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Objective: Rare disease Background: Hemangiomas of the adrenal gland are rare benign non-functional tumors arising from the gland's vascular endothelium. Adrenal hemangiomas are rare in clinical settings, often discovered incidentally during an unrelated diagnostic investigation. Case Report: A 39-year-old man presented with a heterogeneous, enhancing 4.56×4.24×3.9-cm mass originating from the right adrenal gland's lateral limb, discovered incidentally on computed tomography (CT) to investigate renal colic. He was routinely followed up for 2 years with serial CT scans; the mass exhibited considerable growth compared with baseline, with a relatively stable appearance with hyperdense soft tissue component, fat, and foci of calcification. Dexamethasone suppression test demonstrated suppressed cortisol response, indicating a non-functional mass. Therefore, laparoscopic right adrenalectomy was performed, owing to the benign nature of the preoperative diagnosis of myelolipoma and mass size. The patient experienced an uneventful recovery, with no perioperative complications. The resected mass was 5×4×4 cm in size and weighed 30 g. Histopathology confirmed adrenal hemangioma. Serial sectioning revealed an encapsulated lesion with heterogeneous solid and cystic surfaces. Light microscopy examination showed dilated and congested vascular channels lined by flattened endothelium. Focal mature adipose tissue was seen. Conclusions: The infrequent occurrence of adrenal hemangiomas and their nonspecific clinical and radiological presentation results in a considerable diagnostic challenge and, often, misdiagnosis. Surgical resection is usually necessary to exclude malignant disease, alleviate pressure-related symptoms, and decrease risk of retroperitoneum hemorrhage. These lesions are associated with a good prognosis. One limitation of this report is the lack of preoperative adrenal magnetic resonance imaging of the incidental adrenal mass. [ABSTRACT FROM AUTHOR]

Abstract Introduction: Pediatric intraventricular cavernous hemangioma is a rare clinical entity. These categories of tumors in children pose a significant challenge to the treating neurosurgeon. We hereby report a case of cavernous hemangioma located in occipital horn of the lateral ventricle in a 10-year-old child supported by radiological and pathological evidence, which according to our literature search is a very rare phenomenon. Clinical Case Report: A 10-year-old male child was admitted with symptoms of raised intracranial pressure without any other clinical localizing signs. Magnetic resonance imaging (MRI) revealed an intraventricular lesion in the left occipital horn which was intensely hyperintense on T2-weighted (T2W) with contrast enhancement. He underwent gross total excision using a minimally invasive approach. Histopathology was suggestive of cavernous hemangioma. Postoperative recovery was uneventful. Conclusion: Intraventricular hemangiomas itself are very rare tumors. In published literature, till now only 28 such cases in pediatric population are reported. Although MRI provides useful clues to diagnosis, histopathological correlation is mandatory to confirm the diagnosis. Keywords: Cavernous hemangioma, intraventricular, pediatric, Author(s): Pragyan Sarma [1]; Manish Kumar Garg [1]; Sujata Chaturvedi [2,1]; Ishita Pant [2] Introduction Cavernous hemangiomas (CH; cavernomas, cavernous angiomas, cavernous malformations) are developmental malformations that are widely distributed [...]

Background Spinal intramedullary cavernous angioma is a rare form of spinal cord tumor that is associated with myelopathy and significant morbidity and surgical treatment is almost always required. Case We report a case of spinal intramedullary cavernous angioma in a pain clinic with initial symptoms of unilateral interdigital space sensory change. Morton’s neuroma and piriformis syndrome were clinically suspected, however, symptoms acutely aggravated, and paraplegia developed following the patient’s COVID-19 vaccination. Vaccine-associated side effects were ruled out and spinal intramedullary cavernous angioma was confirmed through magnetic resonance image. The patient underwent surgery for complete mass excision. Conclusions Recent reports of COVID-19 vaccine-associated side effects have raised sensitive concerns to both health care providers and the public, that in some cases when the symptoms coincide with vaccination history, it may delay time-sensitive diagnosis and treatment and spend unnecessary costs.

Cavernous hemangioma (CH), or cavernoma, is a type of benign tumor occurring mostly in the brain, liver, skin, and retina.1,2 Although less commonly, CH can also occur in the spine, orbit, gastrointestinal tract, skeletal muscle, and long bones.1 CH comprises a cluster of abnormally dilated blood vessels that form a mass or lesion.2,3 CH is more commonly found in women than men and typically occur between the ages of 40 and 60. Their precise incidence needs to be well-established; however, they account for 2-4% of all parotid gland tumors.2 Still, they are considered one of the less parotid gland common types of tumors.2,3 Most parotid gland tumors are benign, with only about 20% malignant.1,2 CH is typically diagnosed by imaging tests such as MRI or CT scans. The location, size, symptoms, and general health of the patient are among the variables that affect how cavernous hemangiomas are treated. Treatment options in symptomatic cases with functional impairment and high risk of bleeding, include medical (steroid or interferon), embolization, surgery, or radiosurgery.2,4 Parotid gland tumors can be either benign or malignant. CH of the parotid gland is a relatively rare but well-documented entity in the medical literature. There is currently not enough knowledge on the prevalence of CH in the parotid gland; there were roughly 50 cases reported worldwide, most of which were individual case reports. Overall, the literature suggests that cavernous hemangioma of the parotid gland is a rare benign entity more common in females and typically presents as a painless mass in the parotid gland area. Surgical removal is the primary treatment, and this entity has a good prognosis and a low recurrence risk.1-4 CH of the parotid gland can present with various symptoms, including a painless mass or swelling in the area of the gland, facial nerve weakness or paralysis, and even hearing loss in some cases. The diagnosis of a CH is usually based on imaging studies such as MRI or CT scans, which can show a well-defined, sharply demarcated mass with areas of low and high intensity.2-4 A hemangioma's histopathological appearance can help determine the appropriate management and treatment options. Capillary hemangiomas may be treated with topical or oral medications, while surgical removal may be necessary for cavernous hemangiomas, depending on their size and location.2,3 Treatment options for parotid gland cavernous hemangiomas depend on the lesion’s size and location, the patient's symptoms and overall health status. In some cases, surgical removal of the tumor may be necessary, which can be challenging due to the proximity of the facial nerve and the risk of its injury. In other cases, observation or radiation therapy may be recommended.3-5 Cavernous hemangioma is a type of vascular malformation, but other types of vascular malformations can present with similar symptoms or imaging findings. The differential diagnosis of vascular malformation with cavernous hemangioma includes (i) Venous malformation: a type of vascular malformation that affects veins, and it can look similar to cavernous hemangioma on imaging studies. However, venous malformations typically have a more uniform appearance, while cavernous hemangiomas have a characteristic “popcorn” appearance due to multiple blood-filled spaces; (ii) Capillary malformation: a type of vascular malformation that affects small blood vessels called capillaries. Capillary malformations can present as flat, red, or pink marks on the skin and can sometimes be mistaken for cavernous hemangioma; (iii) arteriovenous malformation: a type of vascular malformation that involves abnormal connections between arteries and veins. Arteriovenous malformations can cause symptoms such as headaches, seizures, and neurological deficits and can be mistaken for cavernous hemangioma on imaging studies; (iv) Lymphatic malformation: a type of vascular malformation that affects the lymphatic vessels and can cause swelling or abnormal growths. Lymphatic malformations can sometimes be mistaken for cavernous hemangioma in imaging studies.4,5 Figure 1 refers to a 42-year-old female patient with a painless, slowly growing mass in the right parotid region. The mass had been present for the past 6 months and has gradually increased. The patient reported no other significant symptoms, such as facial weakness or pain. The physical examination revealed a soft, non-tender mass in the right parotid region that measured approximately 6 cm. The overlying skin was normal, and there were no palpable lymph nodes in the neck. The ultrasound examination showed a well-circumscribed, hypoechoic lesion within the superficial lobe of the parotid gland, measuring 5.2 cm. The lesion had a cystic appearance with internal septations, consistent with a vascular lesion. The patient underwent an MRI, which confirmed the presence of a well-defined, lobulated mass in the superficial lobe of the right parotid gland, measuring 5.5 cm. The lesion was hyperintense on T2-weighted images and demonstrated heterogeneous enhancement with gadolinium. The imaging findings were consistent with a diagnosis of vascular malformation of the parotid gland. The patient was referred to a head and neck surgeon for further evaluation and treatment. Due to the lesion’s size and location, surgical resection was recommended. The patient underwent a superficial parotidectomy, and the postoperative course was uneventful. Histopathological examination of the resected specimen confirmed the diagnosis of CH (Figure 1A-1D). The patient was followed up for several months after the surgery, and there was no evidence of recurrence or complications. Figure 1A - gross image showing normal salivary gland tissue along with a well-encapsulated tumor with areas of hemorrhage and comprising of numerous cystic spaces (vascular channels) scale bar = 2,5 cm; B - microscopic examination at low magnification showing normal salivary gland parenchyma along with a capsulated tumor comprised of many dilated vascular channels (H&E 100X); C - higher magnification image showing thick and thin walls vascular spaces in between fibro-muscular stroma (H&E, 400X); D - immunohistochemical reaction for smooth muscle actin (SMA) demonstrating smooth muscle bundles and vessel walls (SMA, 400X).:

Giant cavernomas (GC) are rare lesions, with less than 50 cases reported so far. Clinical presentation usually involves epileptic seizures and less typically focal neurological deficit, due to repeated hemorrhages and GC mass effect and consequentially increased intracranial pressure. Although individual cases have been reported, due to the rarity and variable imaging appearance, GCs are usually not considered in the differential diagnosis of large hemorrhagic lesions, especially when significant mass effect is present. A 17-year-old boy presented due to severe headache, right-sided weakness, and slurred speech. Symptoms started three days before with occasional headaches, which intensified gradually. Emergency computed tomography revealed a left frontal massive heterogeneous lesion. Soon after, right-sided hemiparesis and speech impairment progressed, and the patient became drowsy with the slightly dilated left pupil. Emergency surgery was performed, and the lobed grayish lesion was entirely removed. Based on the macroscopic appearance, the surgeon assumed it was a metastasis of melanoma. Histopathologic analysis result was cavernoma. GC should be considered as an option in hemorrhagic lesions, especially in the young age population. Emergency surgery for mass lesions is not uncommon in neurosurgery; however, bleeding cavernomas are usually planned for elective surgery due to the specific approach and complications.

The nasal cavity presents with various types of neoplasms, including epithelial and mesenchymal tumors. Cavernous hemangioma of nasal cavity is quite rare. It usually presents as a unilateral mass arising from mucosa of nasal cavity. Case Report We describe here, a case of 25-year-old serving soldier, who was referred to our hospital with a mass in both nasal cavities with bilateral nasal obstruction. On examination, the mass originated from the inferior aspect of inferior turbinate of both sides. Subsequently on histological examination after complete endoscopic excision revealed that the mass was a cavernous hemangioma arising from both inferior turbinates. Discussion To our knowledge, this is the first case of cavernous hemangioma arising from both inferior turbinate reported in literature.

Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function.

Rationale: Hemangioma is a common benign disease in clinical practice, but it is rare to find a giant hemangioma in the fetal period., Patient Concerns: Here, we report a case of a giant hemangioma of the fetal head and neck measuring approximately 10.1 × 6.5 cm., Diagnoses: At first, only ultrasonography was used to diagnose the suspected hemangioma. The pregnant woman refused to undergo further testing and requested induction of labor, after which the tumor was finally sent for pathological examination to confirm hemangioma., Interventions and Outcomes: Additionally, the fetus developed severe edema (fluid accumulation in the thoracic, abdominal, and pericardial cavities), which can be fatal to the fetus. Finally, the mother refused to continue the pregnancy and underwent induction of labor with rivanol., Lessons: Most hemangiomas are small and asymptomatic. Giant hemangiomas are rare and associated with a variety of maternal and fetal complications. Therefore, this article aims to summarize the knowledge related to hemangioma through this case, strengthen doctors' understanding of this disease, and bring the attention of pregnant women to this disease to ensure early diagnosis and treatment and prevent a poor prognosis., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Competing Interests: None

Objective: Symptomatic developmental venous anomalies (DVAs) are rare. Here, we illustrate the varied clinicoradiologic profiles of symptomatic DVAs and contemplate the mechanisms that render these (allegedly) benign entities symptomatic supported by a review of literature., Methods: Institutional databases were searched to identify cases of symptomatic DVAs. Clinical and imaging (angiographic and cross-sectional) data of 9 cases with 11 neurovascular symptoms consequent to inflow/outflow perturbations and mechanical obstruction that manifested because of the strategic topography of underlying DVAs were analyzed. A review of the existing literature on DVAs in agreement with our case series was performed on publications retrieved from the PubMed database., Results: Symptoms secondary to venous hypertension arising from flow-related perturbations were broadly divided into those arising from restricted outflow and increased inflow. Restricted outflow occurred because of collector vein stenosis (n = 2) and collector vein/DVA thrombosis (n = 3), whereas the latter pathomechanism was initiated by arterialized/transitional DVAs (n = 2). A mechanical/obstructive pathomechanism culminating in moderate supratentorial ventriculomegaly was noted in 1 case. One patient was given a diagnosis of hemorrhage associated with a cavernoma., Conclusions: Awareness and contextualization of potential flow-related perturbations and mechanical insults that render DVAs symptomatic aid in accurate diagnosis, management, and prognostication., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Cavernous-type malformations are venous lesions that occur in multiple locations throughout the body, and when present in the CNS, they have canonically been referred to as cavernomas, cavernous angiomas, and cerebral cavernous malformations. Herein all these lesions are referred to as "cavernous venous malformations" (CavVMs), which is congruent with the current International Society for the Study of Vascular Anomalies classification system. Even though histologically similar, depending on their location relative to the dura mater, these malformations can have different features. In Part 1 of this review, the authors discuss and review pertinent clinical knowledge with regard to CavVMs as influenced by anatomical location, starting with the dural and extradural malformations. They particularly emphasize dural CavVMs (including those in the cavernous sinus), orbital CavVMs, and spinal CavVMs. The genetic and histopathological features of CavVMs in these locations are reviewed, and commonalities in their presumed mechanisms of pathogenesis support the authors' conceptualization of a spectrum of a single disease entity. Illustrative cases for each subtype are presented, and the pathophysiological and genetic features linking dural and extradural to intradural CavVMs are examined. A new classification is proposed to segregate CavVMs based on the location from which they arise, which guides their natural history and treatment.