BACKGROUND Cutaneous epithelioid angiomatous nodules(CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confuse...BACKGROUND Cutaneous epithelioid angiomatous nodules(CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confused with benign and malignant vascular tumors. However, the etiology of CEAN remains unclear, and no association with infection, trauma, or immunosuppression has been described.This case study indicated that CEAN is closely related to the patient’s impaired immune status and may be induced by cyclosporine.CASE SUMMARY A 19-year-old boy with nephrotic syndrome(NS) developed large CEAN on the left foot during treatment for NS. He had repeated relapses of edema in the past 6 years and different types of immunosuppressants were administered including methylprednisolone, mycophenolate mofetil, tacrolimus and cyclosporine;the dosages of these drugs were frequently adjusted. The patient had been receiving cyclosporine and methylprednisolone for 7 mo before he developed CEAN.Cyclosporine was discontinued due to its side effects on skin. After cessation of cyclosporine and 16 mo follow-up, the nodules gradually disappeared without any other treatment for the CEAN.CONCLUSION Impaired immune status is proposed to be a risk factor for CEAN, which may be induced by cyclosporine.展开更多
Meningiomas are classified into three types according to the World Health Organization classification system which is based on morphologic criteria. Type 1 is the benign variant, in which meningothelial is the most co...Meningiomas are classified into three types according to the World Health Organization classification system which is based on morphologic criteria. Type 1 is the benign variant, in which meningothelial is the most common subtype. Angiomatous also belongs to the same subtype but comprises only 2.1% of all meningiomas. Although most meningiomas are asymptomatic, some may present with varying symptoms ranging from seizures to focal deficits. Often, large meningiomas can also manifest as neuropsychiatric symptoms ranging from depression to overt psychosis. Here, in this case, we have further elaborated the importance of the organic cause of psychiatric symptoms as our patient initially presented with symptoms of depression. Regarding the diagnosis of meningiomas, nowadays excellent neuro-imaging methods are available, however, histological examination and immunohistochemistry remain the gold standard tools for a definite diagnosis. In our patient, the histological examination showed well-formed sinusoids and vascular channels which were consistent with the diagnosis of an angiomatous variant. Gross total resection of the lesion remains the treatment of choice with radiation therapy being used for residual tumors postoperatively. Being a type 1 variant, these meningiomas have a very small risk of recurrence. Here, we have presented a rare variant of meningioma initially presenting with prominent psychiatric symptoms of depression advancing to focal deficits.展开更多
文摘BACKGROUND Cutaneous epithelioid angiomatous nodules(CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confused with benign and malignant vascular tumors. However, the etiology of CEAN remains unclear, and no association with infection, trauma, or immunosuppression has been described.This case study indicated that CEAN is closely related to the patient’s impaired immune status and may be induced by cyclosporine.CASE SUMMARY A 19-year-old boy with nephrotic syndrome(NS) developed large CEAN on the left foot during treatment for NS. He had repeated relapses of edema in the past 6 years and different types of immunosuppressants were administered including methylprednisolone, mycophenolate mofetil, tacrolimus and cyclosporine;the dosages of these drugs were frequently adjusted. The patient had been receiving cyclosporine and methylprednisolone for 7 mo before he developed CEAN.Cyclosporine was discontinued due to its side effects on skin. After cessation of cyclosporine and 16 mo follow-up, the nodules gradually disappeared without any other treatment for the CEAN.CONCLUSION Impaired immune status is proposed to be a risk factor for CEAN, which may be induced by cyclosporine.
文摘Meningiomas are classified into three types according to the World Health Organization classification system which is based on morphologic criteria. Type 1 is the benign variant, in which meningothelial is the most common subtype. Angiomatous also belongs to the same subtype but comprises only 2.1% of all meningiomas. Although most meningiomas are asymptomatic, some may present with varying symptoms ranging from seizures to focal deficits. Often, large meningiomas can also manifest as neuropsychiatric symptoms ranging from depression to overt psychosis. Here, in this case, we have further elaborated the importance of the organic cause of psychiatric symptoms as our patient initially presented with symptoms of depression. Regarding the diagnosis of meningiomas, nowadays excellent neuro-imaging methods are available, however, histological examination and immunohistochemistry remain the gold standard tools for a definite diagnosis. In our patient, the histological examination showed well-formed sinusoids and vascular channels which were consistent with the diagnosis of an angiomatous variant. Gross total resection of the lesion remains the treatment of choice with radiation therapy being used for residual tumors postoperatively. Being a type 1 variant, these meningiomas have a very small risk of recurrence. Here, we have presented a rare variant of meningioma initially presenting with prominent psychiatric symptoms of depression advancing to focal deficits.
