Intraosseous Venous Malformations of the Zygoma

Abstract

Primary intraosseous venous malformations affecting the zygoma are rare vascular lesions, with only 35 cases reported in the surgical literature. Despite the establishment of the binary classification system, which serves to distinguish vascular tumors from malformations, inappropriate use of the term "hemangioma" to describe a variety of distinct vascular anomalies remains widespread. The authors present 3 cases of zygomatic intraosseous venous malformations and summarize the clinical, radiographic, and immunohistochemical features of these lesions. In each case, an insidious clinical course, combined with the pathognomonic finding of radiating trabeculae on computed tomography, suggests the diagnosis of intraosseous venous malformation. Negative glucose transporter isoform 1 immunoreactivity and histopathological analysis were used to reinforce this diagnosis in 1 patient. Management was individualized in each case, based on symptom complex and aesthetic concern. Given that the therapeutic approach to vascular anomalies is dependent on accurate diagnosis, resolution of semantic matters will optimize the management of these lesions.

Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature

“…In the group of patients that presented symptoms, the most frequent was pain, followed by ophthalmological alterations [ 26 , 27 ]. There was a history of trauma in 15% of patients with venous malformations, despite having been postulated as one of the most common causes of intraosseous hemangiomas [ 28 , 29 ], which also leads us to believe that the erroneous terminology used in many publications may be responsible for this lack of relationship. Of the remaining cases, nine of them ruled out a history of trauma and two patients did not know.…”

“…However, only two cases of venous malformation were handled in this way, and years later, they received surgical rescue due to the progressive growth of the lesion. Surgical treatment is the most adopted option by the authors, mainly through complete resection [ 29 , 33 , 34 ]. While management may differ in vascular anomalies that exclusively affect soft tissues, in intraosseous malformations, it seems to be the most appropriate option because it has shown the lowest recurrence rates.…”

“…Reconstruction with autologous bone is commonly used. Calvarial graft (38%, five cases) [ 27 , 29 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] and iliac crest (7.6%, one case) [ 1 , 46 , 47 , 48 , 49 ] are the two most frequent bone donor areas used; in the treatment of vascular malformations with the same location, rib (three cases) is the third most used autologous graft [ 50 , 51 , 52 ].…”

“… 2 Srinivasan et al (2009) [ 8 ] 66/F R, 3 × 3 cm 4 y N N N CT: radiating spoke wheel Excision ? Not required N 2.5 y, no recurrence GLUT-1 negative 3 Defazio et al (2012) [ 29 ] 58/F R, 1 × 1.5 cm 2 y N N Y CT: sunburst; MRI: T2 with high signal intensity Incisional biopsy; Surveillance ? Not required ?…”

Correction of Facial Deformity in Sturge–Weber Syndrome

“…However, there may be an increased risk of morbidity associated with an extensive approach and complicated reconstructions. 30 Partial resection of osseous lesions can be an alternative with satisfactory results. 33,34 In contrast, osseous hypertrophy in SWS was assumed to be derived mainly from local hypervascularity around either periosteum or spongiosa, or both.…”