scholarly journals Multicentric epithelioid hemangioendothelioma of humerus and scapula

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
S B Dhanya ◽  
Ramakrishna Narayanan ◽  
Anu Kapoor ◽  
Shantveer G. Uppin
Keyword(s):  
Adult Population ◽  
Bone Lesion ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Adolescent Male ◽  
Lytic Lesion ◽  
Imaging Features ◽  
Post Contrast ◽  
Imaging Characteristics ◽  
The Right

Epithelioid hemangioendothelioma (EH) is a rare malignant vascular tumor occurring mainly in the liver and lungs, with bones being a rare site and primarily seen in the adult population. We present a rare case of multicentric EH in the right humerus in an adolescent male, who presented with complaints of pain and swelling in the right shoulder. Radiographs and Computed tomography showed a large expansile lytic lesion in the proximal end of the right humerus with areas of cortical destruction and matrix calcification. On Magnetic resonance imaging, the lesion was predominantly isointense on T1-weighted image, hyperintense on T2-weighted, and Short Tau Inversion Recovery images with prominent flow voids within. On post-contrast sequences, the lesion showed intense heterogenous enhancement with a non-enhancing central necrotic area. Multiple smaller lytic lesions with similar imaging characteristics were also found in the mid and distal shaft of the right humerus and the right coracoid process. Differentials of Telangiectatic osteosarcoma, Giant cell tumor, brown tumors of hyperparathyroidism, and metastasis were considered. Core biopsy revealed that the lesion was an EH. Though the imaging features of EH are non-specific, it may be considered in the differential diagnosis of an expansile lytic bone lesion with no periosteal reaction, showing cortical break and soft tissue component, especially if it is multifocal and multicentric.

scholarly journals Pubic and ischial sarcoidosis: a single bone lesion

2021 ◽  
Author(s):  
Kaoutar Imrani ◽  
Kawtar Znati ◽  
Ittimade Nassar ◽  
Nabil Moatassim Billah
Keyword(s):  
Bone Biopsy ◽  
Histological Study ◽  
Bone Lesion ◽  
Lymph Node Involvement ◽  
Lytic Lesion ◽  
Imaging Features ◽  
Pubic Ramus ◽  
Single Bone ◽  
The Right ◽  
Bone Sarcoidosis

Bone sarcoidosis is very rarely indicative of the disease. When bone lesion is associated with lung and lymph node involvement, diagnosis can be made based on clinical and imaging features. When bone lesion is isolated, it is difficult to differentiate it from bone metastases because they both have similar appearance in imaging : in this case, the diagnosis is made by bone biopsy with histological study. We report the case of a 61-year-old male with a lytic lesion of the right ischio pubic ramus which appears to be aggressive whose biopsy revealed bone sarcoidosis.

scholarly journals A Multidisciplinary Approach to the Management of Atypical Osseous Epithelioid Hemangioendothelioma

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
J. K. Ma ◽  
J. Barr ◽  
S. Vijayakumar
Keyword(s):  
Multidisciplinary Approach ◽  
Pathological Fracture ◽  
Soft Tissues ◽  
Intensity Modulated Radiation Therapy ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Histopathological Study ◽  
Incisional Biopsy ◽  
Multidisciplinary Intervention ◽  
Imaging Characteristics

Hemangioendothelioma is a rare vascular tumor of intermediate malignant potential. Though epithelioid hemangioendothelioma (EH) is commonly found in soft tissues, it has been known to be present in skeletal tissues. The authors present a case of a 50-year-old woman diagnosed with EH of the iliac bone and acetabulum, who experienced pathological fracture at presentation. This report describes a multidisciplinary approach to the management that includes initial incisional biopsy, curettage, and bone grafting, followed by Intensity Modulated Radiation Therapy. The patient finally underwent hemipelvic resection with allograft reconstruction after recurrence. Histopathological study revealed osseous EH of low mitotic activity that stained positively for CD31, CD34, vimentin, and Factor VIII. Herein, the authors discuss the imaging characteristics, histopathological aspects, cytogenetic findings, and the radiobiological behavior of osseous EH. After an aggressive multidisciplinary intervention, the patient is able to achieve local control with no evidence of distal metastatic disease.

scholarly journals Lymphangioma of popliteal fossa masquerading as Baker’s cyst

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Elamparidhi Padmanaban ◽  
Sanika Suryawanshi ◽  
Umamageswari Amirthalingam ◽  
Thara Keloth ◽  
Rintu George
Keyword(s):  
Cystic Lesion ◽  
Popliteal Fossa ◽  
Internal Derangement ◽  
Contrast Study ◽  
Imaging Features ◽  
Baker’S Cyst ◽  
Post Contrast ◽  
Baker's Cyst ◽  
Inferior Aspect ◽  
The Right

Abstract Background Lymphatic malformations are the second most common vascular malformations after venous malformations. These slow-flow lesions occur most often in the paediatric population and seldom in the extremities. We report a case of lymphangioma at the popliteal fossa in an adult who underwent complete surgical resection. Case presentation A 30-year-old male presented to the department of orthopaedics with a swelling in the right calf region. Clinically, it was suspected to be a Baker’s cyst. Ultrasound showed a multiloculated anechoic cystic lesion in the inferior aspect of popliteal fossa along the intermuscular plane with multiple internal septations. Infected Baker’s cyst was considered, and MRI was suggested for further evaluation. On MRI, the lesion measured 7.2 × 4.6 × 5.8 cm, appeared as a low signal on T1 and high signal on STIR and T2, with multiple internal septations and was situated in the inferior aspect of the right popliteal fossa along the intermuscular plane between the lateral head of gastrocnemius and soleus muscles. No obvious synovial extension. A post-contrast study showed minimal peripheral and septal enhancement. Neither internal enhancing solid components nor significant internal derangement of the knee was observed. Diagnosis of lymphangioma was considered based on the imaging features and ruling out the common differentials for cystic lesions around the knee. Wide local excision was performed. Histopathological evaluation showed multiple irregularly dilated lymphatic channels lined by flatted epithelium. The lymphatic channels were seen to be surrounded by thick fibro collagenous cyst wall with scattered congested blood vessels, skeletal muscle fibre and chronic inflammatory cells. Conclusion Lymphangioma must be included in the differential diagnosis of any cystic lesion if the lesion appears multiseptated and/or infiltrative. At the popliteal fossa, it presents as a multiseptated cyst with no synovial continuity or internal derangement of the knee.

scholarly journals Oral Epithelioid Hemangioendothelioma — Unusual Location of a Rare Entity

2017 ◽  
Vol 2 (4) ◽  
pp. 349-353
Author(s):  
Alina Iacob ◽  
Sebastian Comișel ◽  
Mariana Tilinca ◽  
Tibor Mezei ◽  
Cecilia Petrovan
Keyword(s):  
Oral Cavity ◽  
Immunohistochemical Analysis ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Rare Entity ◽  
Oncological Treatment ◽  
The Right ◽  
Ulcerative Stomatitis ◽  
Patient’S History

AbstractIntroduction:Epithelioid hemangioendothelioma is a rare, locally aggressive vascular tumor, originating from soft tissue, bone, skin, and organs such as the liver or lung, exceptionally located in the oral cavity. Most of the cases of oral epithelioid hemangioendothelioma are asymptomatic, and diagnosis is hampered by the fact that the histological features are somewhat between hemangioma and angiosarcoma, with epithelioid cells, intracytoplasmic vacuoles, low mitotic activity, and (rarely) necrosis. Immunohistochemical analysis is required to rule out carcinoma or other epithelioid vascular neoplasms.Case presentation:We present a rare case of a 59-year-old Caucasian male patient with oral epithelioid hemangioendothelioma for which clinical and cytological diagnosis was difficult, in spite of the patient’s history. The lesion was nonspecific, mimicking ulcerative stomatitis, but histological and immunohistochemical evaluation finally managed to establish the right diagnosis. Subsequently, the patient underwent surgical excision of the lesion followed by oncological treatment — chemotherapy.Conclusions:Although at first examination seemed that another lesion has developed, rigorous histology and immunohistochemistry tests proved the presence of epithelioid hemangioendothelioma, a very rare entity located in the oral cavity, which required a proper surgical and oncological approach.

scholarly journals A Case-Based Review of Cerebral Venous Infarcts With Perfusion Imaging and Comparison to Arterial Ischemic Stroke

2021 ◽  
Vol 1 ◽  
Author(s):  
Anna Y. Li ◽  
Elizabeth Tong ◽  
Vivek S. Yedavalli
Keyword(s):  
Perfusion Imaging ◽  
Adult Population ◽  
Neurological Complications ◽  
Imaging Features ◽  
Arterial Ischemic Stroke ◽  
Mr Perfusion Imaging ◽  
Imaging Characteristics ◽  
Life Threatening ◽  
Venous Infarcts ◽  
Case Based

Cerebral venous thrombosis (CVT) and cerebral venous infarcts (CVI) are diagnostic dilemmas secondary to their rarity, non-specific symptomatology at presentation, and variable imaging features. Despite its relatively infrequence, CVT is particularly prevalent in the younger adult population and is a potentially life-threatening disease with devastating neurological complications if not addressed in a timely manner. However, when treated promptly, CVT has the potential for a more reversible course and favorable prognosis than arterial ischemic strokes (AIS). The pathophysiology of CVI is distinct from that of AIS and is closely related to its potentially reversible nature. Familiarity with the conventional and variant venous anatomy, as well as the temporal evolution of imaging findings, is crucial in establishing diagnostic confidence. The use of MR perfusion imaging (MRP) and arterial spin-labeling (ASL) can potentially aid in the diagnosis of CVT/CVI via characterization of cerebral blood flow. The presence and extent of a cerebral perfusion deficit on either CT or MRI may play a role in clinical outcomes for patients with CVT, although future larger studies must be performed. This review presents a case-based overview focusing on the classic imaging characteristics of CVT and CVI in conjunction with bolus MRP and ASL findings in the adult population.

Malignant Vascular Bone Tumors

2019 ◽  
pp. 308-312
Author(s):  
G. Scott Stacy
Keyword(s):  
Bone Tumors ◽  
Malignant Tumors ◽  
Treatment Strategies ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Vascular Tumors ◽  
Bone Lesions ◽  
Imaging Features ◽  
Vascular Bone Tumors ◽  
Health Organization

The organization of vascular bone tumors can be thought of as a spectrum of disease including both benign and malignant entities. Chapter 61 focuses on the malignant tumors, which have elicited much controversy and debate. These include 2 vascular tumors of bone recognized by the World Health Organization: epithelioid hemangioendothelioma and angiosarcoma. Although there are no characteristic imaging features that would obviate the need for biopsy of these entities, they may present with multifocal bone lesions, which can suggest the diagnosis of a vascular tumor. This chapter will describe the clinical, pathophysiological, and imaging features of these malignant vascular bone tumors, with a brief mention of treatment strategies.

scholarly journals Imaging Features of Superficial and Deep Fibromatoses in the Adult Population

Sarcoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Eric A. Walker ◽  
Jonelle M. Petscavage ◽  
Pamela L. Brian ◽  
Chika Iloanusi Logie ◽  
Kenneth M. Montini ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Signal Intensity ◽  
Adult Population ◽  
Pulse Sequences ◽  
Biological Behavior ◽  
Imaging Features ◽  
Adult Type ◽  
Patient Demographics ◽  
Imaging Characteristics ◽  
Plantar Fibromatosis

The fibromatoses are a group of benign fibroblastic proliferations that vary from benign to intermediate in biological behavior. This article will discuss imaging characteristics and patient demographics of the adult type superficial (fascial) and deep (musculoaponeurotic) fibromatoses. The imaging appearance of these lesions can be characteristic (particularly when using magnetic resonance imaging). Palmar fibromatosis demonstrates multiple nodular or band-like soft tissue masses arising from the proximal palmar aponeurosis and extending along the subcutaneous tissues of the finger in parallel to the flexor tendons. T1 and T2-weighted signal intensity can vary from low (higher collagen) to intermediate (higher cellularity), similar to the other fibromatoses. Plantar fibromatosis manifests as superficial lesions along the deep plantar aponeurosis, which typically blend with the adjacent plantar musculature. Linear tails of extension (“fascial tail sign”) along the aponeurosis are frequent. Extraabdominal and abdominal wall fibromatosis often appear as a heterogeneous lesion with low signal intensity bands on all pulse sequences and linear fascial extensions (“fascial tail” sign) with MR imaging. Mesenteric fibromatosis usually demonstrates a soft tissue density on CT with radiating strands projecting into the adjacent mesenteric fat. When imaging is combined with patient demographics, a diagnosis can frequently be obtained.

scholarly journals Hepatic Epithelioid Hemangioendothelioma Presenting as an Enlarging Vascular Lesion within the Spleen

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Juliet A. Emamaullee ◽  
Klaudia Nowak ◽  
Marla Beach ◽  
Julinor Bacani ◽  
A. M. James Shapiro
Keyword(s):  
Liver Transplantation ◽  
Vascular Tumor ◽  
Current Treatment ◽  
Vascular Lesion ◽  
Epithelioid Hemangioendothelioma ◽  
Long Term Results ◽  
Imaging Features ◽  
Treatment Paradigm ◽  
Hepatic Lesions ◽  
Left Hepatic Lobectomy

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm with variable malignant potential that most often presents within the liver. Many patients present with bilobar or extrahepatic disease, and the current treatment paradigm involves liver transplantation, with favorable long term results. Up to 25% of patients are diagnosed incidentally following imaging for other indications, and confirmation of diagnosis requires histologic analysis, as there are no classical imaging features to distinguish hepatic EHE (HEHE) from other solid hepatic lesions. Here we describe a case of microscopic HEHE that was diagnosed following splenectomy for an enlarging vascular tumor within the spleen. Due to the unexpected diagnosis of EHE within the spleen and coexisting but stable appearing liver hemangiomata, a left hepatic lobectomy was performed. Explant histology revealed benign hemangiomata and diffuse, microscopic HEHE. The patient ultimately underwent liver transplantation. HEHE can be a challenging diagnosis, and this case emphasizes that any enlarging vascular lesion, even within the spleen, should prompt a high index of suspicion for HEHE in the setting of known hemangiomata.

scholarly journals Head and neck osteosarcoma: CT and MR imaging features

2020 ◽  
Vol 49 (2) ◽  
pp. 20190202
Author(s):  
Zhendong Luo ◽  
Weiguo Chen ◽  
Xinping Shen ◽  
Genggeng Qin ◽  
Jianxiang Yuan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Head And Neck ◽  
Giant Cell ◽  
High Signal ◽  
Imaging Features ◽  
Matrix Mineralization ◽  
Imaging Characteristics ◽  
Mri Features ◽  
Signal Intensities ◽  
Ct And Mri

Objective: This study aims to assess the CT and MRI features of head and neck osteosarcoma (HNO). Methods: 37 HNOs were identified, and the following imaging characteristics were reviewed on CT and MRI. Results: A total of 37 patients(age 41.5 ± 15.0 years old; 16 males, 21 females) were included in the study. Tumours occurred in the maxilla (16, 43.2%), mandible (8, 21.6%), skull base (6, 16.2%), calvarium (5, 13.5%), paranasal sinuses (1, 2.7%) and cervical soft tissue (1, 2.7%). 16 patients received radiotherapy for nasopharyngeal carcinoma. Three patients (8.1%) developed osteosarcomas related to a primary bone disease. 16 of the (43.2%) tumours demonstrated lytic density on CT scans, followed by 13 (35.1%) showing mixed density and 7 (18.9%) with sclerotic density. Matrix mineralization was present in 32 (86.5%). 3 out of 24 (12.5%) tumours showed lamellar periosteal reactions, 21 out of 24 (87.5%) showed spiculated periosteal reactions. 12 tumours showed low signal intensities on T1WI, with 16 having heterogeneous signal intensities. 10 tumours showed high signal intensities on T2WI, and 18 showed heterogeneous signal intensities. With contrast-enhanced images, 3 tumours showed homogeneous enhancement (2 osteoblastic and 1 giant cell-rich), 18 tumours showed heterogeneous enhancement (13 osteoblastic, 4 fibroblastic and 1 giant cell-rich), and 7 tumours showed peripheral enhancement (6 chondroblastic and 1 osteoblastic). These tumours were characterized by soft tissue masses with a diameter of 5.6 ± 1.8 cm. Conclusions: HNO is a rare condition and is commonly associated with previous radiation exposure. This study provides age, sex distribution, location, CT and MRI features of HNO.

scholarly journals EXPRESS: Chronic thromboembolic pulmonary hypertension following pulmonary embolism with a right ventricular thrombus: A report of two cases

2021 ◽  
pp. 204589402110136
Author(s):  
Tailong Zhang ◽  
Weitao Liang ◽  
Longrong Bian ◽  
Zhong Wu
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Imaging Features ◽  
Pulmonary Endarterectomy ◽  
Right Heart ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Right ◽  
Cardiac Masses

Right heart thrombus (RHT) accompanied by chronic thromboembolic pulmonary hypertension (CTEPH) is a rare entity. RHT may develop in the peripheral veins or in situ within the right heart chambers. The diagnosis of RHT is challenging, since its symptoms are typically non-specific and its imaging features resemble those of cardiac masses. Here, we report two cases of RHT with CTEPH that presented as right ventricular masses initially. Both patients underwent simultaneous pulmonary endarterectomy (PEA) and resection of the ventricular thrombi. Thus, when mass-like features are confirmed by imaging, RHT should be suspected in patients with CTEPH, and simultaneous RHT resection is required along with PEA.

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