Sonodynamic changes after transcatheter arterial embolization in a vaginal hemangioma: case report

Emoto, Makoto; Tamura, Riko; Hayashi, Izumi; Sukimoto, S.; Kawarabayashi, Tatsuhiko; Shirakawa, Kiyoshi

doi:10.1046/j.1469-0705.1997.10010066.x

Cited by 13 publications

(9 citation statements)

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“…Selective embolisation sometimes has to be carried out through two or more steps to avoid or reduce risks of complications, primarily acute ischaemia caused by occlusion of important anomalous arteries 10. Besides our case, we found two other case reports showing good results after embolisation of vulvar arterio-venous malformation by using a coil 11 12…”

Section: Discussionmentioning

confidence: 51%

Coiling of a vulvar arterio-venous malformation

Woude

Stegeman²,

Seelen³

2011

Case Reports

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SummaryThe authors report the case of a 13-year-old girl with a painful vulvar swelling and abnormal vaginal bleeding, increasing in size after trauma. With MRI (GE Signa HDx 1.5 Tesla), it is diagnosed as an arterio-venous malformation arising from the left superior femoral artery. It is treated by embolisation using a coil. benign soft-tissue tumours characterised by rapid postnatal growth followed by slow, invariable, spontaneous regression during childhood. 2 Vascular malformations are developmental errors which do not regress, and are composed of dysmorphic vessels with normal endothelial turnover. 2 3 The latter is subcategorised into arterial, venous (formerly 'cavernous haemangioma'), capillary, lymphatic or mixed types. 1 4 Vascular malformations can also be differentiated at the haemodynamic level between low-fl ow malformations, that include capillary and venous malformations, and high-fl ow malformations that include arterial malformations, arterio-venous fi stula and arterio-venous malformations. 1-2 5 The diagnosis of vascular malformations can be strongly suspected by careful history and physical examination. Venous malformations present as bluish, easily compressible non-pulsatile masses that increase in size with manoeuvres to increase venous pressure (Valsalva manoeuvre). 3 6 In case of vascular high fl ow malformations, pulsations are present. 7 Clinical symptoms include vulvar dysmenorrhoea, sexual dysfunction, swelling, pressure, discomfort, pain, abnormal vaginal bleeding and cosmetic problems. 2-3 8 Vascular malformations may be complicated by cutaneous ulceration and haemorrhage, limb hypertrophy or even high-output cardiac failure. 7 Venous malformations should be distinguished from vulvar varicosities ( table 1 ). 3 Vulvar varicosities are typical complications of pregnancy resulting from pelvic venous hypertension and they appear as a grapelike cluster of veins on the vulva. 3 6 While vulvar varicosities result from venous insuffi ciency or stasis, vascular malformations of the vulva are developmental errors, composed of dysmorphic vessels, and they do not regress. 6 Vascular malformations may undergo a rapid increase in size as a result of infection, thrombosis, trauma, surgical intervention and hormonal changes (as during puberty or in pregnancy). 2 5 7 For cases with progressive lesions in older women, a pathologic opinion is always necessary to rule out underlying malignancies. Regarding this point, biopsy may be indicated for superfi cial, localised and small lesions when clinical and imaging presentation is atypical. 2 Other differential diagnostic thoughts, besides varicosities and vulvar malignancies are outlined in table 2 . 2 Diagnosis of vascular malformations is primarily clinical and is confi rmed by ultrasound, colour Doppler ultrasound and MRI. 2 3 6-7 Ultrasounds reveal hypoechoic, heterogeneous lesions and yields reliable and adequate information regarding the nature and extend of a superfi cial malformation. 2-3 6 Colour Doppler analysis illustrates mono-or biphasi...

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Section: Discussionmentioning

confidence: 51%

Coiling of a vulvar arterio-venous malformation

Woude

Stegeman²,

Seelen³

2011

Case Reports

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“…A literature search revealed that a surgical excision remains the curative treatment in most cases, and conservative therapy, such as sclerosing agents, cryotherapy, carbon dioxide laser and LEEP, may alternatively be used [5]. Transcatheter arterial embolisation, after delivery, has been reported in the treatment of rapidly growing vaginal haemangioma [11]. Although hysterectomy, as a primary mode of therapy for cases of haemangioma of the cervix presenting with vaginal bleeding, has been reported by Powell et al, most were performed because the lesion was suspected to be malignant [12].…”

Section: Discussionmentioning

confidence: 99%

Haemangioma of the Cervix Micking Cervical Endometriosis: A Case Report

Kouach¹,

Benabdejlil²,

Rachadi³

et al. 2015

JGO

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“…When symptomatic, they manifest with symptoms related to mass effect [93,97] or abnormal vaginal bleeding in females [96]. During pregnancy, hemangiomas may grow rapidly, increasing the risk of bleeding, especially during delivery, and may necessitate caesarian section [96][97][98].…”

Section: Genital Hemangiomamentioning

confidence: 99%

“…Sonographic findings are nonspecific and may reveal a complex mass with echogenic, shadowing foci corresponding to phleboliths [99]. Intralesional vascularity on Doppler sonography with low-resistance flow can be seen [98,99]. CT characteristics include a mass with lobulated margins and phleboliths.…”

Section: Genital Hemangiomamentioning

confidence: 99%