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BACKGROUND Lobular capillary hemangioma (LCH; also referred to as pyogenic granuloma) is a common benign vascular tumor that is characterized by proliferation of capillaries with a lobular architecture. Lobular capillary hemangioma can involve superficial cutaneous, mucosal, or subcutaneous structures; the subcutaneous and intravascular variant is very rare. METHODS A 26-year-old female patient presented with a small infraorbital mass that was slowly growing within the last 6 months. She reported no pain but an uncomfortable feeling of pressure in this area. Six months before symptom onset, the patient had undergone a closed rhinoplasty with osteotomies without any reported complication. RESULTS An excisional biopsy was performed via a transconjunctival approach, and the histopathological findings were characteristic for a subcutaneous intravascular LCH. At the 3-month follow-up, the patient was asymptomatic with no evidence of a recurrent lesion. CONCLUSION To our knowledge, this is the first report of a subcutaneous intravascular LCH after rhinoplasty. We would like to draw the attention of stakeholders to this rare condition and raise awareness among clinicians to what seems to be a late finding after rhinosurgery.

Lobular capillary hemangioma mostly occurs in the anterior portion of the nasal cavity, rarely occurring in the posterior end of the inferior turbinate, as in this case. We report a case of lobular capillary hemangioma originating from the posterior end of the right inferior turbinate, which was successfully removed via an endoscopic endonasal approach.

Hemangiomas are common tumors characterized microscopically by massive proliferation of blood vessels predominantly blood capillaries. The congenital hemangioma is often present at birth and may become more apparent throughout life. They are probably developmental rather than neoplastic in origin. Although they are seen in head and neck, they are rarely reported in the oral cavity, especially those associated to palatal mucosa. This case report presents a case of a rare capillary hemangioma of palatal mucosa in a 2 months old infant.

BACKGROUND Thoracic epidural capillary hemangioma is exceedingly rare, with only a few reported cases. The typical presentation usually includes chronic, progressive symptoms of spinal cord compression in middle-aged adults. To the authors’ knowledge, this case is the first report in the literature of acute traumatic capillary hemangioma rupture. OBSERVATIONS A 22-year-old male presented with worsening lower extremity weakness and paresthesias after a fall onto his spine. Imaging showed no evidence of spinal fracture but revealed an expanding hematoma over 24 hours. Removal of the lesion demonstrated a ruptured capillary hemangioma. LESSONS This unique case highlights a rare occurrence of traumatic rupture of a previously unknown asymptomatic thoracic capillary hemangioma in a young adult.

Background Antibodies to PD-1 and PD-L1 have remarkably improved the overall survival of many patients with advanced solid tumors. SHR-1210 is an anti-PD-1 monoclonal antibody. Dermatologic reactive capillary hemangiomas (RCH) were the most common and unique drug-related AEs of SHR-1210, but rare on oral mucosa and gastrointestinal mucosa. Herein we report a case of RCH occurred in oral mucosa during the clinical trials of SHR-1210 in the treatment of non-small cell lung cancer. Case presentation A male in his 60 s with a history of non-small cell lung cancer received injection of anti-PD-1 monoclonal antibodies SHR-1210. The patient developed drug-related RCH on skin after the first injection and began to have gingival hyperplasia one year after the first injection which gradually increased in size and affect eating and speaking. Anti-PD-1 treatments were continued. After periodontal treatment, two oral lesions and one skin lesion were surgically removed. Similar histological manifestation was found in all three lesions as reactive capillary hemangiomas. All lesions had a good prognosis without recurrence on oral mucosa within one year after surgery. Conclusions Oral reactive capillary hemangiomas could be induced by SHR-1210 in the treatment of non-small cell lung cancer. Surgical resection is an effective treatment with a good prognosis.

Hemangioma is a benign vascular soft tissue tumor. It is the most common soft tissue tumor in children and >60% of hemangiomas occur in the head and neck region. However, these tumors are rare in the external auditory canal (EAC). This case report describes a case of capillary hemangioma in the EAC in a woman 54 years of age. With the patient under local anesthesia in microscopic surgery, the mass was excised completely via a transcanal approach. If there is a cystic and pinkish mass in the EAC with symptoms of bleeding or pulsatile tinnitus, hemangioma should be considered. For symptomatic hemangioma, complete surgical excision is necessary and the prognosis is good after excision. Histopathologic confirmation is mandatory after excision.

We report a 43-year-old female who presented with recurrent non-massive hemoptysis for four months. Chest radiograph was normal. Thoracic computed tomography (CT) scan revealed a 0.8-centimeter intraluminal polypoid mass abutting the middle part of trachea. A fiber-optic bronchoscopy demonstrated a lobulated reddish mass at dorsolateral aspect of the right side of tracheal wall. Cryotherapy to remove the mass and argon plasma coagulation to stop bleeding at the stump was performed. The histological evaluation confirmed the diagnosis of a tracheal lobular capillary hemangioma. There was no recurrence hemoptysis nor the recurrence of tumor during a one-year follow-up.

Background and objectives Hemangioma is an extremely uncommon benign tumor of blood vessels, which occurs mostly during childhood, particularly in the head and neck regions, it remains unusual in the oral cavity and exceedingly rare in the tongue, and larynx. This report recorded a patient's case of cavernous tongue hemangioma and explained how this case was treated and a review of the literature. Methods Review of the literature with a new case presentation. Results Here we report a case of a 49-year-old female patient was referred to our clinic at Rania Medical City Private-Hospital, Iraq country with the complaint of slowly enlarging mass and bleeding. The patient was diagnosed with multiple cavernous hemangioma of the lounge, larynx, pharynx, epiglottis, and lip. The patient was diagnosed by CT-angiography. Treatment consisted of surgical resection. Healing have occurred after 1 month of surgery. From 18 articles we obtained after searching (Google scholar and PubMed), we selected those papers focused on oral cavity, most of the cases were from India between 1961 and 2021, the average age range was 40 yrs. Females constituted the major gender. Dyspnea and swelling accounted for many complaints, especially from varied sides of the tongue and pharynx. Almost all cases have cavernous hemangioma regarding the histological types. Concerning treatment, surgery especially under general anaesthesia were the major. Nevertheless, bleeding was the major recorded complications, otherwise not any other significant complication were seen. Overall, the majority of cases had nearly 1 year of follow-up according to the year of the procedure. Recovering after the procedures were concluded the majority of recorded results. Conclusion The authors declare that cavernous hemangioma is extremely rare in adults, particularly in oro-pharynx, it needs to be included in the differential diagnosis of oral lesions, and there are many complications post operatively such as hemorrhage, it needs to be followed up to control complications.

Encephalotrigeminal angiomatosis, also called Sturge-Weber syndrome (SWS), is a syndrome of etiology which is not yet clear. It is a nonhereditary condition. The clinical features include pigmentation over the facial skin known as port-wine stain, abnormalities of ocular region, and central nervous system involvement as leptomeningeal angioma. In this manuscript, we present a rare case report with an unusual combination of SWS with facial lobular capillary hemangioma.

Hemangioma is a relatively common benign proliferation of blood vessel that primarily develops during childhood. It is a most common benign tumor of vascular origin is the region of head and neck. The common sites are lips, tongue, buccal mucosa, and palate in oral cavity. Due to aesthetic concern and appearance problems of the hemangioma of lower lip and face it requires appropriate management. This is a case report of a rare hemangioma of lower lip and face bilaterally with involvement of mandible, floor of mouth, oropharynx, anterior 2/3rd of tongue parotid/submandibular glands in a 46-years-old female along the course of facial artery bilaterally with arterial feeders from the facial artery bilaterally, and draining into the jugular veins. This type of case is being reported first time in English literature.

Capillary hemangioma disguised in the form of mucocele – a case report - Aim: To report a case of capillary hemangioma which

We report a very rare case of intracranial capillary hemangioma. This 15-year-old girl complained of pulsating headache in the temple area that aggravated with change of body positions. This headache usually lasted for 5 min and resolved without any treatment. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) strongly suggested cavernous hemangioma in the right deep parietal lobe. She underwent complete resection of the tumor through right parietal craniotomy. Postoperative course was uneventful. Histologic examinations demonstrated a densely grown numerous capillary-like vascular structure with endothelial cells, hemosiderin deposition, and hemorrhage. Intracranial, intra-parenchymal capillary hemangioma is a very rare vascular tumor or tumor like lesions. Only four cases with intracranial, intra-parenchymal capillary hemangioma were reported previously. Differential diagnosis includes other vascular tumors such as cavernous hemangioma, but it is not so easy to differentiate capillary hemangioma from other lesions. Therefore, surgical excision and histologic diagnosis would be important to diagnose it if possible.

Cellular hemangioma is rare immature form of capillary hemangioma. Keywords: Hemangioma, Buccal mucosa.

Highlights • Intra muscular lipoma are rare with an incidence of 1.8%. • Most common site for oral intramuscular lipoma is tongue. • Intramuscular lipoma has shown recurrence due to difficulty in complete excision of the lesion. • Immunohistochemistry plays a crucial role to distinguish Lobular capillary hemangioma from pyogenic granuloma. • Co-existence of other lesions with Lipoma are reported in literature hence it is crucial to do a complete clinical examination in such cases., Introduction Intramuscular lipoma are benign mesenchymal soft tissue neoplasm of mature adipocytes that arises within the muscle. Oral intramuscular lipoma are more commonly seen on tongue. Lobular capillary hemangioma (LCH) on the other hand are common benign vascular neoplasms which are often confused with pyogenic granuloma. Presentation of case In this paper we present a rare case of co-existence of oral intramuscular lipoma with LCH. A 65 year old male complains of swelling on the left chin region from past 4–5 years. On complete intraoral examination another mass was noted on ventral surface of tongue. After performing USG and FNAC of the swelling in the chin region, an excisional biopsy was done and was sent for histopathological examination which showed thin connective tissue septa separating lobules of mature adipocytes. Histopathological examination of tongue mass revealed a benign tumor composed of blood vessels comprising of small capillary sized vascular channels. After a follow-up of 1 year patient showed no signs of recurrence. Discussion According to the literature recurrences are seen in case of intramuscular lipoma due to difficulty in total excision of the lesion. Immunohistochemistry plays a crucial role in distinguishing LCH from pyogenic granuloma. Intraoral LCH should be properly excised after understanding the vascularity of the lesion. Conclusion In literature, the co-existence of intraoral lipoma with other lesions have been encountered hence for a surgeon a complete examination of oral cavity plays a crucial role to rule out such co-existence.

Capillary hemangioma is a congenital malformation of the capillary. It commonly affects the face, eyelids, lips and skin. Adult capillary hemangioma involving the nasal cavity is rare and may be misdiagnosed as polyps or another tumor. This case report illustrated a middle-age adult patient in Malaysia who presents with unilateral nasal obstruction and intermittent epistaxis who later confirmed capillary hemangioma involving the right nasal septum. Endoscopic surgery excision of the hemangioma was successfully performed. There were no known risk factors present in him. A treating doctor in the outpatient clinic seeing symptoms such as unilateral nasal obstruction must consider alternative diagnosis such as hemangioma besides usual diagnosis of polyps.

Capillary hemangioma is a rare entity among testicular tumors. We demonstrate the case of an 18-year-old patient with palpatoric and sonographic conspicuous left testicle and negative serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase). Ultrasound (US) imaging represented an isoechogenic lesion with high vascularization in both power Doppler and microflow imaging with central feeding artery. Both strain elastography and shear wave elastography demonstrated a stiff lesion compared to surrounding testicular tissue. While contrast-enhanced ultrasound (CEUS) clearly depicted high vascular load, time intensity curve (TIC) analysis was able to show shorter median transit time, higher peak enhancement, and higher wash-in area under the curve compared to regular testicular tissue. Histopathological examination revealed a lobular constructed and rich vascularized proliferation without cellular atypia and feeder vessels with positive reaction to CD34, CD31, CD99, and Vimentin. Proliferative activity was quantified to 3–5% by Ki-67 index. Two days after surgery, the patient could leave the hospital in subjective wellbeing. While histology remains the gold standard to make a precise diagnosis of capillary hemangiomas due to small case numbers and variety of this benign tumor, the combination of multiparametric US and clinical information may be a promising future tool in preoperative assessment.

Background Splenic cord capillary hemangioma is a rare benign vascular lesion classified as a splenic hamartoma. On the other hand, non-islet cell tumor hypoglycemia (NICTH) is one of the rare causes of spontaneous hypoglycemia and is considered to be one of the paraneoplastic syndromes. To the best of our knowledge, this is the first reported case of a splenic cord capillary hemangioma with NICTH. Case presentation A 25-year-old male was referred to our hospital with hypoglycemia. Except for his low blood sugar, there were no abnormal findings from laboratory tests, which included an endocrinological examination. Enhanced computed tomography confirmed the presence of a solid mass measuring about 6 cm in the retroperitoneum, and a tumorectomy was performed. During this operation, it became clear that the tumor turned out to be a splenic parenchyma, and as a result, a total splenectomy was performed. Microscopically, we diagnosed this as a cord capillary hemangioma, and through immunohistochemistry, we found that some tumor cells were positive for insulin-like growth factor -II. Fortunately, the hypoglycemia-related symptoms disappeared after surgical resection was performed. The patient is still alive and well without evidence of local tumor recurrence 15 years after the operation. Conclusions Splenic cord capillary hemangioma, one of the types of splenic hamartomas, is a very rare benign vascular lesion and might be associated with hypoglycemia thought to be NICTH.

The authors present a novel surgical approach for the treatment of retinal capillary hemangiomas (RCHs) secondary to von Hippel-Lindau (VHL) disease. This is a case report of a 23-year-old male patient with VHL that presented with multiple large RCHs and a thick epiretinal membrane (ERM) in his left eye, with best-corrected visual acuity (BCVA) of 20/80. This condition was surgically addressed with 23-gauge pars plana vitrectomy, ERM and internal limiting membrane peeling, and panretinal photocoagulation. Three monthly intravitreal injections of bevacizumab were administered after surgery. In a 14-month follow-up period, hemangiomas have regressed after laser therapy, macular anatomy has improved, retina remained completely attached, and there has been no development of new tumors or proliferative vitreoretinopathy. The patient achieved a BCVA of 20/40 in the treated eye. Panretinal photocoagulation combined with pars plana vitrectomy may be useful to reduce development of new capillary hemangiomas and reduce overall occurrence of complications in patients with VHL disease. Postoperative intravitreal injections of bevacizumab may have a role in this positive outcome.

Background: Purely epidural spinal hemangioma (PESH) represents a rare clinical entity. The majority of such reports focuses on the cavernous variety and the capillary type remains extremely rare. A minority of these lesions may cause acute clinical presentations, mostly from hemorrhage or less commonly due to tumor expansion. Acute paraplegia in pregnancy from PESH is extremely rare and may pose management dilemma. Case report: A 25-year old pregnant lady, 34 weeks into her pregnancy, presented with one-week history of paraplegia with bladder bowel involvement. On MRI, a dorsal epidural contrast enhancing mass with transforaminal extension was noted at D10–11 level. An emergency caesarean section (CS) to deliver the baby was followed by tumor excision after 48 h. The patient gradually recovered and regained 3/5 power in her lower limbs at 6 months follow up. Conclusion: PESH of capillary variety is a rare cause of acute paraplegia in pregnancy. Preoperative suspicion of this diagnosis is extremely unlikely and regardless of the timing of surgery, such acute paraplegias rarely improve completely. Fetal lung maturity is an important factor determining the surgical priority. Keywords: Vertebral hemangioma, Purely epidural capillary hemangioma, Pregnancy, Acute paraplegia