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Query: UMLS:C0030193 (pain)
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The incidence of intraosseous haemangiomas is very low. The mandible, the zygoma, the maxilla and the frontal bone are the most frequent areas of localization in the craniomaxillofacial region. Pain and swelling are the most important symptoms of these tumors when they are localized in the orbit or in zygoma. Surgery, without preoperative embolization is always the best treatment for intraosseous haemangiomas of the zygoma. The radical removal of the tumor frequently causes a plain aesthetical loss which has to be restored. Calvarial grafts are a good solution to the problem of reconstruction of bone loss. They are easy to prepare, near to the implant zone, and they don't need changes of the patient's position during the operation. The implants fixed by mini- and micro-fixation systems provide a good functional and aesthetical result. The authors, after a review of the literature about intraosseous haemangiomas of the cranio-maxillofacial region, report two cases of intraosseous haemangioma of the zygoma in which removal of the tumor and reconstruction with calvarial grafts has been performed.
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PMID:[Surgical treatment of hemangioma of bones of the orbito-zygomatic region]. 798 35

Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients no. 1 and 2 were females aged 64 and 71 years, respectively; patient no. 1 had a two-year history of weakness in the lower limbs and patient no. 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient no. 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (no. 1) developed intercostal neuralgia of several hours duration after the procedure. All three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Value of vertebroplasty combined with surgical decompression in the treatment of aggressive spinal angioma. Apropos of 3 cases]. 800 Mar 96

Tufted angioma or angioblastoma of Nakagawa is a rare vascular tumor that usually appears in early childhood. It frequently is seen as an erythematous to red-brown, frequently indurated plaque that usually occurs on the trunk or neck. Typically tufted angiomas enlarge for a few years and then cease growing and remain stable. Histopathologic findings are pathognomonic. We describe a patient with a tufted angioma of the thigh who sought treatment for paroxysmal episodes of pain. Treatment with topical clobetasol propionate resulted in a decreased frequency of painful episodes.
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PMID:Tufted angioma of the thigh. 803 93

The surface-based hemangioma of bone is an uncommon cause of periosteal- or cortical-based lesions. The files of the Armed Forces Institute of Pathology were searched for lesions diagnosed as cortical hemangioma or periosteal hemangioma received between the years 1950 and 1990; 11 cases with follow-up results were identified. The 11 patients ranged in age from 11 to 31 years of age at the time of initial symptoms (average, 21 years; mean, 23 years). Sixty percent of the patients were male and 40% were female. Skeletal sites of involvement included the tibia (45%), the fibula (36%), the femur (9%), and the ulna (9%). Seventy percent of patients complained initially of pain (duration, two months to five years), whereas 30% reported pain and a mass at the time of initial diagnosis (duration, six months to two years). On plain film radiographs, eight lesions showed localized cortical thickening, two showed cortical erosion, and one had a permeative/destructive pattern. Bone scans showed solitary lesions with increased uptake in all 11 patients. The range of histologic types of cortical hemangioma included cavernous (six cases), arteriovenous (three cases), venous (one case), and pyogenic granuloma type (one case). Clinically, the majority of cases were diagnosed as osteoid osteomas; primary pathologic diagnoses included hemangioma (27%) and cortical sclerosis (18%). Persistent complaints were reported in three patients after intralesional biopsy; no recurrences were reported after en bloc excision.
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PMID:Surface-based hemangiomas of bone. A review of 11 cases. 813 41

We reviewed the consultation files of the ARmed Forces Institute of Pathology for 1951 through 1989 and identified fourteen patients who had had skeletal-extraskeletal angiomatosis. Skeletal-extraskeletal angiomatosis was defined as a benign vascular proliferation involving the medullary cavity of bone and at least one other type of tissue. The age of the patients at the time of initial biopsy ranged from nine months to sixty-nine years (average, twenty-two years; median, ten years). Ten of the patients were male and four were female. The presenting signs and symptoms were highly variable; they included pain (four patients), a mass noted at birth (three patients), a painless mass that developed after birth (two patients), both pain and a mass (one patient), a localized deformity of the thoracic spine (one patient), and anemia associated with chronic bleeding of the gastrointestinal tract (one patient); in this last patient, skeletal lesions subsequently were found and biopsied. Skeletal-extraskeletal angiomatosis was an incidental finding in the remaining two patients. Multiple bones were involved in thirteen of the fourteen patients. Histologically, three patterns of lesion could be identified: cavernous lymphangioma (six patients), cavernous hemangioma (six patients), and arteriovenous hemangioma (two patients). Five of the patients died (three of sepsis associated with persistent lesions of angiomatosis and two of unrelated causes); eight of the patients survived but had residual disease, and one survived and had no evidence of residual disease.
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PMID:Skeletal-extraskeletal angiomatosis. A clinicopathological study of fourteen patients and nosologic considerations. 820 Aug 95

A 28-year-old Japanese man was admitted to our institute because of sharp anal pain and a mass that prolapsed from the anus after defecation. After spinal anesthesia for emergency operation, the mass spontaneously withdrew into the anus and the pain disappeared. Surgery was postponed. Barium enema and colonoscopy revealed a pedunculated polyp in the sigmoid colon, which was removed by snare polypectomy with electrocautery. The resected polyp was granular and reddish, and measured 33 x 22 x 14 mm. Histological examination of the polyp revealed a cavernous hemangioma. Hemangioma of the colon is rare; only 52 cases have been reported in Japan. Of these patients, eight underwent endoscopic polypectomy. The present lesion is the largest thus treated that has been documented. Endoscopic polypectomy seems to be a safe and preferable procedure for the diagnosis and treatment of small, solitary polypoid hemangiomas of the colon.
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PMID:A case of polypoid cavernous hemangioma of the sigmoid colon excised by colonoscopic polypectomy. 822 23

We report on a 44-year-old male with primary cardiac angiosarcoma who died 11 months after onset of nonspecific symptoms (thoracic pain and general fatigue) of intracerebral metastases. A right atrial tumor mass and a pericardial effusion could be demonstrated by transthoracic and transesophageal echocardiography. Cardiac angiography showed a right atrial hemangioma, fed by the right coronary artery. In a review of 108 cases of primary cardiac angiosarcoma we summarize clinical features, diagnostic means, therapeutic approaches and life expectancy of this rare disease.
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PMID:Primary angiosarcoma of the heart. Report of a case and review of the literature. 830 53

True synovial-based hemangiomas are uncommon lesions and, as such, may enter the differential diagnosis of other lesions encountered more frequently in clinical practice, including pigmented villonodular synovitis and traumatic hemarthrosis. The consultation files of the Armed Forces Institute of Pathology were searched for benign vascular lesions diagnosed as synovial or bursal hemangiomas vascular lesions diagnosed as synovial or bursal hemangiomas submitted between the years 1960 and 1985; 20 cases of synovial hemangioma were identified. The patients ranged in age from 9 to 49 years at the time of presentation (average age, 25 years). Sixty-five percent of the patients were male; 35% were female. Presenting symptoms included pain and swelling (31%), pain alone (31%), and a painless mass (31%). Affected regions included the knee (60%), the elbow (30%), and the finger (10%). In 65% of cases the lesion was confined to the intra-articular synovium; in 30% of cases the hemangioma was located in a bursa adjacent to a joint. One case was located largely within the joint cavity but had an area of extension into the suprapatellar recess. The dominant histologic patterns included cavernous hemangioma (50%), lobular capillary hemangioma (25%), arteriovenous hemangioma (20%), and venous hemangioma (5%). One lesion (which had been incompletely excised) was removed in its entirety 3 months after the initial subtotal resection; otherwise, none of the patients studied developed recurrent disease. The clinical diagnosis of hemangioma was made in 22% of cases, while an initial pathologic diagnosis of hemangioma was reached in 67% of cases. Pathologic differential diagnostic considerations include nonspecific synovitis/bursitis, pigmented villonodular synovitis, nodular synovitis, and organizing hemorrhage. A relationship between synovial hemangioma and pigmented villonodular synovitis was not suggested by this analysis of our material.
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PMID:Synovial hemangioma: a report of 20 cases with differential diagnostic considerations. 824 30

We reported a case of migraine with aura associated with meningioma. A 66-year-old female visited to our department in 1985, with occipital throbbing pain following visual hallucination and nausea. She had been diagnosed as migraine. CT scan, magnetic resonance image and angiography showed a right occipital tumor, which was totally removed in 1990. Postoperatively, the migraine disappeared completely. The tumor was histologically diagnosed as fibroblastic meningioma. We supposed that the migraine had been associated with meningioma. Although some previous papers reported correlation with brain tumor and migraine, as example of arteriovenous malformation or angioma, migraine associated with meningioma is very rare. In arteriovenous malformation, pathophysiology of migraine is unclear, but induction of circulatory disturbance in the distribution of the posterior cerebral, posterior communicating and basilar artery is supposed. And then a space occupying lesion in the occipital lobe is possible to cause in the circulatory disturbance of the posterior cerebral and basilar artery. In the diagnosis of migraine, we should consider its relation to brain tumors, such as meningioma.
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PMID:[A case of migraine with aura associated with meningioma]. 837 Feb 1

Fifty-nine cases of vertebral hemangioma were seen at the Mayo Clinic between 1980 and 1990. Vertebral hemangiomas were discovered incidentally in 35 patients, while pain was the presenting complaint in 13 patients. Five patients presented directly with progressive neurological deficit requiring surgery, and six patients had surgery elsewhere for spinal cord compression and were referred for follow-up evaluation. To better define the natural history of these lesions, a historical review of these patients was conducted; progression of an asymptomatic or painful lesion to neurological symptoms was found in only two cases (mean follow-up period 7.4 years, range 1 to 35 years). New-onset back pain followed by subacute progression (mean time to progression 4.4 months, range 0.25 to 12 months) of a thoracic myelopathy was the most common presentation for patients with neurological deficit. Initially, all 11 patients with spinal cord compression underwent decompressive surgery with full neurological recovery. Recurrent neurological symptoms were observed in three of six patients following subtotal tumor resection and postoperative administration of 1000 cGy or less radiation therapy (mean follow-up period 8.7 years, range 1 to 17 years). No recurrences were noted in four patients who had subtotal excision plus radiotherapy between 2600 and 4500 cGy. One other patient had gross total tumor removal without radiotherapy and has not had a recurrence. Based on these patients and a review of the literature, the authors recommend annual neurological and radiological examinations for patients with hemangiomas associated with pain, especially young females with thoracic lesions in whom spinal cord compression is most likely to develop. Radiation therapy or embolization is an effective therapeutic alternative for patients with severe medically refractory pain. Regular follow-up monitoring for patients with asymptomatic lesions is unnecessary unless pain develops at the appropriate spinal level. It is concluded that management of patients with a progressive neurological deficit should include preoperative angiography and embolization, decompressive surgery with the approach determined by the degree of vertebral involvement and site of spinal cord compression, and postoperative radiation therapy in patients following subtotal tumor removal. Operative management and complications are discussed.
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PMID:The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. 841 40


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