Hemangioma

Most hemangiomas that appear in childhood involute spontaneously and no intervention is required. Occasionally they can enlarge, endangering vital structures, and then steroids or interferon alfa-2 have a role (Ezekowitz et al., 1992). Later in life, smaller capillary, venous, or cavernous hemangiomas can present, often with epistaxis. They can originate from the septum or the turbinates and alarm the patient and primary care physician, who may suspect malignancy. They can emulate pyogenic granulomas (granuloma gravi-darum, which is due to a florid reaction as a result of local trauma, typically in the third trimester of pregnancy) (Fig. 15.40a-d). Outpatient endoscopic examination along with gentle palpation with a round-ended probe will help make the diagnosis as this will help define its base and differentiate it from a hemor-rhagic tumor originating from the skull base or lateral nasal wall (Fig. 15.41 a-c). All these lesions are readily removed endoscopically after infiltration and by taking a margin of tissue around the lesion. More ex-

Enlarged Turbinates Coronal
Fig. 15.39 Laterally placed osteoma not accessible endoscopi-cally. Note that there is disease present, otherwise surgery would rarely be justified.

tensive hemangioma should not be removed surgically unless imaging, including angiography, has shown that resection and vascular control are possible. These lesions often require major surgery, sometimes with preoperative embolization, and they are not suitable for endoscopic excision. Their blood vessels do not contract and the bleeding that can occur with their removal can be life-threatening. (Fig. 15.42 a-d).

Image Turbinate

Fig. 15.40 a Hemangioma in the right nasal cavity. b Coronal MR image showing a hemangioma coming from the sphenopalatine artery. Fig. 15.40 c, d >

Fig. 15.40 a Hemangioma in the right nasal cavity. b Coronal MR image showing a hemangioma coming from the sphenopalatine artery. Fig. 15.40 c, d >

Hemangiomas Vertebrales Turbinate Osteoma

Fig. 15.41 a Coronal CT scan of a left cavernous hemangio-osteoma. b Postoperative cavity after resection of cavernous hemangio-osteoma. c Histology showing a hemangio-osteoma.

Fig. 15.41 a Coronal CT scan of a left cavernous hemangio-osteoma. b Postoperative cavity after resection of cavernous hemangio-osteoma. c Histology showing a hemangio-osteoma.

Pyogenic Granuloma

Fig. 15.42 a Coronal CT scan of giant pyogenic granuloma that has eroded the skull base. b Sagittal MR image showing sizable vessels within the pyogenic granuloma. c Operative specimen of pyogenic granuloma. d Postoperative coronal MR image scan following resection of pyogenic granuloma.

Fig. 15.42 a Coronal CT scan of giant pyogenic granuloma that has eroded the skull base. b Sagittal MR image showing sizable vessels within the pyogenic granuloma. c Operative specimen of pyogenic granuloma. d Postoperative coronal MR image scan following resection of pyogenic granuloma.

Was this article helpful?

0 0
Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

Get My Free Ebook


Responses

  • gerda
    What is a sizable Hemangiomas?
    7 years ago
  • judith
    Do pyogenic granuloma occur in the bladder?
    7 years ago

Post a comment