Imaging findings of retroperitoneal anastomosing hemangioma: a case report and literature review

Abstract

Background Anastomosing hemangioma is an uncommon benign vascular tumor that may be mistaken for a malignancy. The imaging findings of anastomosing hemangioma are not well provided from the previous reports. Herein, in the study, we discuss the imaging findings for one case of retroperitoneal anastomosing hemangioma. Case presentation One 64-year-old female patient had a left retroperitoneal mass that was incidentally detected upon physical examination. A hypoechoic mass with abundant blood flow signals was found by US in the perirenal space. CT and MRI detected a large cystic and solid lesion in the left retroperitoneal space. Plain CT indicated that the internal density was uneven, and the pattern of enhancement was obvious and progressive. MRI-T2WI showed high intensity, DWI showed isointensity, and the mass also showed obvious progressive enhancement. Finally, anastomosing hemangioma was diagnosed via histopathological studies. Conclusion As a rare and benign tumour, anastomosing hemangioma is easily misinterpreted. We suggest that the observation of “genitourinary tract related, well defined, hyperintensity or isointensity on T2WI, isointensity on DWI, and obvious progressive enhancement patterns likely to the vascular enhancement” may consider the diagnosis of AH.

Hepatic anastomosing hemangioma: description of a rare case and a literature analysis

“…However, in the 4 cases of their study, only 1 case showed high signal on DWI with low signal on the ADC map; another patient exhibited slight hyperintensity on both DWI and ADC, which was consistent with the diffusion features of our cases and was likely due to the T2 shine-through effect rather than true restricted diffusion; ADC maps of the remaining 2 cases were not provided. In the case reported by Rogers et al , hepatic AH demonstrated no restricted diffusion ( 10 ), which is similar to a recently published case of retroperitoneal AH ( 15 ). In a previously published hepatic AH case at our hospital ( 14 ), the lesion showed no obviously restricted diffusion, with a mean an ADC value of 1.81×10 -3 mm 2 /s.…”

Primary anastomosing hemangioma as a preoperative diagnostic mimicker of retroperitoneal cavernous hemangioma: A case report

“…In this report, the lesions showed uniform enhancement both peripherally and centrally in the arterial phase, which persisted in the delayed phase. Either way, the enhancement pattern of MRI was similar to that of CT, with clear heterogeneous enhancement in the arterial phase and persistent hyperenhancement in the portal and delayed phases (12,14,15). In our case, the lesion showed heterogeneous septal enhancement in the arterial phase and persisted peripherally and centrally in the portal phase.…”

Anastomosing haemangioma of adrenal gland: an unusual vascular tumour

“…However, these findings are non-specific and will need more reporting and validation, till then it remains difficult to diagnose an AAH on the basis of imaging alone preoperatively. MRI was not performed in our case although findings provide additional impetus to the suggestion of Xue et al that possibility of AH must be kept in mind while dealing with well-circumscribed adrenal lesions demonstrating peripheral arterial enhancement 24. This finding seems more evident in larger lesions; clearly evident in our incident case, also seen in the radiological picture of the larger lesion seen in the Cleveland Clinic series.…”

“…The addition of contrast may help in visualising adrenal lesions but cannot differentiate between benign and malignant lesions 23. Application of colour Doppler has shown increased blood flow in some cases of AH 24…”