Intraosseous Venous Malformations of the Facial Bone: A Retrospective Study in 11 Patients

2012 ◽  
Vol 28 (5) ◽  
pp. 257-263 ◽  
Author(s):  
C Zhu ◽  
H G Zhu ◽  
Z Y Zhang ◽  
L Z Wang ◽  
J W Zheng ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Binary Classification ◽  
Venous Malformation ◽  
Surgical Techniques ◽  
Odontogenic Cysts ◽  
Venous Malformations ◽  
Facial Bone ◽  
En Bloc ◽  
Promising Alternative ◽  
Ct Features

Objectives: To investigate the clinical symptoms, computed tomography (CT) features and treatments of intraosseous venous malformations (IVM) that occur in the facial bone. Methods and Results: Eleven patients with facial IVM were treated with two surgical techniques, excision ( n = 4) or curettage ( n = 7). No recurrence was encountered at follow-up (45.8 ± 16.0 months). Postoperative deformities were left in two paediatric patients who were treated with excision. Conclusions: The diagnosis of IVM can be difficult and is mainly based on clinical symptoms and CT features. IVM should be differentiated from other lesions, including ameloblastoma, odontogenic cysts, osteosarcoma, aneurysmal bone cysts and arteriovenous malformations, among others. Conventional block biopsy should be replaced by fine needle aspiration cytology for further diagnosis. Curettage is a more appropriate method for IVM compared with excessive en-bloc osteotomy, while transosseous embolo-sclerotherapy may be a promising alternative method. Finally, the terminological confusion between ‘intraosseous haemangioma’ and ‘intraosseous venous malformation’ should be avoided according to the binary classification.

Operative management of equinus associated with lower limb venous malformations

2021 ◽  
pp. 026835552110472
Author(s):  
Li Hu ◽  
Hui Chen ◽  
Xi Yang ◽  
Yi Sun ◽  
Hongyuan Liu ◽  
...  
Keyword(s):  
Lower Limb ◽  
Clinical Symptoms ◽  
Venous Malformation ◽  
Operative Management ◽  
Venous Malformations ◽  
Optimal Outcomes ◽  
Percutaneous Sclerotherapy ◽  
Experienced Pain ◽  
Male Patients

Objectives Functional impairment is a common complaint in patients with venous malformations. Equinus can occur when the venous malformation involves the lower limb, a challenging condition with only a few studies to guide treatment choices. This study was aimed to investigate the operative management of equinus associated with lower limb venous malformations. Method Between August 2015 and September 2017, a total of 12 patients presented with equinus associated with lower limb venous malformations and underwent surgical correction. Preoperative and postoperative clinical symptoms, physical examination and orthopaedic evaluation were retrospectively reviewed. 8 patients who experienced pain underwent percutaneous sclerotherapy prior to the operation. Surgical management included gastrocnemius intramuscular aponeurotic recession, Z-lengthening of the Achilles tendon, Hoke technique and Taylor Spatial Frame external fixation. Results There were eight female and four male patients with a mean age of 14.3 ± 5.9 years. The mean follow-up period was 34.8 ± 9 months. The range of motion of ankle dorsiflexion (with knee extended) improved for each patient (mean, 25.4 degrees; standard deviation, 8.5 degrees). No neurovascular complications were observed. Conclusion Operative correction of equinus associated with lower limb venous malformations is safe and effective. Selective preoperative sclerotherapy is necessary for optimal outcomes.

Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 477-483
Author(s):  
Robert Karl Clemens ◽  
Frederic Baumann ◽  
Marc Husmann ◽  
Thomas Oleg Meier ◽  
Christoph Thalhammer ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Venous Malformation ◽  
Primary Treatment ◽  
Venous Malformations ◽  
Treated Area ◽  
Item Questionnaire ◽  
Percutaneous Sclerotherapy ◽  
Multiple Treatments ◽  
Pain Improvement

Abstract. Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in significant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.

En bloc transurethral resection of bladder tumor: A review of the literature

2021 ◽  
pp. 205141582199373
Author(s):  
Jonathan Kopel ◽  
Pranav Sharma
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Clinical Stage ◽  
Surgical Techniques ◽  
Cancer Recurrence ◽  
En Bloc ◽  
Level Of Evidence ◽  
Alternative Technologies ◽  
Bladder Cancer Recurrence

Bladder cancer remains one of the most common malignancies of the genitourinary tract. Transurethral resection of the bladder tumor (TURBT) via cystoscopy with examination under anesthesia remains the primary method for determining the diagnosis and clinical stage of bladder cancer. Given the substantial cost of treatment and risk of bladder cancer recurrence after TURBT, novel approaches to transurethral resection, such as the en bloc technique, have been developed in an attempt to address these limitations. In this review, we examined the postoperative and oncological outcomes of en bloc TURBT compared to traditional resection techniques. Further prospective clinical studies, however, are still necessary to determine whether these alternative technologies or surgical techniques may improve treatment in bladder cancer patients. Level of evidence: Not applicable.

Clinical value of classification of venous malformations with contrast-enhanced MR Angiography

2016 ◽  
Vol 32 (9) ◽  
pp. 628-633 ◽  
Author(s):  
Ahmed Abdel Khalek Abdel Razek ◽  
Germeen Ashmalla Albair ◽  
Sieza Samir
Keyword(s):  
Mr Angiography ◽  
Treatment Plan ◽  
Venous Malformation ◽  
Observer Agreement ◽  
Type I ◽  
Venous Malformations ◽  
Single Measure ◽  
Intra Class Correlation ◽  
Contrast Enhanced

Aim To classify venous malformations based on contrast-enhanced MR angiography that may serve as a basis for treatment plan. Patients and methods A retrospective analysis was performed in 58 patients with venous malformations who underwent contrast-enhanced MR angiography. Venous malformations were classified according to their venous drainage into: type I, isolated malformation without peripheral drainage; type II, malformation that drains into normal veins; type III, malformation that drains into dilated veins; and type IV, malformation that represents dysplastic venous ectasia. Image analysis was done by two reviewers. Intra and inter-observer agreement of both reviewers and intra-class correlation was done. Results The intra-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for the first reviewer ( k = 0.83, 95% CI = 0.724–0.951, P = 0.001) and substantial for the second reviewer ( K = 0.79, 95% CI = 0.656-0.931, P = 0.001). The inter-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for both reviewers at the first time ( K = 0.96, 95% CI = 0.933–1.000, P = 0.001) and second time ( k = 0.81, 95% CI = 0.678–0.942, P = 0.001). There was high intra-class correlation of both reviewers for single measure ( ICC = 0.85, 95% CI = 0.776–0.918, P = 0.001) and for average measures ( ICC = 0.96, 95% CI = 0.933–0.978, P = 0.001). Conclusion Contrast-enhanced MR angiography classification of venous malformations may be a useful, simple and reliable tool to accurately classify venous malformation and this topographic classification helps for better management strategy.

scholarly journals Mobile spine chordoma: results of 166 patients from the AOSpine Knowledge Forum Tumor database

2016 ◽  
Vol 24 (4) ◽  
pp. 644-651 ◽  
Author(s):  
Ziya L. Gokaslan ◽  
Patricia L. Zadnik ◽  
Daniel M. Sciubba ◽  
Niccole Germscheid ◽  
C. Rory Goodwin ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Survival Data ◽  
Large Scale ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Increased Risk ◽  
Significant Difference ◽  
Mobile Spine

OBJECT A chordoma is an indolent primary spinal tumor that has devastating effects on the patient's life. These lesions are chemoresistant, resistant to conventional radiotherapy, and moderately sensitive to proton therapy; however, en bloc resection remains the preferred treatment for optimizing patient outcomes. While multiple small and largely retrospective studies have investigated the outcomes following en bloc resection of chordomas in the sacrum, there have been few large-scale studies on patients with chordomas of the mobile spine. The goal of this study was to review the outcomes of surgically treated patients with mobile spine chordomas at multiple international centers with respect to local recurrence and survival. This multiinstitutional retrospective study collected data between 1988 and 2012 about prognosis-predicting factors, including various clinical characteristics and surgical techniques for mobile spine chordoma. Tumors were classified according to the Enneking principles and analyzed in 2 treatment cohorts: Enneking-appropriate (EA) and Enneking-inappropriate (EI) cohorts. Patients were categorized as EA when the final pathological assessment of the margin matched the Enneking recommendation; otherwise, they were categorized as EI. METHODS Descriptive statistics were used to summarize the data (Student t-test, chi-square, and Fisher exact tests). Recurrence and survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariate Cox proportional hazard modeling. RESULTS A total of 166 patients (55 female and 111 male patients) with mobile spine chordoma were included. The median patient follow-up was 2.6 years (range 1 day to 22.5 years). Fifty-eight (41%) patients were EA and 84 (59%) patients were EI. The type of biopsy (p < 0.001), spinal location (p = 0.018), and if the patient received adjuvant therapy (p < 0.001) were significantly different between the 2 cohorts. Overall, 58 (35%) patients developed local recurrence and 57 (34%) patients died. Median survival was 7.0 years postoperative: 8.4 years postoperative for EA patients and 6.4 years postoperative for EI patients (p = 0.023). The multivariate analysis showed that the EI cohort was significantly associated with an increased risk of local recurrence in comparison with the EA cohort (HR 7.02; 95% CI 2.96–16.6; p < 0.001), although no significant difference in survival was observed. CONCLUSIONS EA resection plays a major role in decreasing the risk for local recurrence in patients with chordoma of the mobile spine.

scholarly journals Venous malformation and Sodium tetra decyl sulphate as sclerosant: a treatment option

2020 ◽  
pp. 1-3
Author(s):  
Asif Iqbal Shaikh ◽  
Imran Ahmad ◽  
M. Fahud Khurram ◽  
Lalit Agrawal
Keyword(s):  
Treatment Option ◽  
Venous Malformation ◽  
Vascular Lesion ◽  
Treatment Modalities ◽  
Venous Malformations ◽  
Variable Presentation

Venous malformations are common vascular lesion with variable presentation. They are benign but sometimes troublesome because of their location, size, bleeding. There are various treatment modalities available and different patients are benefitted with different modality. Sclerotherapy is good nonsurgical means of treatment. This study is undertaken to further explore the utility of sodium tetra decyl sulphate as a sclerosant for venous malformation.

Intramuscular venous malformations of the calf: Surgical treatment outcomes of 57 patients

2020 ◽  
Vol 35 (8) ◽  
pp. 597-604
Author(s):  
Claude Laurian ◽  
Pierre Cerceau ◽  
Nikos Paraskevas ◽  
Claudine Massoni ◽  
Veronique Marteau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Venous Malformation ◽  
Functional Limitation ◽  
Venous Malformations ◽  
Complete Excision ◽  
Muscle Involvement ◽  
Residual Functional

Objectives To report the outcomes of surgical treatment of calf intramuscular venous malformations (IMVMs) on pain, functional limitation, and quality of life. Methods We retrospectively reviewed 57 consecutive patients who had surgery for IMVM of the posterior compartment of the leg between 2010 and 2015. Treatments were all done at a single institution. Results Patients presented with pain (52), muscle contracture (14), or pulmonary embolism (4). Muscle involvement included the soleus muscle (n = 28, 49%), the gastrocnemius muscle (n = 25, 43%), and deep muscles (n = 4, 7%). Complete excision was possible in 52 patients (91%) and partial excision in 5 (9%). Thirty-five of 46 patients who had an MRI follow-up at six months had no residual venous malformation. At the final follow-up (mean 39 months), 32 of 40 patients seen had no residual pain and 37 had no residual functional impairment. Conclusion In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life.

scholarly journals Outcomes of Venous Malformation Sclerotherapy: A Review of Study Methodology and Long-Term Results

2017 ◽  
Vol 34 (03) ◽  
pp. 288-293 ◽  
Author(s):  
Sumera Ali ◽  
Sally Mitchell
Keyword(s):  
Venous Malformation ◽  
Long Term Results ◽  
International Studies ◽  
Venous Malformations ◽  
Long Term Outcomes ◽  
Relative Paucity ◽  
Study Methodology ◽  
Grading Scales

AbstractIt is very important that patients seeking sclerotherapy for the treatment of venous malformations are aware of the expected course of the therapy. They should be thoroughly counseled about the complications, the need for multiple sessions of therapy, and also about the expected clinical outcome. The aim of this review is to discuss the long-term outcomes of sclerotherapy for the treatment of venous malformation. Many studies have discussed their individual center's experiences and short-midterm results, but there is a relative paucity of data on long-term outcomes. We have reviewed the literature and also shared our experience of a large cohort of patients (n = 116) with a relatively longer follow-up period of more than 1 year. Venous malformations are very complex lesions and their treatment is quite variable depending on its extent and complexity. As a result, outcome studies vary considerably in the choice of sclerosant, study methodology, outcome assessment (clinical vs. imaging), and grading scales. This review also highlights this extreme heterogeneity in the literature of the sclerotherapy outcome and summarizes a few national and international studies for comparison.

scholarly journals Intra-articular venous malformation of the knee in children: magnetic resonance imaging findings and significance of synovial involvement

2019 ◽  
Vol 50 (4) ◽  
pp. 509-515 ◽  
Author(s):  
Katariina A. Mattila ◽  
Johanna Aronniemi ◽  
Päivi Salminen ◽  
Risto J. Rintala ◽  
Kristiina Kyrklund
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Pain ◽  
Venous Malformation ◽  
Cartilage Damage ◽  
Venous Malformations ◽  
Resonance Imaging ◽  
Cutaneous Manifestations ◽  
Timely Diagnosis ◽  
Clinical Awareness

Abstract Background Intra-articular venous malformations of the knee are an uncommon cause of unilateral knee pain in children. Timely diagnosis is important because lesions with intrasynovial involvement can lead to joint space hemorrhage and secondary cartilage damage. Objective To describe our tertiary center’s experience of diagnostics and typical magnetic resonance imaging (MRI) findings. Materials and methods A retrospective review of all patients ≤16 years of age managed for intra-articular venous malformations of the knee at our institution between 2002 and 2018. Results Of 14 patients (8 male), the mean age at presentation was 6 years (range: 0–14 years). The most common clinical findings were unilateral knee pain (93%), joint swelling (79%), quadriceps atrophy (50%) and a limited range of motion (29%). Cutaneous manifestations were present in four patients (29%). Contrast-enhanced MRI was available in all cases. After initial MRI, a vascular anomaly etiology had been identified in 11 cases (79%), and correctly reported as a venous malformation in 6 (55%). Three patients received entirely different diagnoses (arthritis, tumor or pigmented villonodular synovitis). Three of seven patients with intrasynovial lesions had established chondropathy at diagnosis. Two patients with lesions of the suprapatellar fat pad had intrasynovial involvement that was not visualised on MRI. Conclusion Although MRI usually permits the diagnosis, clinical awareness of these lesions is important for optimal imaging, accurate interpretation and timely diagnosis. Involvement of the intrasynovial cavity carries a risk of hemarthrosis and progressive chondropathy that may be underestimated by MRI.

scholarly journals Parathyroid Carcinoma: An Up-to-Date Retrospective Multicentric Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Francesco Quaglino ◽  
Luca Manfrino ◽  
Luca Cestino ◽  
Massimo Giusti ◽  
Enrico Mazza ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Parathyroid Carcinoma ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Region Data ◽  
Males And Females ◽  
Cancer Network ◽  
Multiple Symptoms

Parathyroid carcinoma (PC) is a rare disease responsible for about 1% of primary hyperparathyroidism (PHPT) cases. PC usually has an indolent course, tough to differentiate from the benign causes of PHPT, and the only certain diagnosis is histologic. The gold standard surgical treatment is the en bloc resection associated with the homolateral thyroid loboistmectomy. The aim of this study was to underline the main differences between PC and benign PHPT, along with gathering epidemiological knowledge relative to PC in our region. Data from the regional cancer network (Rete Oncologica del Piemonte e della Valle d’Aosta) since 2007 have been reported, including 21 patients from three hospitals (AO S. Croce e Carle of Cuneo, AOU Città della Salute of Turin, and ASL Città di Torino). The incidence of the disease, gender, age at time of diagnosis, presence of renal and bone symptoms, serum calcium and PTH levels, surgical technique performed, and percentage of recurrence were analysed. PC data were than compared with a series of patients affected by benign PHPT, referred to ASL Città di Torino, Maria Vittoria Hospital, from 2007 to 2019. A PC incidence of 0.05 cases per 100,000 inhabitants was found in our region. Benign forms occurred more frequently in females (p=0.0002), while PC equally occurred in males and females and affected younger patients (p=0.026). Serum calcium and PTH levels were significantly higher in PC patients; accordingly, typical PHPT symptoms were more frequently reported in PC than in benign PHPT. In the PC group, the en bloc resection shows a 13 times lower risk for relapse compared with all the other surgical techniques. PC is equally gender distributed, and the average patients’ age is in the fifth decade of life. It is usually functioning, with greater biochemical activity and multiple symptoms. A not-radical surgical resection is associated with a higher recurrence rate. A meticulous presurgical evaluation of PHPT patients showing PC’s evocative features is mandatory to obtain a complete disease extirpation.

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