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This bibliometric analysis aimed to analyze global research trends in laser therapy for hemangiomas, a common benign vascular tumor in children from 1977 to 2024. Publications in laser therapy for hemangiomas from 1977 to 2024 were retrieved from the Web of Science Core Collection (WoSCC) database, and only articles published in English were analyzed. Bibliometric and visual analyses were performed using VOSviewer, CiteSpace, and the R package "bibliometrix." A total of 1,028 publications from 66 countries and 4,199 authors were analyzed, showing an annual growth rate of 5.61%. The United States led with 365 articles and 11,713 citations. Major contributors included the University of California System and Harvard Medical School, and key journals were Lasers in Surgery and Medicine and Dermatologic Surgery. Pulsed dye laser (PDL) was the most studied laser type. Research focused on optimizing treatment safety, effectiveness, and management, especially in children. The rise of propranolol as a keyword highlighted its increasing role in hemangioma therapy, and the keyword like "classification" and "vascular anomalies" underlining the importance of accurate diagnosis and classification. This study highlights the growing importance of laser therapies for hemangiomas. Future research should explore combining propranolol with laser treatments and the role of precise diagnosis in improving treatment outcomes., (© 2025. The Author(s).)

Background: Circumscribed choroidal hemangioma (CCH) is a benign vascular hamartoma caused by congenital vascular malformation. And, central serous chorioretinopathy (CSCR) is a chorioretinal disease characterized by pachychoroid, RPE irregularities, and subretinal fluid (SRF) accumulation. Some literature has indicated a potential correlation between the occurrences of CCH and CSCR., Case Presentation: A 59-year-old man presented with blurred vision in his right eye for six months, with an unremarkable history. Multimodal imaging techniques including color fundus photography, fundus autofluorescence (FAF), B-scan ultrasonography (USG), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT), revealed the presence of CCH accompanying CSCR in the right eye. The patient received treatment with SML for CSCR, while no specific treatment was administered for CCH. The SRF was fully resolved one month after the treatment. At the 3- and 6-month follow-up, SRF resolved, and best-corrected visual acuity (BCVA) improved from 0.6 to 0.9 in the decimal format in the right eye, without notable changes in subfoveal choroidal thickness (SFCT) or the size of CCH., Conclusion: This case reported the coexistence of CCH and CSCR in the right eye, both characterized by choroidal vascular abnormalities. Further research is necessary to determine the favorable effect of SML in patients with CSCR and concurrent CCH., Competing Interests: Declarations. Ethics approval and consent to participate: Written informed consent was obtained from the patient for utilizing his clinical details for this manuscript. Permission for using the patient data for this report was obtained from the ethics committee of the First Affiliated Hospital of Army Medical University, PLA ((B) KY2024156). Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Gastric duplication cysts (GDCs) are rare cystic neoplasms that are often difficult to distinguish from other entities. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. We present a case of a gastric duplication cyst in a 17-year-old female, presenting with discomfort in the upper abdomen. Gastroscopy showed a submucosal mass about 40 mm in diameter on the side of the greater curvature of stomach. Computed tomography (CT) reveals a submucosal prominence in the body of stomach, which could indicate a foregut cyst or an ectopic structure. Endoscopic ultrasonography (EUS) showed a submucosal bulge of the corpus body of stomach, and may be lipomas. Patients undergo endoscopic submucosal dissection (ESD) to relieve symptoms and confirm the diagnosis of lesions. The procedure went smoothly and the solid cystic lesions were completely removed. Histopathological examination reveals gastric duplication with mixed hemangioma, and intrinsic fat liquefaction. After resection, the patient was successfully discharged from the hospital, and during the 6-month follow-up period, there are no symptoms or evidence of disease recurrence. This is a rare case of gastric duplication with mixed hemangioma. ESD can be used as an alternative treatment to provide a definitive diagnosis., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2025 Elsevier GmbH. All rights reserved.)

Cardiac hemangiomas (CH) arise predominantly from the epicardium and their location in the right ventricular outflow tract is uncommon; we report a unique case of RVOT cardiac hemangioma. Urgent operative intervention resulted in immediate relief and was associated with an uneventful recovery., (© 2025 Wiley Periodicals LLC.)

Testicular hemangioma is a rare benign vascular neoplasm originating from the inner layer of the tunica albuginea, predominantly affecting the pediatric population and often associated with hemangiomas in other organs. Histopathologically can be categorized into four types, including capillary, cavernous, papillary endothelial hyperplasia, and epithelioid (histiocytoid). We report a case of a 24-year-old presenting with left inguinal pain, diagnosed with an epithelioid (histiocytoid) hemangioma of the testis. Diagnostic evaluation included scrotal doppler ultrasonography, which revealed a small, hypoechoic formation with evident vascularization. Serum tumor markers were within normal limits. Surgical excision via testis-sparing surgery (TSS) was performed based on frozen section analysis. A literature review underscores the rarity of testicular histiocytoid hemangiomas. Advancements in diagnostic technique have improved the accuracy of diagnosis and allowed for more conservative surgical approaches, preserving fertility and minimizing long-term adverse effects. In conclusion, while testicular hemangiomas may present characteristic features on ultrasound, frozen section examination remains crucial in guiding surgical decision-making. TSS offers significant advantages over traditional excisional surgery, including reduced morbidity and preservation of cancer control, making it an essential option in the management of testicular hemangiomas, particularly in young patients concerned about fertility preservation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Subglottic cysts and hemangiomas are rare but potentially life-threatening conditions in pediatric patients. Subglottic cysts are generally associated with premature infants with a history of prolonged endotracheal intubation, while subglottic hemangiomas are congenital vascular lesions that grow rapidly and are uncommon head and neck tumours in pediatric patients. Both conditions can present with generalised respiratory symptoms such as stridor. Early diagnosis and treatment are crucial in avoiding airway compromise. Medical records of three pediatric patients were reviewed. All cases involved the use of coblation as treatment for subglottic cysts or hemangiomas. All three cases responded well to coblation. Subsequent endoscopies have shown excellent healing with no additional cyst or hemangioma formation with minimal stenosis. The study's results suggest coblation is a safe and effective alternative to cautery and CO 2 laser for treating pediatric subglottic cysts and hemangiomas., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

The epidemiological characteristics and surgical treatment of inpatients with superficial hemangioma in Shandong province were investigated and analyzed. The first-page medical records of hospitalized patients with superficial hemangioma from 2019 to 2020 reported by all secondary and above medical institutions in Shandong province were selected from the National Health Information Platform of Shandong province to analyze their population characteristics and surgical treatment. A total of 3 775 patients with superficial hemangioma were included, with the age of [ M ( Q 1 )] 3.0(0, 33.0)years, including 1 419 males (37.6%) and 2 356 females (62.4%). The head and neck superficial hemangioma accounted for the highest proportion of 37.8% (1 425/3 775), followed by limbs 34.5% (1 302/3 775) and trunk 24.4% (922/3 775). Infants accounted for the highest proportion of 37.2% (1 406/3 775). There were 2 874 (76.1%) patients with superficial hemangioma received surgical treatment, and the proportion of male patients receiving surgery was higher than that of female patients[78.2%(1 110/1 419) vs 74.9%(1 764/2 356), Q 3 0.001). In terms of different parts, the proportion of patients with superficial hemangioma in the limbs who received surgery was the highest at 86.2%(1 123/1 302) ( P <0.001). The majority of the surgical operations were secondary surgery (55.8%, 1 110/1 988), elective surgery (91.4%, 1 818/1 988), class Ⅰ incision (53.5%, 1 338/2 501), and general anesthesia (50.9%, 1 219/2 397). The main treatment method was resection (48.1%, 1 816/3 775). The study found that the majority of inpatients with superficial hemangioma in Shandong province were mostly in head and neck, with more females than males, and infants being the main group, and surgical treatment was the main treatment.P trend < 0.001). In terms of different parts, the proportion of patients with superficial hemangioma in the limbs who received surgery was the highest at 86.2%(1 123/1 302) ( P <0.001). The majority of the surgical operations were secondary surgery (55.8%, 1 110/1 988), elective surgery (91.4%, 1 818/1 988), class Ⅰ incision (53.5%, 1 338/2 501), and general anesthesia (50.9%, 1 219/2 397). The main treatment method was resection (48.1%, 1 816/3 775). The study found that the majority of inpatients with superficial hemangioma in Shandong province were mostly in head and neck, with more females than males, and infants being the main group, and surgical treatment was the main treatment.

Cardiac hemangiomas are rare tumors of the heart which account for less than one-twentieth of all primary cardiac tumors. They can be seen in all age groups but are mostly diagnosed in neonates and children. Although cardiac hemangiomas are benign in nature they can present with features of congestive heart failure and occasionally be life-threatening. We present such a case in a two-month-old child who underwent successful surgical excision of the mass., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Importance: Adult laryngeal hemangiomas are rare and may cause symptoms such as dysphonia, dysphagia, and dyspnea. Carbon dioxide (CO2) lasers offer an alternative approach to managing this rare condition., Objective: The objective of this study is to evaluate the effectiveness of CO2 lasers in treating adult hemangioma and to identify potential side effects associated with this treatment modality., Design/methods: The study utilizes the PRISMA model to systematically collect articles available in the current literature. The numbers obtained from each academic manuscript were then used to calculate the effectiveness of CO2 laser therapy in patients with laryngeal hemangiomas. Articles from 1949 to 2023 were gathered using the PRISMA systematic review method., Setting: Not applicable., Participants: Adult patients with laryngeal hemangioma who were treated with CO2 lasers., Intervention or Exposures: Surgical management with CO2 lasers., Main Outcome Measures: Number of patients with at least a 50% reduction in laryngeal hemangioma size., Results: Two case reports, 4 case series, and 2 observational studies were included in this systematic review. For the case reports and series, only 1 out of the 19 patients experienced recurrence following CO2 laser treatment. However, some studies did not have adequate follow-up time. In the 2 observational studies, efficacy rates of 100% and 90.9% were reported by the authors respectively., Conclusion and Relevance: Adult laryngeal hemangioma can be safely and successfully treated with CO2 laser microsurgery in well-selected cases. More studies, as well as longer patient follow-ups, are needed to truly assess the efficacy of CO2 laser in treating laryngeal hemangioma. This method provides a minimally invasive technique for adult patients with this rare disease., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The 595-nm wavelength pulsed dye laser (PDL) is well-established in the treatment of vascular lesions. In June 2023, it received FDA clearance for the treatment of port-wine birthmarks (PWB) and infantile hemangiomas (IH) in the pediatric population., Objective: Review the evidence regarding the efficacy, safety, and implications of using PDL for management of pediatric PWB and IH., Methods: A systematic literature search was performed to identify peer-reviewed articles and clinical trials published between July 2002 and December 2022 in which PDL was used to treat pediatric PWB and IH., Results: After application of criteria, 33 journal articles with 7725 total patients were included. Only 16 (0.8%) of the 2,033 patients with PWB and 11 (0.2%) of the 5692 patients with hemangioma reported permanent adverse effects including scarring, keloids, or permanent pigmentation change, and none reported blindness or other serious injury. Good, excellent, or complete clearance after PDL-on average or in greater than 50% of patients-was reported in 17 of 19 studies (89%) that reported these measures for PWB, and seven of the seven studies (100%) for IH., Conclusion: The 595-nm PDL is an excellent treatment option for early intervention in pediatric patients with PWB or IH., (© 2024 The Author(s). Lasers in Surgery and Medicine published by Wiley Periodicals LLC.)

Hemangiomas in the head and neck region, especially those that may impact the airway, require special attention perioperatively because of the potential for difficulties with airway management and bleeding control. This case report describes the management of a 31-year-old male with a large hemangioma of the tongue and pharynx undergoing surgical extraction of mandibular third molars under intubated general anesthesia. Despite taking precautions and avoiding traumatizing the hemangioma while securing the airway, massive bleeding occurred during the surgical extractions, which prompted emergent transfer for angiographic embolization and a stay in the intensive care unit until extubation. This case report highlights the additional attention needed for patients with hemangiomas within the oral cavity and upper airway because of the potential for unexpected massive bleeding that can affect airway management and cardiovascular stability.

Although hemangiomas are common in the head and neck area, they are uncommon in the temporal bone. External auditory canal (EAC) hemangiomas are a relatively uncommon otologic condition. In the English literature, only 29 cases of temporal bone hemangioma have been reported. We also present the case of a 32-year-old male patient who presented with an 8-month history of decreased hearing, tinnitus, and aural fullness on the right side. Otoscopic examination of the right ear revealed a smooth, oval, well-circumscribed, reddish, pulsatile, nontender mass, which was about 1 cm in diameter and occupied two-thirds of the EAC. It was soft in consistency, compressible, and appeared to be arising from the right posterior-superior portion of the bony canal wall; the tympanic membrane seemed to be uninvolved. The patient had mild conductive hearing loss of the right ear with an average air-bone gap of 20 dB; the left side was normal. High-resolution contrast-enhanced computed tomographic scanning of the temporal bone showed well-defined, rounded, homogenously enhancing lesions at the posterior-superior aspect of right EAC measuring 0.7 × 0.8 cm. Angiography was performed and there was evidence of vascular blush in the region of the right EAC. Three blood vessels were identified and embolized. The mass was completely removed by the endaural approach, and a retroauricular skin graft to restore cutaneous integrity was not required. Histopathology indicated a capillary hemangioma without cytological atypia or mitotic activity. There was no recurrence 1 year after the surgery., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Summary: Hemangiomas of the nasal tip are a relatively uncommon presentation of a common tumor. While optimal medical and surgical management of nasal tip infantile hemangiomas has been described and debated extensively in the literature, to our knowledge, there is no report of secondary aesthetic and functional rhinoplasty in these patients at skeletal maturity, until now. This special topic article provides an excellent example of the 5 key technical elements to revision rhinoplasty in the skeletally mature patient with a history of nasal tip infantile hemangioma., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Objective : To evaluate the curative effect of Potassium titanyl phosphate (KTP) laser and pingyangmycin injection for adult laryngeal hemangiomas (ALH). Methods : This was a retrospective study conducted on patients treated with either KTP laser or pingyangmycin injection to assess the efficacy of both treatment and compare the effects on different types of adult laryngeal hemangioma. Results : The ordinal logistic regression test showed the surgery methods had no effect on the therapeutic results. On the contrary, the shape of ALH and the interaction between surgical procedures and ALH shape affected the prognosis of the ALH. This meant that the shape of ALH might be a confounding factor affecting the therapeutic effect of ALH. Thus, the Cochran-Mantel-Haenszel test which is a stratification analysis was used to assess the interaction between surgical procedures and ALH shape. Then better results were achieved using the KTP laser for the plane and raised types of ALH. Conclusions : The selection of surgical procedures (the KTP laser or pingyangmycin injection approaches) affects the treatment of ALH. For plane and raised ALH, the KTP laser may be recommended., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The authors assessed the impact of propranolol as the first-line treatment of infantile hemangioma (IH) on the need for surgery in the management of IH., Methods: In this retrospective study, 420 patients with IH referred to a multidisciplinary center between January of 2005 and August of 2014 were included. Clinical data, including sex; age at first consultation and at treatment initiation; location, size, number, aspect, and complications of IH; and type of treatment were collected. Statistical analyses were conducted considering each patient and each tumor independently., Results: A total of 625 IHs (420 patients) were reviewed; 113 patients had more than 1 IH (26.91%). Median age at first consultation was 7 months. Overall, 243 patients were treated (57.86%) using surgery ( n = 128 patients, 141 IHs), propranolol ( n = 79 patients, 89 IHs), corticosteroids ( n = 51 patients, 56 IHs), or laser ( n = 34 patients, 36 IHs). Propranolol was effective in all but 2 infants with IH. Seven of 79 patients (8.86%) initially treated with propranolol still required surgery, in contrast to 18 of 51 patients (35.29%) initially treated with corticosteroids and 103 of 290 patients (35.51%) with no medical treatment. Since the availability of propranolol, patients were less likely to undergo surgery (48 versus 80 patients; P < 0.001). This demonstrated that the use of propranolol reduced the need for surgery ( P < 0.001; OR, 0.177; 95% CI, 0.079 to 0.396)., Conclusions: Propranolol dramatically reduced the need for surgery, regarding indications and number of patients. Surgical correction remains important for sequelae management, nonresponders, or strawberry-like IH., Clinical Question/level of Evidence: Risk, III., (Copyright © 2024 by the American Society of Plastic Surgeons.)

We describe a case of laryngeal angioleiomyoma, discuss its characteristic features and management, and provide a review of the literature, to improve clinical diagnosis and treatment. We report the oldest patient with a laryngeal angioleiomyoma to date and analyze the clinicopathological features reported in the literature. To the best of our knowledge, a total of 36 cases have been described in the English and Chinese medical literature (including our case). The male-to-female ratio was 5:1 and the mean age was 53.89 years. The most common laryngeal site was the supraglottic region (23 cases; 63.89%), followed by the subglottic region (8 cases; 22.22%), and glottis (5 cases; 13.89%). The most common and serious intra- and postoperative complication was massive bleeding. Angioleiomyoma is a benign tumor that rarely occurs in the larynx. Biopsy of this lesion should not be performed; complete surgical resection is the best treatment. Recurrence and malignant transformation are extremely rare., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We present the clinical course of an 8-month-old infant with a giant cutaneous hemangioma resulting in high-output heart failure and pulmonary hypertension. The lesion was successfully embolized and excised, with rapid resolution of heart failure and improvement in pulmonary hypertension., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Informed consent: Verbal informed consent was obtained from the legal guardians., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Cardiac hemangioma is a rare, benign vascular primary tumor. Clinical presentation is either asymptomatic or with symptoms due to its location and spatial interaction with adjacent structures. The authors present a case of right cardiac hemangioma whose clinical diagnosis was triggered by symptoms of anasarca status, hepatic damage with ascites, pleural effusion and right heart failure. The 79 years-old patient has been treated with complete resection of the tumor by means of cardiopulmonary bypass, without complications. The mid-term outcome (12 months) was favorable. The aim of this study is to report a case of cardiac hemangioma with relevant dimensions, in a rare location (tricuspid valve) with acute onset and interesting aspects of clinical presentation., (© 2024. The Author(s).)

Background: Early evaluation and treatment of periorbital infantile hemangiomas (POIH) were associated with lower rates of ophthalmological complications. Objective: To evaluate age and characteristics associated with improved anisometropic astigmatism (anisoastigmatism) and eye symmetry measured by diopters and a 5-point scale, respectively, in patients with POIH treated with surgical excision. Methods: A retrospective study was performed on patients with POIH. Patient characteristics and eye symmetry were analyzed between patients with resolved and unresolved anisoastigmatism after surgery. Statistical analyses included the Mann-Whitney U tests, chi-square tests, and linear regression models. Results: In total, 54 patients were included (male: 20, female: 34). Upper medial eyelid was the most commonly affected site (resolved: 45%, unresolved: 43%), followed by upper lateral and upper central. Fifty-six percent (31/55) had postoperative resolution of anisoastigmatism, whereas 44% (24/55) did not. Earlier surgical evaluation (median: 4.5 vs. 6.0 months, p = 0.047) and excision (median: 5.0 vs. 12.0 months, p = 0.005) were associated with reversible anisoastigmatism. Good and suboptimal eye symmetry were not associated with earlier surgical excision (median: 6 vs. 6.5 months, p = 0.87). Follow-up ranged from 1 month to 12 years. Conclusion: Earlier surgical excision was associated with reversing anisoastigmatism but was not significant for improving eye symmetry.

Introduction: SH is considered to be the most common benign tumor within the human spine. 1-2% of SH get symptomatic with back pain in most cases. Less often, ingrowth of vessels into the spinal canal is seen. In these cases, more invasive surgical treatment is required. Recurrence of SH following surgical treatment is a very rare condition., Methods: We present the results of a retrospective chart review, with description of the clinical course of 12 patients with spinal canal invading SH without recurrence and of 5 patients with a recurrent SH., Results: Recurrence was diagnosed 70 months (mean value) after the first procedure. All patients with a recurrent SH had received an incomplete tumor resection as a first treatment. The distribution of gender, age at the diagnosis, levels involved by the tumor, and initial symptoms were comparable in the group of patients with and without recurrence. The patients with recurrent SH were treated with preoperative embolization and en bloc resection or complete piecemeal resection of the affected vertebra. For stabilization, a combined, circumferential fixation was used consisting in a TSM cage filled by bone graft and posterior pedicle screw rod instrumentation in all patients. We followed these patients until 09/ 2023, mean FU 122 months (range 72-184 months). At this time, we found no evidence of tumor recurrence, good clinical conditions in all patients, no signs of implant failure or pseudarthrosis., Discussion: Thus, radical excision, sufficient stabilization and fusion is considered to be an adequate treatment concept for recurrent SH., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Objectives: We present our experience in the management of symptomatic vertebral hemangiomas with epidural extension (SVHEE) using spine stereotactic radiosurgery (SSRS)., Methods: An Institutional Review Board approved retrospective review of all SVHEE patients treated with SSRS at our institution (2007-2022) was performed. Baseline patient demographics, clinical presentation, lesion volume, and Bilsky grade (to directly evaluate the epidural component) were determined. Clinical and radiographic response and treatment outcomes were subsequently evaluated at first (∼6 months) and final follow-up., Results: Fourteen patients with SVHEE underwent SSRS (16-18 Gy/1-fraction); the mean follow-up was 24 months. The median lesion volume (cc) was 36.9 (range: 7.02-94.1), 31.5 (range: 6.53-69.7), and 25.15 (range: 6.01-52.5) at pre-SSRS, first, and final follow-up, respectively. Overall volume reduction was seen in the last follow-up in all 14 patients, median 29.01% (range: 6.58%-71.58%). Bilsky score was stable or improved in all patients at the last follow-up when compared with pre-SSRS score. Patients who underwent both surgical decompression and SSRS (n = 9): 8 had improved myelopathic symptoms and pain and 1 had stable radiculopathy postintervention. In the 5 patients treated with SSRS monotherapy, 2 had stable radicular pain and the other 3 improved pain and numbness. No patients experienced adverse outcomes., Conclusion: To our knowledge, this represents the largest series of SVHEE patients treated with SSRS, either as monotherapy or part of a multimodal/separation surgery treatment approach. We demonstrate that SSRS represents a potentially safe and effective treatment option in these patients. However, larger prospective studies and longer follow-ups are necessary to further assess the role, durability, and toxicity of SSRS in the management of these patients., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Background: Large involuted infantile hemangioma remains a challenge in facial reconstruction. The characteristic fibrofatty residuum and multiple subunits/tissues involvement contribute significantly to the difficulty of surgical management. Tissue expander plays an important role in facial reconstruction, allowing plastic surgeons to repair skin damaged by both congenital and acquired defects., Methods: Between 2009 and 2021, 30 patients who underwent tissue expansion surgery were reviewed in a single hospital. The demographic data, lesion characteristics, surgical approaches, complication rate, and aesthetic outcomes were analyzed., Results: Thirty patients (5 men and 25 women) with a mean age of 14.03 ± 7.25 years (range, 4-33 years) were included. The mean follow-up is 35.92 months, ranging from 9 to 75 months. Tissue expansion-related complications include closed infection, 2/30 (6.67%); skin ischemia, 2/30 (6.67%); hematoma, 1/30 (3.33%); flap necrosis, 1/30 (3.33%)., Conclusion: Large facial involuted infantile hemangiomas have variable patterns of presentation and necessitate tailored therapy. Tissue expansion is a reproducible approach to achieving aesthetic reconstruction., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Haemangioma of the ribs is considered an extremely rare benign tumour. Here, we present a case of a young male with left tenth rib haemangioma vascularised by a costal artery giving the artery of Adamkiewicz presented as chronic cough. This was successfully treated through preoperative embolisation and surgical resection. A preoperative angiogram was performed to identify the origin of the artery of Adamkiewicz. The final diagnosis was confirmed histopathologically. There were no complications in the postoperative course and no recurrence during 12 months of follow-up., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Intramuscular hemangiomas (IMH) account for 0.8 % or less of all benign soft tissue tumors in the general population. Due to their uncommon nature, especially in the head and neck, they are often misdiagnosed and not included in the differential diagnosis., Methods: This study describes a case series of eleven pediatric patients with a diagnosis of IMH through a retrospective review of the electronic health records and archival records in the Department of Pathology at Children's Hospital of Colorado (CHCO)., Results: The index case had a unique presentation in the submandibular triangle, while the remaining ten cases are appendicular and thoracolumbar in nature., Conclusions: This case series contributes to the sparse scientific literature available regarding IMH, particularly in its head and neck presentation as relevant to otolaryngologists., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Adrenal hemangiomas are extremely rare benign tumors that often need to be distinguished from malignancies. Adrenal tumors >4 cm in size are treated surgically because the possibility of malignancy cannot be ruled out. Traditionally, open surgery has been the mainstay of treatment; however, in recent years, robot-assisted surgery has been increasingly used for tumors of larger size and suspected malignancy. Here, we report a case of robot-assisted adrenalectomy for an 11 cm adrenal hemangioma., Case Report: A 62-year-old male with lateral abdominal pain was referred to our hospital for further examination and treatment. His medical history was significant for hypertension, diabetes, and dyslipidemia. Computed tomography revealed an 11 cm left adrenal tumor, and all endocrinological screening tests were negative. Because the possibility of malignancy could not be ruled out, a robot-assisted adrenalectomy was performed. The operation time was 129 min, and the estimated blood loss was 7 ml. Pathological findings revealed an adrenal hemangioma. The postoperative course was uneventful, and patient's condition subsequently improved postoperatively., Conclusion: Robot-assisted adrenalectomy was performed for a giant adrenal hemangioma without any complications. Robotic surgery is useful for resecting adrenal hemangiomas even exceeding 11 cm in diameter., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

A constant search for methods to limit blood loss, especially the vascular lesions of the tongue, has led to the acceptance of ultrasonic harmonic scalpels.The harmonic scalpel's reliability exists in its ability for lasting hemostasis with minimal heat dispersion to the surrounding structures.Surgical removal of the vascular pathology in a restricted area of the oral cavity and oropharynx dictates a bloodless surgical field, further allowing increased visibility of the lesion and the surrounding anatomical structures, subsequently narrowing the surgical time frame.We report a rare case of haemangioma of the lateral border of the tongue managed with complete resection of the tumor achieved using the harmonic scalpel with reduced intraoperative blood loss, increased visibility, evidently reduced post-operative necrosis and highly preserved tissue for the histopathological examination., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Rationale: Multilocular cystic hemangioma is a rare benign tumor classified as an atypical hemangioma. Currently, there are limited imaging reports available, and the imaging characteristics can be challenging to distinguish from other malignant multilocular cystic liver diseases such as cystadenocarcinoma, necessitating confirmation through pathological diagnosis. Here, we discuss the imaging features of 3 cases of multilocular cystic hemangiomas., Patient Concerns and Diagnoses: Case 1 was a 24-year-old young female, and Case 2 involved a 60-year-old elderly male. Both patients were asymptomatic and physical examination revealed hepatic space-occupying lesions. Imaging findings revealed multilocular cystic lesions in the left liver with septa, calcification, a high diffusion-weighted magnetic resonance imaging (DWI) signal at the edge of the lesion, and progressive enhancement of the cyst wall and septa. Case 3 involved a 50-year-old male patient with epigastric distending pain for 1 month and sudden severe abdominal pain for 14 hours. Imaging results revealed a multilocular cystic lesion in the left liver with septa and tumor bleeding, a high DWI signal, and an enhanced cyst wall and septa. The pathological diagnosis confirmed a hepatic hemangioma., Interventions: All 3 patients underwent liver tumor resection., Outcomes: All 3 patients recovered successfully without any intraoperative or postoperative complications during the follow-up periods of 5 years, 6 months, and 5 months. There were no signs of recurrence., Lessons: Liver imaging revealed multilocular cystic lesions with features, such as compartmentalization, calcification, or bleeding. Multilocular cystic hemangiomas should be considered in imaging diagnosis. Enhancing our understanding of multilocular cystic hemangiomas can aid in improving the differential diagnosis of other malignant multilocular cystic liver diseases, ultimately reducing unnecessary liver resection., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

A 28-year-old female presented with a slowly enlarging, left cheek mass over two years. She underwent neuroimaging and was found to have a well-defined, low attenuating lesion with thickened vertical trabeculation of the left zygoma, consistent with intraosseous hemangioma. To minimize the risk of severe intraoperative hemorrhage, the patient underwent embolization of the mass by neuro-interventional radiology two days prior to resection. The patient subsequently underwent a left anterior orbitotomy and partial zygoma resection followed by reconstruction of the lateral orbit with a custom porous polyethylene zygomaxillary implant. The postoperative course was uneventful with a good cosmetic outcome.

Background: Facial nerve hemangiomas (FNHs) are rare tumors that primarily occur near the geniculate ganglion in the temporal bone. Despite their rarity, they can cause significant facial nerve dysfunction. The optimal management approach for FNHs remains uncertain, with surgery being the mainstay but subject to debate regarding the extent of resection and preservation of the facial nerve., Methods: Systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried the PubMed/Medline (accessed on 5 March 2024) electronic database using combinations of the following search terms and words text: "geniculate ganglion hemangioma", "ganglional hemangioma", "hemangioma of the facial nerve", "facial hemangioma", and "intratemporal hemangioma"., Results: We identified a total of 30 literatures (321 patients). The most common site involved for the facial nerve hemangioma was the geniculate ganglion area followed by internal auditory canal, tympanic segment, labyrinthine segment and mastoid involvement. All patients were treated with conservative management or surgery. We report a 48-year-old female patient with HB grade 2 facial palsy and hemifacial spasm underwent SRS using Cyberknife technology. The treatment targeted the FNH in the left internal acoustic canal near the geniculate ganglion. Six months post-treatment, clinical improvement was evident, and lesion control was confirmed in a follow-up brain MRI., Conclusion: The rarity of FNHs contributes to the lack of consensus on optimal management. This illustrative case demonstrates the feasibility of SRS as a standalone treatment for FNHs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Synovial hemangiomas are rare benign vascular anomalies surrounded by a synovial lining and were first described by Bouchut in 1856. These neoplasms can develop in the intra-articular region, resulting in effusions and knee pain. However, their cause remains unknown. Prompt diagnosis and intervention are critical to prevent chondral damage. Histopathological examination is used to achieve the diagnosis, which is often delayed because of a lack of specific clinical signs. This report describes a unique case in which a painful infrapatellar mass was diagnosed as a synovial hemangioma. The absence of typical magnetic resonance imaging (MRI) findings highlights the importance of arthroscopic excision for diagnosis and symptom relief., Case Presentation: A 20-year-old woman presented with persistent anterior left knee pain that became exacerbated when she climbed stairs. Despite previous pain management and physical therapy, she developed a painful lump beneath her patella that worsened over time. She had also undergone arthrocentesis, but this did not relieve her pain. Physical examination revealed a palpable, immobile 5-cm mass along the patellar tendon with limited knee flexion and extension and normal ligament stability. T1-weighted fat-saturated MRI of the left knee with gadolinium-based contrast revealed a lobulated intra-articular mass in Hoffa's fat pad that resembled a soft tissue chondroma. A biopsy of the mass was performed to provide histopathological evidence, confirming the benign nature of the mass. The subsequent excisional arthroscopy, combined with incision enlargement for mass removal, confirmed the histopathologic diagnosis of synovial hemangioma based on the presence of numerous dilated blood vessels and venous proliferation within sections of the synovium. Recovery was complete, and no residual tumor was detected on follow-up MRI after 1 year., Conclusion: This case study emphasizes the importance of arthroscopic excision over open surgery for patients with synovial hemangioma. The minimally invasive nature of arthroscopy combined with the well-encapsulated nature and location of the mass facilitates complete resection., (© 2024. The Author(s).)

Background: Severe bleeding remains a significant concern in laparoscopic resection for hepatic hemangioma. It is rarely reported that how the degree of major vessels involvement impacts on severe bleeding. The present study primarily aimed to analyze the impacts of the number of involved major vessels (NIMV) during laparoscopic surgery for hepatic hemangioma and evaluate the risk factors associated with increased bleeding., Methods: A database search was carried out for consecutive patients who underwent laparoscopic resection for liver hemangiomas at our department from January 2018 to December 2023. The collected data included demographics, characteristics of the hemangiomas, laboratory data, operation method, surgical and postoperative variables., Results: A total of 72 patients were enrolled in the study. 42 patients were categorized into the group with NIMV < 2, while 30 patients were divided into the group with NIMV ≥ 2. The group with NIMV ≥ 2 demonstrated a significant correlation with special segments, involved multiple segments and diameter of the hemangiomas (P < 0.01). And the perioperative variables including the extent of resection, operative time, blood loss, Pringle maneuver times, postoperative stay, drainage tube duration, and postoperative liver function (ALT, AST) also showed significant differences between the two groups (P < 0.05). Notably, NIMV ≥ 2 was identified as the most important independent risk factor for intraoperative blood loss ≥ 500 ml in laparoscopic surgery for hepatic hemangioma (P = 0.011). For NIMV ≥ 2, the independent risk factor was special segments in multivariate analysis (P = 0.000)., Conclusion: The involvement of multiple major vessels (NIMV ≥ 2) was significantly associated with special segments, resulting in increased intraoperative blood loss, operation difficulty, and delayed postoperative recovery. Moreover, it was identified as the single independent risk factor with a considerable risk for increased blood loss during laparoscopic resection for hepatic hemangioma., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Abstract: We report an unusual presentation of an orbital spindle cell hemangioma in a 40-year-old male, who noted sudden redness and swelling of the left eye on waking up. On examination, the patient was found to have edema of upper eyelid edema, periorbital ecchymosis, and subconjunctival hemorrhage in the left eye at presentation. On treatment with topical medications, patient had transient symptomatic relief; however, he later developed blurring of vision. When seen 10 days later, the patient's left eye showed axial proptosis. Radiological investigations revealed an intraconal soft tissue mass in the left medial rectus. Emergency orbital decompression with mass excision was done; histopathological examination of the excised mass revealed spindle cell hemangioma. Postsurgery patient had complete restoration of vision. To our knowledge, an acute presentation of an orbital hemangioma with subconjunctival hemorrhage and periorbital ecchymosis, visual loss doesn't occur commonly; hence, such presentations have to be reviewed with care., (Copyright © 2023 Copyright: © 2023 Indian Journal of Pathology and Microbiology.)

Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.

Objective: Vertebral hemangiomas (VHs) are relatively common, symptomatic benign tumors of the spine with a reported estimated incidence up to 11%. They usually appear in the body of the vertebrae; however, they can extend into pedicles, laminae, and epidural space. They may cause pain, neurologic deficits. and fractures., Methods: In this retrospective, single-center study, we reviewed our cases with VH and we propose the novel classification system that evaluates these lesions per their views on magnetic resonance imaging and clinical findings under 4 main categories., Results: Our novel classification system proposes that grade I lesions occupy less than 50% of the vertebral body, whereas grade II lesions occupy more than 50% and grade III lesions occupy the whole corpus. Grade IV lesions show an epidural and pedicular extension. We propose that grade I lesions may not be worthwhile for follow-up, whereas asymptomatic grade II (a) lesions to be worthy for a biannual imaging and symptomatic thoracolumbar grade II (b) and thoracolumbar grade III lesions to be considered for percutaneous vertebroplasty. We imply that decompression, posterior spinal instrumentation, and open vertebroplasty may be performed for thoracolumbar grade IV lesions. We further consider cervical grade IIb, III, and grade IV lesions as operable because of the disadvantages of percutaneous vertebroplasty., Conclusions: We suggest that our novel classification system may be useful for the determination of diagnostic and therapeutic procedures in the management of VH. Further multicentric trials on larger series are warranted to validate this system and popularize its utility in larger populations., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: Compressive vertebral hemangiomas with neurological deficits (CVHND) form a rare, unique subset of lesions comprising of differing clinico-imaging findings, pathologic behavior and treatment, when compared to the commoner and usually incidental intra-osseus vertebral hemangiomas (VH). Though various surgical strategies and a broad array of adjuncts have evolved and changed over the years, there is paucity of comprehensive data from sizeable series of such patients treated surgically with long term follow up. The purpose of this study is to device an optimum management strategy in CVHND based on our surgical experience., Materials and Methods: The data from electronic medical records of 26 consecutive patients operated in our department from 2009 to 2019 were retrospectively analyzed., Results: There were 11 males and 15 females with a mean age of 34.7 years. Neurological examination revealed paraparesis or paraplegia with myelopathy in all patients with Frankel score of B, C and D in 1 (3.9%), 11 (42.3%) and 14 (53.8%) patients respectively. Sixteen patients (61%) underwent laminectomy and gross total excision of extradural soft tissue component, 7 (27%) laminectomy with posterolateral fusion, three (12%) underwent additional anterior interbody support. The mean follow up was 72.4 months and at last follow-up 24 patients (92%) were Frankel E. Symptomatic recurrence was seen in two patients operated early in the series, they underwent re-surgery, gross total excision with posterolateral fusion, remaining neurologically intact at last follow up., Conclusions: Pre-operative embolization, surgical excision of extradural component and intra-operative vertebroplasty form the mainstay of treatment for CVHND. Instrumented posterolateral fusion with optional anterior interbody support accomplished through the same approach is required only in a minority of cases. The long-term outcome following timely and appropriate treatment is excellent. Anterior or anterolateral approaches for intervertebral support and radical procedures like total en-bloc spondylectomy (TES) are not usually required.

Anastomosing hemangioma (AH) is a rare benign lesion that is asymptomatic in the majority of cases. Herein, we present the case of a 26-year-old woman with acute lower abdominal pain for 5 months. The patient subsequently developed symptoms of hyperestrogenism with prolonged menstrual periods. The possibility of malignancy could not be ruled out via ultrasonography and computed tomography. The tumor was completely removed using laparoscopic surgery, and pathological examination confirmed AH of the ovary., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Laparoscopic treatment has been increasingly adopted for giant hepatic hemangioma (HH), but the role of liver resection or enucleation remains uncertain. The aim of this study is to compare the laparoscopic resection (LR) with laparoscopic enucleation (LE) for HH, and to provide evidence on how to choose the most suitable approach for HH., Methods: A retrospective analysis of HH patients underwent laparoscopic treatment between March 2015 and August 2022 was performed. Perioperative outcomes were compared based on the surgical approaches, and risk factors for increased blood loss was calculated by logistic regression analysis., Results: A total of 127 patients in LR group and 287 patients in LE group were enrolled in this study. The median blood loss (300 vs. 200 mL, P < 0.001) was higher in LE group than that in LR group. Independent risk factors for blood loss higher than 400 mL were tumor size ≥ 10 cm, tumor adjacent to major vessels, tumor occupying right liver or caudate lobe, and the portal phase enhancement ratio (PER) ≥ 38.9%, respectively. Subgroup analysis showed that LR was associated with less blood loss (155 vs. 400 mL, P < 0.001) than LE procedure in patients with high PER value. Both LR and LE approaches exhibited similar perioperative outcomes in patients with low PER value., Conclusions: Laparoscopic treatment for HH could be feasibly and safely performed by both LE and LR. For patients with PER higher than 38.9%, the LR approach is recommended., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare., Case Presentation: We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma., Conclusions: Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis., (© 2024. The Author(s).)

Background: Lip infantile hemangiomas tend to show less volumetric regression and are more susceptible to visible sequelae in the involuted stage. Some of them still require surgical management after propranolol therapy. This study aimed to evaluate the efficacy and safety of the Stepwise, Multi-Incisional, and Single-Stage (SMISS) approach applied to lip reduction for those with involuted lip hemangiomas., Methods: A retrospective review was performed to evaluate patients with lip hemangioma who received previous propranolol treatment and underwent the aforementioned procedure. Demographic characteristics, lesion morphology, and medical history were reviewed. The Visual Analog Scale was applied to assess the postoperative appearance. Complications within 12 months postoperatively were recorded., Results: A total of 18 patients with lip hemangioma were eligible. All patients received oral propranolol therapy before surgery, with treatment duration ranging from 6.0 to 23.0 months. Their age at surgery ranged from 2.5 to 9.0 years. The median Visual Analog Scale scores were 8.0, ranging from 4.0 to 10.0. No severe complications were reported., Conclusions: This modified technique based on the SMISS approach has proven reliable and effective in improving the aesthetic outcome for involuted lip infantile hemangiomas. Practical surgical techniques still play an important part in the propranolol era., (© 2024. The Author(s).)

Purpose: Preoperative elastoplasty could be an alternative strategy for treating aggressive vertebral hemangiomas (VHs) in frail patients needing for spinal cord decompression, combining the advantages of embolization and vertebroplasty., Methods: Three elderly patients with spinal cord compression from thoracic aggressive VHs underwent XperCT-guided percutaneous injection of silicone (VK100), filling the whole affected vertebra, followed by a decompressive laminectomy. At 12-months follow-up no recurrences, vertebral collapse or segmental kyphosis were noted at the CT scans, with patients reporting an improvement of preoperative neurological deficits, VAS and Smiley-Webster pain scale (SWPS) parameters., Results: With its elastic modulus, non-exothermic hardening, and lower viscosity than PMMA, VK100 allowed a preoperative augmentation of the affected vertebral body, pedicles, and laminae without complications, with a controlled silicone delivery even in part of VH's epidural components thanks to XperCT-guidance., Conclusion: When facing highly bony erosive VH encroaching the spinal canal, VK100 combines the advantages of embolization and vertebroplasty especially in elderly patients, permeating the whole VH's angioarchitecture, significantly reducing tumor., (© 2024. The Author(s).)

A 68-year-old overweight woman with no history of oral contraceptive use presented a large liver mass of 40 cm on abdominal ultrasound without associated symptoms. Complete blood count, coagulation study, and liver biochemistry were unremarkable. Abdominal contrast-enhanced CT revealed a 33x24 cm lesion with discontinuous peripheral globular uptake and centripetal fill-in, consistent with an extremely giant hemangioma. It affected all segments of the right lobe, compressing the right suprahepatic vein and displacing all intra-abdominal structures, with a deviation of the midline structures (stomach and pancreas) to the left. Given the hemangioma size and its significant mass effect, surgery was discussed but declined by the patient, who remains asymptomatic 3 years later. Extremely giant liver hemangiomas (>10 cm) are rare, and the approach to asymptomatic patients is debated. Some advocate for prophylactic excision due to the potential for internal bleeding, growth, or rupture, while others suggest intervention for hemangiomas near major vascular structures. The American College of Gastroenterology recommends surgical intervention in such cases, but the European Association for the Study of the Liver suggests a conservative approach for most patients. This case highlights a successful "watch-and-wait" strategy, bringing attention to this unusual condition and its controversial management.

With only 15 reported cases, anastomosing haemangioma of adrenal is a rare entity and usually presents as adrenal incidentaloma. A hypertensive, diabetic, non-smoker man in his late 60s presented with irritative voiding symptoms. On evaluation, he was found to have a urinary bladder mass and left adrenal incidentaloma measuring 8 cm. Metabolic evaluation confirmed it to be non-functional.The patient underwent transurethral resection of bladder tumour with left laparoscopic adrenalectomy. Intraoperatively, the adrenal tumour was highly vascular with multiple feeder vessels. Grossly it was soft, encapsulated with focal grey-brown areas. Microscopically, most of adrenal gland was replaced by anastomosing proliferating capillary vessels within framework of non-endothelial supporting cells reminiscent of splenic sinusoids. The tumour was positive for CD-31, CD-34, Glut-1 and SMA.Anastomosing haemangioma is a benign entity but it must be differentiated from angiosarcoma. Characteristic imaging features are not yet defined and is, therefore, difficult to diagnose preoperatively., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)