  
William F. Chandler ◽  
John E. McGillicuddy
Keyword(s):  
Arteriovenous Malformations ◽  
Doppler Sonography ◽  
Giant Aneurysm ◽  
Surgical Excision ◽  
Doppler Imaging ◽  
Vascular Lesions ◽  
Color Flow ◽  
Content Type ◽  
Color Flow Doppler Sonography ◽  
Spinal Arteriovenous Malformations

✓ The use of intraoperative color-flow Doppler sonography to image cerebral and spinal arteriovenous malformations (AVM's) and a giant aneurysm is reported in 10 patients. The technique is a useful adjunct in localizing vascular lesions, identifying feeding or draining vessels, and confirming intraoperative surgical excision of AVM's or ligation of giant aneurysms. Imaging of lesions deeper than 4 to 5 cm is, however, limited with the equipment design now commercially available.

scholarly journals Giant epidermal cyst of the foot

2014 ◽  
Vol 142 (9-10) ◽  
pp. 607-609 ◽  
Author(s):  
Melih Malkoc ◽  
Özgür Korkmaz ◽  
Yıldıray Genç ◽  
Ferhat Say ◽  
Mahmut Aytekin
Keyword(s):  
Soft Tissue ◽  
Epidermoid Cyst ◽  
Soft Tissue Mass ◽  
Surgical Excision ◽  
Epidermal Cyst ◽  
Pathology Report ◽  
X Rays ◽  
Tissue Mass ◽  
Palpable Mass ◽  
Soft Tissue Masses

Introduction. Epidermoid inclusion cysts are usually composed of epidermal elements implanted into the dermal layers. Patients are seen in the outpatient clinics with a mass. Most of the complaints are mechanical and cosmetic problems. Case Outline. A 34-year-old female patient was admitted to our clinic because of swelling and pain in her right foot. A palpable mass was detected in the first web. On the x-rays of the foot no osseous lesion was detected. There was a soft tissue mass in the first web according to MRI report. Soft tissue mass was excised and sent to pathology. According to pathology report the mass was an epidermoid cyst 5?2?1.5 cm in size. There were no problems during follow-up of the patient for 6 months after surgery. The patient had no swelling in the foot and had no additional complaints on checkup. Conclusion. In the differential diagnosis, we should take into consideration epidermoid cyst of large soft tissue masses of the foot. Surgical excision should be done within the appropriate limits.

scholarly journals Lipoblastomas and liposarcomas in paediatric patients: A case series

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052098136
Author(s):  
Joyce J.L.H McRae ◽  
Asra Hashmi ◽  
Andrei Radulescu ◽  
Cody S. Carter ◽  
Faraz A. Khan
Keyword(s):  
Soft Tissue ◽  
Histological Examination ◽  
Clinical Case ◽  
Soft Tissue Mass ◽  
Case Series ◽  
Surgical Excision ◽  
Tissue Mass ◽  
Paediatric Patients ◽  
Soft Tissue Masses

Lipoblastomas and liposarcomas are rare causes of soft tissue masses in paediatric patients. In this retrospective clinical case series we identified 11 patients from our paediatric database (10 with a lipoblastoma and one with a liposarcoma) who had attended our hospital between 1998 and 2019. The median age of patients with lipoblastoma was 29 months. All lipoblastoma cases were managed with surgical excision and histological examination. The 18-year old patient with liposarcoma presented with a metastatic and unresectable tumour that was unresponsive to chemotherapy and radiation. Our experience demonstrates the importance of differentiating the type of soft tissue mass in children.

scholarly journals Simple Stepwise Approach to Differentiate Cyst-Like Soft-Tissue Masses by Using Time-Resolved Magnetic Resonance Angiography

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1094
Author(s):  
Ying-Chieh Lai ◽  
Yu-Hsiang Juan ◽  
Shu-Hang Ng ◽  
Tzu-Chin Lo ◽  
Wen-Yu Chuang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Magnetic Resonance Angiography ◽  
Odds Ratio ◽  
Vascular Lesions ◽  
Time Resolved ◽  
Occult Lesion ◽  
Soft Tissue Masses ◽  
Diagnostic Flowchart ◽  
The Masses ◽  
Solid Lesions

This retrospective study aimed to differentiate cyst-like musculoskeletal soft-tissue masses by using time-resolved magnetic resonance angiography (MRA). During May 2015 to November 2019, patients with cyst-like soft-tissue masses examined through contrast-enhanced MRI followed by histologic diagnosis were included. The masses were classified into vascular lesions, solid lesions, and true cysts. Size, T1 hyperintensity, T2 composition, perilesional edema, time-resolved MRA, and static internal enhancement were assessed. The time-resolved MRA manifestations were classified into vascular pooling, solid stain, and occult lesion. Imaging predictors for each type of mass were identified through logistic regression and were used to develop a diagnostic flowchart. A total of 80 patients (47 men; median age, 42 years) were included, with 22 vascular lesions, 38 solid lesions, and 20 true cysts. The T2 composition, time-resolved MRA, and static internal enhancement were significantly different among the masses. Vascular pooling on time-resolved MRA was the sole predictor of vascular lesions (odds ratio = 722.0, p < 0.001). Solid stain on time-resolved MRA was the sole predictor of solid lesions (odds ratio = 73.6, p < 0.001). Occult lesion on time-resolved MRA (odds ratio = 7.4, p = 0.001) and absence of static internal enhancement (odds ratio = 80.0, p < 0.001) both predicted true cysts, while the latter was the sole predictor of true cysts after multivariate analysis. A diagnostic flowchart based on time-resolved MRA correctly classified 89% of the masses. In conclusion, time-resolved MRA accurately differentiates cyst-like soft-tissue masses and provides guidance for management.

scholarly journals The safety of primary surgical excision of small deep indeterminate musculoskeletal soft tissue masses

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200713
Author(s):  
Michèle Calleja ◽  
Qasim Afzaal ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Residual Disease ◽  
Surgical Excision ◽  
Lesion Size ◽  
Safe Procedure ◽  
Deep Soft Tissue ◽  
Tissue Mass ◽  
Oncology Service ◽  
Soft Tissue Masses ◽  
Musculoskeletal Oncology

Objective: To determine the suitability of primary excision of small indeterminate deep soft tissue masses presenting to a tertiary musculoskeletal oncology service. Methods and materials: Review of all patients referred to a specialist musculoskeletal oncology service over a 20-month period with a deep indeterminate soft tissue mass by non-contrast MRI criteria that was recommended for primary surgical excision due to relatively small size (<30 mm). Data collected included age, gender, site and maximal size of the lesion, and final histological diagnosis for excised lesions. Results: 85 patients were included, mean lesion size being 12 mm (range 5–29 mm). Primary surgical resection had been undertaken in 69 cases (81.2%) by the conclusion of data collection, 36 males and 33 females with mean age of 45.6 years (range 11–80 years). Of these, 11 cases (15.9%) were non-neoplastic, 53 (76.8%) were benign, 1 (1.4%) was intermediate grade, while 4 (5.8%) were malignant including 3 synovial sarcomas. Two of these were treated with re-excision of the tumour bed showing no residual disease, with no evidence of local recurrence at a mean of 10.7 months post-excision. Conclusion: Primary surgical excision of small deep soft tissue masses that are indeterminate by non-contrast MRI criteria is considered a safe procedure when undertaken in a specialist musculoskeletal oncology service, with only 4 of 69 cases (5.8%) being malignant. Advances in knowledge: Small indeterminate deep soft tissue masses can safely be treated with primary excision in the setting of a specialist musculoskeletal oncology service.

scholarly journals Soft tissue masses: distribution of entities and rate of malignancy in small lesions

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Felix G. Gassert ◽  
Florian T. Gassert ◽  
Katja Specht ◽  
Carolin Knebel ◽  
Ulrich Lenze ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Benign Lesion ◽  
Maximum Diameter ◽  
Histopathological Diagnosis ◽  
Tumor Diameter ◽  
Mr Images ◽  
Tissue Mass ◽  
Malignancy Rate ◽  
Significant Difference ◽  
Soft Tissue Masses

Abstract Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

scholarly journals Overview of Neo-Vascular Lesions after Delivery or Miscarriage

2021 ◽  
Vol 10 (5) ◽  
pp. 1084
Author(s):  
Yuji Shiina
Keyword(s):  
Arteriovenous Malformations ◽  
Uterine Artery ◽  
Spontaneous Regression ◽  
Vascular Diseases ◽  
Vascular Lesions ◽  
Artery Pseudoaneurysm ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Uterine Artery Pseudoaneurysm ◽  
Retained Products

The concept of intrauterine neo-vascular lesions after pregnancy, initially called placental polyps, has changed gradually. Now, based on diagnostic imaging, such lesions are defined as retained products of conception (RPOC) with vascularization. The lesions appear after delivery or miscarriage, and they are accompanied by frequent abundant vascularization in the myometrium attached to the remnant. Many of these vascular lesions have been reported to resolve spontaneously within a few months. Acquired arteriovenous malformations (AVMs) must be considered in the differential diagnosis of RPOC with vascularization. AVMs are errors of morphogenesis. The lesions start to be constructed at the time of placenta formation. These lesions do not show spontaneous regression. Although these two lesions are recognized as neo-vascular lesions, neo-vascular lesions on imaging may represent conditions other than these two lesions (e.g., peritrophoblastic flow, uterine artery pseudoaneurysm, and villous-derived malignancies). Detecting vasculature at the placenta–myometrium interface and classifying vascular diseases according to hemodynamics in the remnant would facilitate the development of specific treatments.

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