Hemangioma Essay

There is 3 types of Hemangioma. Superficial Hemangioma occur on top of the skin and have a red or purple coloring to it. Deep Hemangiomas

Infantile hemangioma (IH), a benign vascular tumor, is the most common tumor of infancy, with an incidence of 5%–10% at the end of the first year (1). Most lesions are not visible at birth but appear in the first four to six weeks of life. Hemangiomas are characterized by a growth phase which continues for the first year followed by a involution phase lasting from one to nine years (1). Risk factors for development of hemangiomas are being female, Caucasian, low birth weight, and those of multiple gestations (1). The cause

Conservative treatment is recommended for patients who are hemodynamically stable at initial presentation.TAE is the first choice of treatment for unstable patients with continuous intra-abdominal hemorrhage,TAE is thought to be the ideal treatment because it is simple and effective with a success rate of about 90%(10). Definitive treatment of HCC should follow the initial recovery from ruptured HCC.Patients with preserved liver function and resectable tumors should be considered for curative hepatic resection if a low-risk curative resection is possible in a Child A-B patient (10,11,13).TAE is palliative procedure indicated when the liver function is compromised or in the case of multifocal-bilobar HCC.long-term survival is correlated to the stage of the disease, its local spread after rupture and the residual hepatic

○ Stage III: tumor has spread to nearby blood vessels and/or lymph nodes but not to other organs

Bile duct stricture is a rare but challenging clinical condition. There is often delay in diagnosis of biliary stricture because of its slow progression. Benign strictures develop due to injury of the bile ducts during surgery or trauma to the abdomen; a recurring condition like pancreatitis or bile duct stones or a chronic disease like primary sclerosing cholangitis (PSC). Inflammation occurs soon after injury, which is followed by fibrosis and narrowing of the bile duct lumen. Degeneration of the hepatic segment or lobe void by the involved bile ducts, associated with hypertrophy of the natural segments, can occur, especially with chronic strictures. These changes eventually develop to portal hypertension and secondary biliary

Tomas Smith is a 60 years old Native American male who presents with chief complaint of abdominal pain and weakness. After history and examination, I feel the diagnosis is most likely liver failure. Differential diagnosis includes, but not limited to pancreatitis, cholecystitis, and appendicitis. The patient is hemodynamically stable

Of the total 219 focal liver lesions biopsies, 206 biopsy specimens were sufficient for diagnosis (94.1%) and were insufficient in 13 biopsy specimens (5.9%). Nine biopsy specimens (69.2%) were only tissue necrosis and four specimens (30.8%) were too small tissue for definite diagnosis.

Cross sectional imaging with either CT scan or MRI confirms the presence of biliary dilatation and is also used to evaluate vascular involvement, the status of the portal lymph nodes, the presence of metastatic disease and the extent of liver lobar atrophy if present. Endoscopic retrograde cholangiopancreatography (ERCP) combined with percutaneous transhepatic cholangiography define the anatomy of the biliary tree and assesses the distal and proximal extent of the tumor, respectively. It provides the ability to drain the biliary system and obtain brush cytology for pathologic diagnosis before resection. Magnetic resonance cholangiopancreatography (MRCP) has the advantage of providing detailed noninvasive images of the entire biliary tree even the segments that are obstructed by the tumor.

Figure 41. Common hemangioma of infancy in a 9-month-old girl who presented with a right shoulder mass. Coronal unenhanced T1-weighted (a), STIR (b), and gadolinium-enhanced fat-suppressed T1-weighted (c) MR images show a well-defined, lobulated soft-tissue mass confined to the subcutaneous soft tissues. The mass is isointense relative to muscle on the unenhanced T1-weighted image, is hyperintense on the STIR image, and shows diffuse enhancement on the gadolinium-enhanced image. All three images demonstrate small, intralesional signal void foci due to high-flow vessels.quoted from(Navarro et al;2009).

Portal biliopathy (PB) is a clinical condition defined as the presence of abnormalities in the biliary tree (including biliary tree and gallbladder) in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC)[1]. In literature, this disease has been named as “portal hypertensive biliopathy” [2], “portal cavernoma-associated cholangiopathy” [3], “portal cavernomacholangiopathy” [4], “cholangiopathy associated with portal hypertension” [5], “pseudosclerosing cholangitis” [6] and “pseudocholangiocarcinoma”[7] due to the fact that PB biliary alterations can mimic sclerosing cholangitis or cholangiocarcinoma, respectively.

Multiple paraneoplastic syndromes have been introduced for HCC. Thrombocytosis is one of these rare paraneoplastic findings in cases of liver cirrhosis with HCC. Degree of thrombocytosis correlates with the size of the HCC and the level of Alpfa FetoProtein (AFP).

Upper GI tract obstruction Tanaka et al. [8]reported that in 19 of the 29 patients, in whom HCC involved directly the upper GI tract; initial endoscopic assessment revealed an ulcerative hemorrhagic tumor protruding into the lumen of the stomach or duodenum [9], in most of these cases were very advanced HCCs like in our case.

Von Hippel Lindau (VHL) disease has characteristic tumors that result from germ mutations in the VHL tumor suppressor gene on chromosome 3p25.13 One of these tumors is the hemangioblastoma. These tumors consistently occur in “the retina, cerebellum, brainstem and dorsal spinal cord.”13 Hemangioblastomas are benign neoplasms with no potential to metastasize. They are space occupying lesions that can cause neurological deficit and can have a high mortality rate due to tonsillar herniation, compression of the brainstem, and hydrocephalus if left untreated. Hemangioblastomas may have a syrinx or pseudocyst evident with magnetic resonance imaging (MRI). Also on MRI, they can have the typical appearance of a “densely contrast-enhancing solid mass with smooth margins.”13 Central nervous

The meticulous identification of gallbladder and extrahepatic biliary tract and its normal anatomy that facing a surgeon during surgical operations is essential in the prevention of iatrogenic injury. Equally important, an understanding of congenital variation of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their operative implications [1]. This study reviews the world literature on congenital variation of extrahepatic biliary anatomy. Further studies on image techniques and hepatobiliary scintigraphy for diagnosis of biliary diseases may details of the whole biliary ductal system and show some kinds of biliary malformation,

The use of liver location estimation based on lung location effectively removes the need of any models to estimate the location of liver, enabling the random walker segmentation to segment the liver more accurately, in case any lesions are present inside the liver envelope, these lesions are also seeded and the ability of multi- region segmentation of the random walker means that these lesions will be also segmented with no regards to their location inside the liver, as segmenting the pathological livers in contrast-enhanced CT imaging are the main reason for taking the challenge of liver segmentation. Examples of challenging pathological livers segmented can be seen in Figs 9-11. These examples represent severe pathological disorders on livers