The Magnetic Resonance Image and Pathology of Spinal Cord Cavernous Hemangioma

Objective:To investigate the characteristics of magmetic resonance image (MRI) of spinal cord cavernous hemangioma.Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology were reviewed.The characteristics of MRI were analyzed and correlated with pathological characteristics of spinal cord cavernous hemangioma.Results In 4 cases, the tumors were located in thoracic segment of the spinal cord and 2 in cervical cord.All lesions were solitary and the spinal cords were normal or a little thicker.The MRI showed that the im-ages of focus were ball-like popcorn or mulberry with mixed signal,with short T2 signal around the fo-cus.Under microscope,the hemangioma was composed of highly expanded blood sinusoids and its wall was thin and consisted of flat epithelial cells.There were some red blood cells in the cavity of the sinu-soid and a little fibrous tissue in the diazoma between blood sinusoids.And also some fresh and old hem-orrhages could be seen in the specimen.Conclusio MRI has high sensitivity and specificity in the diagnosis of spinal cavernous hemangioma.     

Small bowel autotransplantation combined with pancreato- duodenectomy for enormous cavernous hemangioma of the small intestine mesentery

Recent advances in transplantation techniques have allowed pancreatoduodenectomy, distal gastrectomy,hemicolectomy and small bowel autotransplantation to be the therapy of choice for enormous cavernous hemangioma of the small intestine mesentery. There have been a few case reports about small bowel autotransplantation combined with pancreatoduodenectomy for enormous mesenteric cavernous hemangioma of small intestine. The present surgical methods for enormous cavernous bemangioma of the small intestine mesentery mainly included tumor excision and/or small bowel resection. However, these therapies are not effective for those patients in whom the angiocavemoma has infiltrated the mesenteric artery or pancreas, and these patients often give up therapy. It is recognized that enormous cavernous hemangioma of the small intestine mesentery is a benign lesion, and patients may have an excellent prognosis after complete resection of the lesion.     

Use of ABC Method in the Study of Lectin Receptors in Liver Tumors

The high affinity interaction of avidin-biotin inimmunoenzymatic techniques has provided a simple and sen-sitive method to localize antigens in formalin-fixed and paraf-fin-embedded tissues. The distribution of lectin receptors inprimary hepatooellular carcinoma, intrahepaticcholangiocarcinoma and cavernous hemangioma was studied     

Minimally invasive approaches for histological diagnosis of anterior mediastinal masses

Background Anterior mediastinal masses include a wide variety of diseases from benign lesions to extremely malignant tumors. Management strategies are highly diverse and depend strongly on the histological diagnosis as well as the extent of the disease. We reported a prospective study comparing the usefulness of core needle biopsy and mini-mediastinotomy under local anesthesia for histological diagnosis in anterior mediastinal masses. Methods Atotal of 40 patients with masses of unknown histology and located either at or near the anterior mediastinum received biopsy prior to treatment. The diagnostic methods were core needle biopsy in 28 patients and biopsy through mini-mediastinotomy under local anesthesia in 15 patients （including 3 patients for whom core needle biopsy failed to yield a definite diagnosis）. Results Histological diagnosis was achieved in 18 of the 28 patients receiving core needle biopsy. Of them, all 4 patients with pleural fibromas and 9 of the 12 patients （75%） with pulmonary mass were diagnosed definitively. In the remaining 12 patients with mediastinal mass, histological diagnosis was achieved in only 5 patients （41.7%）. In contrast, biopsy through a mini-mediastinotomy failed in only 3 patients. In the remaining 12 patients with huge mediastinal masses, who underwent mini-mediastinotomy, a definitive histological diagnosis was reached by pathological and/or immunohistochemical study （diagnostic yield 85.7% in 12 of 14 cases of mediastinal mass, P=0.038 vs core needle biopsy）. For the 9 patients with thymic epithelial tumors, the diagnostic yield was 40% （2 in 5 cases） for core needle biopsy and 83.3% （5 in 6 cases） for mini-mediastinotomy. There was no morbidity in patients receiving mini-mediastinotomy. In the 30 patients with biopsy-proven histological diagnosis, the results contributed to therapeutic decision making in 25 cases （83.3%）. Conclusions Core needle biopsy is effective in the diagnosis of pulmonary and pleural diseases. Yet its diagnostic yield in mediastinal mass is rather low. Superior to core needle biopsy, biopsy through a mini-mediastinotomy under local anesthesia is highly effective in the histological diagnosis of anterior mediastinal mass, and has a satisfactory diagnostic yield. The method is safe, minimally invasive, cost-effective, and useful in therapeutic decision making for anterior mediastinal masses.     

Papillary thyroid microcarcinoma presenting as skull base metastasis

Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and is considered to be a relatively indolent tumor in which distant metastasis and death are rare.1 The metastasis of PTC is usually to regional lymph nodes, especially the cervical and mediastinal nodes. Metastases to the brain are rare, and constitute 0.1%-5.0% of distant metastases of papillary carcinoma.2 Skull metastasis is uncommon,and is found in 2.5%-5.8% of cases of thyroid cancer.3 Skull base metastasis of PTC is extremely rare, with only eight reported cases in the literature involving the clivus,cavernous sinus, sella turcica, and the petrous apex and ridge.4 A metastatic lesion can arise from histologically benign and silent thyroid neoplasms,5 and differential diagnosis between ectopic and metastatic thyroid cancer can be difficult,6 therefore, the management of thyroid cancer is controversial after removal of metastatic disease.Here we reported a case of papillary thyroid microcarcinoma (PTMC) that was manifested as a solitary clivus metastasis and discussed the diagnostic and therapeutic management strategies. The 73-year-old patient presented with visual impairment in the right eye,and epistaxis. The patient subsequently underwent complete total thyroidectomy after a diagnosis of papillary microcarcinoma. This finding emphasizes that clinically significant metastases can arise from thyroid papillary microcarcinoma. Total thyroidectomy and careful review of the histology are necessary to prevent delay in proper diagnosis.     

Structural concept of intracranial cavernous angioma for the surgical treatment

To tile editor： We reported three cases of cavernous anglomas in different locations that were surgically treated and discussed thesurgical strategy of cavernous angiomas.Case 1： A 35-year-old woman experienced right-side numbness, right facial palsy, swallowing difficulty, gait disturbance and refractory hiccups. Magnetic resonance imaging （MRI） showed a round 3 cm cavernous angioma in the medulla oblongata （Figure IA）. She underwent surgery via a midline suboccipital approach （Figure 1B and I C）. The postoperative MRI confirmed total resection. She discharged on toot with residual right sided numbness, trunkal ataxia and nystagmus.     

Extended operation for thoracic malignancies invading superior vena cava and/or innominate vein

Patients with thoracic malignancies invading the superior vena cava （SVC） and innominate vein that cause venous flow obstruction have a poor quality of lite and short survival time. Dartevelle et al reported that the 3-year survival rates were 27% for patients with mediastinal malignancies and non-small cell lung cancer. Recently, some surgeons＇ experience suggested that the results of extensive resection and reconstruction of the SVC and innominate vein were excellent. From May 2003 to December 2005, radical resection and reconstruction of the SVC and/or innominate vein were performed in a group of patients for mediastinal or lung tumors invading the superior vena cava and/or innominate vein. We reported our experience in this retrospective study to explore the operative method, the optimal vascular graft, and the benefits of extended resection and reconstruction of SVC and/or innominate vein for invasive thoracic tumors.     

Multiple small bowel cavernous hemangioma with hemorrhage： A case report

Hemangiomas of the gastrointestinal tract are uncommon, accounting for only 0. 05% of all intestinal neoplasm. Bleeding, chronic anemia, and abdominal pain are the most common presenting features. We report a case of small bowel multiple cavernous hemangioma presenting as gastrointestinal tract bleeding.     

Adenomatoid tumor of the suprarenal region with high plasma adrenocorticotropic hormone: a case report

Adenomatoid tumors （ATs） are benign neoplasms that most commonly occur in the genital tracts of both male and females. Extragenital ATs are rare and have been reported in the pleura, heart, omentum, the mesentery of the small intestine, pancreas, mediastinal lymph nodes and peri-umbilical skin. 1,2 AT of the adrenal gland is typically an asymptomatic neoplasm with benign behavior, which has been recently recognized as a diagnostic challenge, as it is both rare and can present in such a manner as to suggest a wide range of differential diagnoses. 1,3-8 Here we report a very large AT of the left adrenal gland, which at present appears to be the largest tumor of this type that has ever been reported. It may be the first case of AT associated with a high level of plasma adrenocorticotropic hormone （ACTH）.     

Adenomatoid tumor of the suprarenal region with high plasma adrenocorticotropinhormone: a case report

A denomatoid tumors (ATs) are benign neoplasms that most commonly occur in the genital tracts of both male and females.~1 Extragenital ATs are rare and have been reported in the pleura, heart, omentum, the mesentery of the small intestine, pancreas, mediastinal lymph nodes and peri-umbilical skin.~(1,2) AT of the adrenal gland is typically an asymptomatic neoplasm with benign behavior, which has been recently recognized as a diagnostic challenge, as it is both rare and can present in such a manner as to suggest a wide range of differential diagnoses.1'3'8 Here we report a very large AT of the left adrenal gland, which at present appears to be the largest tumor of this type that has ever been reported. It may be the first case of AT associated with a high level of plasma adrenocorticotropic hormone (ACTH).     

平阳霉素治疗口腔内及面部血管瘤的临床分析

目的：总结平阳霉素（PYM）瘤内流射治疗口腔内及面部各种血管瘤的疗效。方法：收集1993年1月－1999年1月,用PYM注射治疗口腔及面部海绵状、草莓状和混合性等血管瘤450例（528个瘤体）每7－10天注射1次,每次注射含PYM1.6mg/ml的0.5％－1％普鲁卡因1－5ml,3－5次为一个疗程。结果：经6个月－6年随访,治愈和基本治愈率为86.89%,好转为12％,总有效率为98.86%。按瘤体个数统计,海绵状、草莓状和混合性血管瘤的治愈和基本治愈率分别为91.04%、86.05%和78.01%,葡萄酒色斑的基本治愈率只有14.29%。结论：PYM治疗海绵着、草莓状和混合性血管瘤疗效高、疗程短,是一种简便、安全的有效方法。     

肝海绵状血管瘤剥除术101例临床应用体会

目的：探讨肝海绵状血管瘤剥除术在临床上的运用价值。方法选取我院2010年1月－2012年1月收治的101例肝海绵状血管瘤患者,给予剥除术治疗,直径大于10 cm 的肝海绵状血管瘤同时给予肝门间歇阻断治疗。结果101例肝海绵状血管瘤全部剥除成功,无手术死亡病例,无术后严重并发症发生,随访6个月～2年,无复发现象。邻近肝门的血管瘤患者手术时间明显长于远离肝门的患者,差异有统计学意义（ P ﹤0.05）。术后平均恢复时间在邻近肝门和远离肝门的血管瘤患者之间差异无统计学意义。结论肝海绵状血管瘤剥除术临床疗效显著,安全有效,值得临床推广与运用。     

咽喉部海绵状血管瘤瘤内平阳霉素注射治疗后的病理变化及疗效观察

目的 探讨平阳霉素治疗海绵状血管瘤后的病理变化及疗效，为阐明平阳霉素治疗海绵状血管瘤提供理论依据。方法 对24例咽喉部海绵状血管瘤进行瘤内平阳霉素注射并随访观察疗效，同时对平阳霉素注射后的瘤体组织进行病理观察。结果 24例咽喉部海绵状血管瘤经平阳霉素治疗后痊愈20例，治愈率为83．3％。而未治愈的4例患者，2例行手术治疗时，出血量明显减少。病理检查显示海绵状血管瘤注射平阳霉素后纤维组织增生并部分机化，血窦变窄小、融合，腺体变性、融合。结论 平阳霉素治疗海绵状血管瘤的疗效高，并发症少。其病理变化是瘤体组织纤维增生和机化。     

钝性剥离术治疗71例肝海绵状血管瘤

目的探讨采用包膜外钝性剥离法切除肝海绵状血管瘤的治疗经验。方法分析总结作者在肝门阻断下采用包膜外钝性剥离法切除71例肝海绵状血管瘤患者的临床资料。结果全部病例手术经过顺利,术中出血少,术后恢复良好,并发症低于其他术式。结论包膜外钝性剥离治疗肝海绵状血管瘤是一种安全、简便、有效且创伤小的手术方式     

MR磁敏感加权成像诊断脑海绵状血管瘤的价值

目的探讨磁敏感加权成像（SWI）在脑内海绵状血管瘤诊断中的价值。方法19例脑内海绵状血管瘤患者接受MRI检查,比较T2WI—TSE及SWI序列对脑内海绵状血管瘤的诊断情况。结果1．T2WI—TSE序列共显示脑内海绵状血管瘤81处,SWI序列共显示脑内海绵状血管瘤292处,SWI序列显示脑内海绵状血管瘤的比例显著高于T2WI—TSE序列（P〈0．01）。2．在铁环征的显示中,T2WI—TSE序列显著高于SWI序列（P〈0．01）。SWI序列显示脑内海绵状血管瘤平均径线显著高于T2WI—TSE序列（p〈0．01）。结论SWI序列对脑内海绵状血管瘤十分敏感,可以清晰显示其影像学特征,具有很高的应用价值。     

结膜微创术摘除眼眶海绵状血管瘤

目的：回顾近年来结膜微创术摘除眶深部肌锥内海绵状血管瘤，探讨其疗效。方法：总结分析近年来本院收治的48例眼眶海绵状血管瘤病人的CT表现，麻醉，手术方法以及术后效果。结果：42例行结膜微创术摘除眼眶海绵状血管瘤收到了良好效果。术中依据病情变换外侧开眶6例，都有效地摘除了肿瘤，保护了视功能。结论：眼眶海绵状血管瘤是眶深部肌锥内肿瘤，在CT提示下采用结膜微创术可以有效地摘除肿瘤，术后效果较好。减少了手术并发症。只有极少数病例术中依据病情变换外侧开眶术。     

平阳霉素与地塞米松联合治疗颌面部海绵状血管瘤的临床分析

目的 总结分析平阳霉素与地塞米松联合治疗颌面部海绵状血管瘤的疗效。方法 选取颌面部海绵状血管瘤36例，采用平阳霉素和地塞米松配伍注射治疗，观察疗效。结果 经过3个月～2年的随访，治愈31例（86％），好转5例（14％），无效0例，总有效率100％。结论 平阳霉素和地塞米松配伍注射治疗颌面部海绵状血管瘤，疗效好，副作用小，是安全、简便、有效的治疗方法。     

平阳霉素治疗口腔颌面部海绵状血管瘤201例临床观察

目的 探讨平阳霉素瘤体内注射治疗口腔颌面部海绵状血管瘤的临床疗效.方法 收集1990年12月至2004年12月用平阳霉素瘤内注射治疗口腔颌面部海绵状血管瘤201例.结果 随访6个月至2年,治愈率80.2%、总有效率96.5%.结论 平阳霉素治疗口腔颌面部海绵状血管瘤疗效高,是一种简便、安全的有效方法.     

颅内海绵状血管瘤31例显微外科治疗

目的探讨颅内海绵状血管瘤显微手术治疗方法。方法总结31例颅内海绵状血管瘤的临床表现、神经影像学特征及显微治疗方法。结果全切除27例(87.1%),大部分切除3例(9.7%),部分切除1例(3.2%)。结论显微手术治疗颅内海绵状血管瘤是更为安全和有效的方法,未完全切除者术后给予放疗,疗效满意。     

差别显示法研究海绵状血管瘤的形成机制

目的　初步探讨人海绵状血管瘤的形成机制。方法　收集 16例经病理证实的海绵状血管瘤组织标本 ,及 10例正常大隐静脉标本。采用DDRT PCR方法分析人海绵状血管瘤和人正常静脉基因表达的差异。结果　人海绵状血管瘤在 70 0bp左右cDNA相对应的mRNA表达明显减少 (P <0 .0 5 )。结论　该基因可能对血管形成具有抑制作用 ,缺乏该基因的表达可能是人海绵状血管瘤形成的重要发病机制