|
Case#21:
Large mass like lesion the thigh
|
An
infant presented with a large soft tissue mass-like
lesion in the thigh. Reportedly the previous surgical
excision of the lesion had revealed histopathological
diagnosis of kaposiform
hemangioendothelioma. Steroid treatment was
initiated; however, the patient returned with clinical
signs of hemorrhage. Diagnostic work up revealed
severe degree low platelets, consistent with Kasabach
Merritt syndrome. Despite aggressive medical therapy,
the patient required angiographic assessment, then
transcatheter embolization.
The patient recovered completely. Kaposiform
hemangioendothelioma is associated with Kasabach
Merritt syndrome in some patients and may require
aggressive therapy. Although a surgical intervention
is needed in some patient, some benefit significantly
from transcatheter embolization. It is important to
follow these patients closely for potential bleeding
complications. |
|
Case#22:
Macrocystic cervical lymphatic malformation
("cystic hygroma"
|
patient with a progressive
enlargement in the submandibular area,
slightly right of the midline. The lesion
reportedly becomes more prominent
occasionally and barely noticeable in some
days. The patient described some
discomfort in the area. Physical
examination revealed a soft tissue prominence in
the area, soft to palpation, not sensitive to
touch, easily compressible. No thrill is noted
over the lesion to suggest a high flow anomaly.
There are no skin changes over or near the
lesion. MRI examination (not shown here)
revealed a large cyst like signal abnormality in
the area. The clinical findings, history and
imaging findings all consistent with a
macrocystic lymphatic malformation (commonly
called "cystic hygroma"). |
|
Case#23:
Mediastinal - Chest AVM
|
34
year old woman presented with significant chest pain
over the sternal area and shortness of breath.
Previous diagnostic work-up including Doppler studies
and noninvasive arteriograms - CTA (not shown here)
revealed an arteriovenous
malformation in the retrosternal area. The patient
stated that she had this chest pain for the last
several years, changing in intensity and did not
respond well to pain meds. A decision was made to
proceed with conventional arteriogram with possible transcatheter
embolization if feasible. |
