Intravenous Lobular Capillary Hemangioma in the Subclavian Vein

Abstract

We report the case of a 73-year-old man with severe edema of the right upper extremity. Computed tomography, magnetic resonance imaging, and venography revealed an intravenous tumor in the middle portion of the right subclavian vein. The tumor was completely resected, and an accompanying thrombus was also removed using the transmanubrial osteomuscular sparing approach. The patient recovered well without any complications or recurrence. The histopathologic diagnosis was intravenous lobular capillary hemangioma, which is also called pyogenic granuloma. To our knowledge, this is the first reported surgical case involving this type of benign tumor originating in a thoracic vein.

Pyogenic Granuloma – A Common Benign Vascular Tumor with Variable Clinical Presentation: New Findings and Treatment Options

“…Gastrointestinal PG can cause severe anaemia [ 25 ]. Extremely rare are intravascular tumours which bear the risk of thrombosis [ 26 ].…”

Intravascular lobular capillary hemangioma of the temporal artery

“…2 , 5 One of the major factors suspected of contributing to the pathogenesis of LCHs is related to the concept of a hyperproliferative response to trauma, with imbalances involving both promoters and suppressors of angiogenesis. 2 , 3 , 4 , 5 , 6 , 7 This concept has been supported in the literature, with numerous immunohistochemistry reports outlining the association between LCHs and increased expression of angiogenic markers, including CD31, CD34, smooth muscle actin, and factor VIII. 1 , 2 , 4 …”

“…2 , 3 , 4 , 5 , 6 , 7 This concept has been supported in the literature, with numerous immunohistochemistry reports outlining the association between LCHs and increased expression of angiogenic markers, including CD31, CD34, smooth muscle actin, and factor VIII. 1 , 2 , 4 …”

“…Lobular capillary hemangiomas (LCHs), also often referred to as pyogenic granulomas , represent a well-researched form of benign vascular tumor typically confined to the skin and subcutaneous tissues of the head, neck, and upper extremities. 1 , 2 , 3 , 4 , 5 , 6…”

Venous outlet syndrome caused by capillary hemangioma of the subclavian vein

“…There are several surgical approaches for symptomatic venous thoracic outlet syndrome, but in the case of a neoplastic lesion, we recommend the anterior cervicothoracic approach to obtain complete control of the medial and distal SCV and prevent potential bleeding. Matsuzaki and colleagues 7 , reported the first case of intravenous lobular capillary hemangioma in the right SCV, which was treated with partial resection of the vein, removal of the neoplasm with its endothelial implant and reconstruction through the Grunenwald approach. In our case, we chose the Dartevelle approach because, in the absence of a preoperative diagnosis, we preferred a wider surgical field to enlarge the resection if necessary.…”