Chițac, Celesta Drăgulescu, B.
Pharyngeal haemangioma – case report
Petrescu, Alexandru Ciucă, M. Vasilca, A. We present the case of a year-old female patient, accusing oral haemorrhage and mild dysphagia. Clinical examination, flexible fibroscopy and imaging pointed to a diagnosis of a haemangioma of the right hypopharynx.
Traducere "tumor benigno" în română
A microscopic laryngoscopy procedure was carried out, with intratumoral monopolar electrocauterization which led to a complete retraction of the tumour. The postoperative evolution was favourable, with no postoperative complications or recurrence up to 1-year check-up. Keywords haemangioma, angiography, monopolar electrocauterization Rezumat Autorii prezintă cazul unei paciente în vârstă de 31 de ani care se internează în lipoma papilloma noastră pentru sângerare exteriorizată oral şi disfagie uşoară.
Pe baza examenului clinic, fibroscopic şi a investigaţiilor imagistice, se pune diagnosticul de formaţiune tumorală vasculară hipofaringiană dreaptă. Se practică prin abord microlaringoscopic electrocauterizarea intratumorală cu ac monopolar, cu retracţia până la dispariţie a hemangiomului faringian.
Evoluţia postoperatorie a fost bună, lipoma papilloma de complicaţii hemoragice sau dispnee. Nu s-a constatat recidivă tumorală la ultimul control efectuat la un an postoperator. Cuvinte cheie hemangiom angiografie cauterizare monopolară Case report Haemangiomas are benign lipoma papilloma originating in the vascular endothelium.
They represent a type of tumour rarely encountered in clinical practice, especially in the pharynx, with a small number of cases cited in literature. The lipoma papilloma represents a challenge, as there is no agreed-upon standard, due to the rarity of the disease, the variable clinical aspect, and the location of the tumour. A year-old woman consulted our clinic, accusing two episodes of oral haemorrhage, in moderate quantity, which ceased spontaneously, and mild dysphagia, lipoma papilloma occurring in the last month.
She had no record of other significant illness of herself or her family. She is a smoker and works as a clinical nurse. The physical examination and naso-pharyngeal-laryngeal fibroscopic examination revealed a lipoma papilloma sessile blueish tumour, approximately 1 cm in size, located in the right lateral hypopharyngeal wall, extending from the lower edge of the tonsil to the aryepiglottic fold Figure 1. No abnormalities were found in the larynx. Figure 1. Polylobulated sessile tumour, blueish lipoma papilloma color, with approximately 1 cm in size, situated on the right lateral hypopharinx wall Laboratory tests revealed no signs of anaemia or other pathological findings.
After contrast administration, the lesion presented intense enhancement Figures 2 a, b and c. A digital subtraction angiography was carried out, with selective injection of internal, external carotid and vertebral arteries bilaterally and thyrocervical trunk, which did not reveal any tumoral enhancement or arterial feeders which could be embolised.
Figure 2. Intravenous contrast axial CT showing intense fixation in the tumour; c.
Intravenous contrast coronal CT Figure 3. A surgical approach under general anaesthesia was decided upon. Through microscope-aided direct laryngoscopy, electrocauterization is applied via a monopolar needle inserted into the tumour, until complete lipoma papilloma of the tumour is achieved Figures 4 a, b and c.
It is worth noting that no biopsy was carried out due to the very high risk of haemorrhage. The postoperative treatment consisted of intravenous antibiotic, non-steroid anti-inflammatory drugs and haemostatic drugs.
Figure 4. Intraoperatory image, right hypopharingeal vascular tumour; b. Electrocauterisation by a monopolar lipoma papilloma inserted into the tumour; c. Figure 5. Remission of the haemangioma and edema of the margin of the epiglottis and right arytenoid Next-day fibroscopic examination showed the complete remission of lipoma papilloma vascular tumour and the presence of oedema of the right margin of the epiglottis and the right arytenoid, lipoma papilloma diminished in the following days Figure 5.
The patient was discharged 9 days after the procedure. Further follow-ups at 1, 3, 6 and 12 months did not find any recurrence of the tumour Figure 6. Figure 6. Flexible fibroscopy image of the region on the day of discharge, showing no remaining tumour Discussion Haemangiomas are a class of benign tumours of vascular origin.
They mostly develop in infants, with an incidence of 2.
Despite this, they are rarely present at the moment of birth. They are found more often in people of Caucasian descent, with a ratio of females to males.
Hemangiomul faringian – caz clinic
They often have a phase of rapid progression followed by a period of stabilization and regression until the age of 7. Haemangiomas are found much less often in adult life and they have a lipoma papilloma evolution, with progressive growth and no spontaneous involution.
Less frequently, they can be found inside the oral cavity, more lipoma papilloma on the lips or tongue, or in the nasal cavity, larynx or salivary glands. Pharyngeal localization is very rare, as there are a relatively small number of cases presented in literature. The macroscopic aspect of a haemangioma is a globular tumour that is reddish or blue in colour, usually sessile, lipoma papilloma, incompressible, non-pulsating and painless. Sometimes it can be covered by normal mucosa, making it harder to differentiate.
Its size varies from a few millimeters to several centimeters, with individual variation from supine to virus hpv homme symptomes position.
Histologically, they are classified into capillary and cavernous haemangiomas.
They are characterized by endothelial proliferation and hyperplasia, increased turnover and in vitro capillary neoformation. The Mulliken and Glowacki classification defines them as distinct from vascular malformations, with which they are often mistaken. The latter are present at birth and have a slow growth through endothelial turnover, with occasional rapid growth periods after local trauma, infections of lipoma papilloma changes.
Haemangiomas of the head and neck can be clinically silent and found during lipoma papilloma investigations or they may cause symptoms ranging from foreign body sensation in the oral cavity or throat, nasal obstruction, hearing impairment, dysphagia, dysphonia, up papillomavirus 16 traitement severe dyspnoea, congestive heart failure or coagulopathy Kasabach-Merrit syndrome.
In some cases, epistaxis, oral haemorrhage or haemoptysis are the first symptoms to appear. Imaging procedures are crucial for the diagnosis of haemangiomas. A fibroscopic examination lipoma papilloma important information about the location and aspect of the tumour, but it cannot be used to estimate its extension. A Doppler examination can indicate the vascular nature of the pathology.
Intravenous contrast CT scan and MRI are important for determining the extension and nature of the haemangioma. MRI typically describes a lobulated, heterogeneous lesion, with well-defined margins, with lipoma papilloma intermediary signal in T1 and moderately-strong signal in T2, with intense signal enhancement after the administration of intravenous contrast agents.
Digital subtraction angiography can be particularly useful, as it can determine the presence of vascular pedicles, and may be used for lipoma papilloma as a stand-alone treatment or before surgery. It is important to note that a biopsy may not be possible due to the high risk of bleeding. The differential diagnosis of haemangioma must take into account other vascular tumours, such as haemangiopericytoma, haemangioendothelioma, or angiofibroma.
Other pathologies must be excluded: foreign body granuloma, submucosal hematoma, other benign tumours cysts, papilloma, fibroma, lymphangioma, lipoma, neurinoma, hamartoma, ectopic thyroid tissue or a malignant tumour most often, spinocelular carcinoma and sarcomas.
The treatment of haemangiomas in ENT is difficult, as there is no agreed-upon standard. Most haemangiomas do not require treatment and are simply monitored. The pharmaceutical treatment is lipoma papilloma in juvenile cases where corticosteroids can be administered or, more recently, beta-receptor blockers.
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- tumor benigno - Traducere în română - exemple în spaniolă | Reverso Context
Criocauterisation and sclerotherapy have been described with variable results. Embolization may be attempted if there is a suitable lipoma papilloma pedicle. Wherever possible, complete surgical excision is the most effective treatment method. Choosing any method must take into account the risks during and after surgery that derive from the vascular nature of lipoma papilloma tumour.
Possible complications include tissue necrosis, infection, oedema or hematoma of the surrounding regions, which can lead to acute respiratory distress, early and lipoma papilloma post operatory bleeding, with possible flooding of the airways. The patient must be properly informed regarding all these risks and must consent to the possibility of blood transfusion, vascular ligation or emergency tracheotomy, if necessary.
The long-term evolution of haemangiomas is spontaneous involution in juvenile cases. In adults who have suffered surgery, recurrence is possible after 3 to 6 lipoma papilloma. The particular findings in the case presented: Very rare location of the tumour in an adult, at the pharyngeal level.
Oral haemorrhage was the reason for consultation and discovery of the pathology. The diagnosis was based on imaging, instead lipoma papilloma biopsy, due to the risk of lipoma papilloma close to the airways, which is difficult to control. The surgical treatment is unstandardized and was decided upon after taking into account the risks during and after surgery due to the proximity of large vessels and the airways.
Follow-up did not note any recurrence or complications up to the present date. Conclusion Haemangiomas are a class of benign vascular tumours, rare in the ENT speciality, especially in lipoma papilloma life, which may remain hidden until severe lipoma papilloma appear, such as bleeding, dysphagia or dyspnoea.
The diagnosis relies mainly in fibroscopic examination and imaging, while biopsy should be avoided due to the high risk of haemorrhage. The lack of an international consensus on the treatment strategy represents a challenge for each patient individually. Choosing any method must take into account the natural progression of the disease, the risks of treatment and the evolution after treatment.
Un copil de 9 ani cu cancer în stadiu terminal se trezește cu o tumoare benignă crescându-i pe inimă.
Conflict of interests: The authors declare no conflict of interests. Supraglotic hemangioma as a rare cause of recurrent hemoptysis: A new treatment modality with Argon plasma coagulation. Lechien JR et al. Unusual presentation of an adult pedunculated hemangioma of the oropharinx. Clin Case Rep.
Khil EK et al. Nasopharyngeal hemangioma in adult: A case report. J Korean Soc Radiol.
Hemangiomul faringian – caz clinic
Gangavati R et al. A review of hemangiomas of the oral cavity. Head and Neck Surgery, 16th edition. BC Decker. Pyriform sinus haemangioma: an unusual presentation of an unusual condition.