Peritoneal cavernous hemangiomatosis:A case report

BACKGROUND Cavernous hemangiomatosis in the liver and spleen has been reported, but it occurs less commonly in the peritoneum. Here we report a case of peritoneal cavernous hemangiomatosis and share some valuable information about this disease.CASE SUMMARY A 57-year-old Chinese man had a huge abdominal mass with abdominal distention and a significant reduction of food consumption. An enhanced abdominal and pelvic computed tomography and positron emission tomography–computed tomography revealed multiple cystic masses on the peritoneum, greater omentum, small intestinal mesentery and the surface of the spleen, and a high maximum standardized uptake value of the largest cystic lesion. Exploratory laparotomy was performed, and multiple cystic masses were found on the surface of the peritoneum, greater omentum, mesentery of the small intestine, and surface of the liver and spleen. Dark red bloody cystic fluid was present in the cystic tumor. Pathological examination showed that in the stromal components, the irregular vascular wall was thin. The vessel lumen was interlinked, and the lumen was lined with flat endothelium. According to the intraoperative findings and pathologic results, the patient was diagnosed with peritoneal cavernous hemangiomatosis.CONCLUSION The possibility of peritoneal cavernous hemangiomatosis should be considered when multiple cystic masses are found in the abdominal cavity by preoperative examination.

Right hepatectomy for giant cavernous hemangioma with diffuse hemangiomatosis around Glisson's capsule

Diffuse liver hemangiomatosis with giant cavernous hemangioma in adult is extremely rare. A 35 year-old woman presented to hospital with main complaint of epigastric pain and abdominal fullness. An enhanced computed tomography scan revealed a massive liver tumor in right lobe about 150 mm in size. There was contrast enhancement at the periphery of the mass consistent with a cavernous hemangioma. She underwent right hepatectomy. Histologically, it was diagnosed as a cavernous hemangioma. And also, hemangiomatous lesions were scattered around the Glisson's capsule on the back ground liver. These hemangiomatous lesions were not recognized preoperatively. Even if we couldn't diagnose hemangiomatosis around the main giant hemangioma preoperatively, we need to take enough surgical margins because the giant hemangioma has the potential to have small hemangiomatous lesions around the tumor. We reported right hepatectomy for giant cavern-ous hemangioma with diffuse hepatic hemangiomatosis without an extrahepatic lesion in an adult.

Pulmonary Capillary Hemangiomatosis Associated with CREST Syndrome： A Challenge of Diagnosis and Treatment

To the Editor： A 65-year-old woman with calcinosis, Raynaud＆#39;s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia （CREST） syndrome was admitted to hospital because of progressive dyspnea on exertion for about 1 year. In the past, she had been diagnosed as gastroesophageal reflux disease and scleroderma for 10 years. Physical examination showed masked face, Raynaud＇s phenomenon, finger sclerodactyly, and skin telangiectasia on her neck and back [Figure 1a and 1b]. The titer of anticentromere antibody in serum increased to 1： 1000. Analysis of arterial gas on room air revealed the partial pressure of arterial oxygen （PaO2） was 54 mmHg （1 mmHg = 0.133 kPa） and carbon dioxide （PaCO2） was 32 mmHg. Echocardiogram showed severe tricuspid regurgitation and elevated pulmonary arterial pressure of 78 mmHg.

Clinical features and imaging findings in pulmonary capillary hemangiomatosis： report of two cases and a pooled analysis

Background Pulmonary capillary hemangiomatosis （PCH） is a rare disease and no Chinese case has been reported yet. The disease is often misdiagnosed and its clinical characteristics are incompletely described. The aim of this study was to describe two Chinese cases and to clarify the clinical and radiographic parameters of patients with PCH. Methods Two PCH cases were presented and other cases were searched from the English literature. All available clinical and radiographic data were collected from 62 literature reported PCH cases. A pooled analysis of total 64 cases was made. Results Dyspnea and hemoptysis were the most common clinical symptoms of PCH. Pulmonary hypertension （PH） was found in 78% of the reported cases. PCH typically showed characteristic diffuse or patchy ground-glass opacities （GGOs） and/or multiple ill-defined centrilobular nodules in the computed tomography. Conclusions The diagnosis of PCH requires a high clinical suspicion. However, both clinical presentations and radiographic studies often provide clues to the diagnosis, which may prompt early lung biopsy for a definite diagnosis.