Surgical treatment of hemangiomas and arteriovenous malformations in upper extermity

Abstract

Hemangiomas belong to one of the most common type of tumors occurring in childhood. They are benign and often do not require any treatment, with the tendency to. frequently disappearing spontaneously at the age of 5-7 years. The tumors usually develop in the head and neck area, whereas vascular malformations (AVMs) are rare congenital anomalies, which may occur anywhere. In upper limb, they may amount to 30-60% of cases. It is common for these changes not to require any surgical treatment. In case they do, the main indications for such treatment of upper limb AVMs may be as follows: signs of compression of the peripheral nerves, limited mobility of the fingers because of the tumor, which entails difficulties in the functioning of the whole arm, pain and aesthetic considerations. aim of the study was to present the results of surgical treatment of vascular tumors (hemangiomas and AVMs) in the upper limb that was applied in our department, as well as a broader discussion on epidemiology, diagnosis, and treatment of these changes. material and methods. In 2003-2011 period we treated 11 patients aged 24-39, suffering from vascular tumors (hemangiomas / vascular malformations) in the upper limb; the group included 3 men and 8 women. In this group we diagnosed 2 cases with arm hemangiomas, 2 cases of intramuscular hemangiomas of the forearm, 2 cases of hemangiomas in metacarpal area, 2 cases of AVMs of the finger and metacarpal area, and 4 cases of isolated vascular malformations (mainly arteriovenous malformations) of the fingers. All preparations were examined histologically. results. No complications or recurrence were found in 7 cases, recurrences of AVMs were observed in 4 patients with finger changes. In one patient with AVMs of the index finger, we observed a treble recurrence, which severely impaired functioning of his hand. We eventually suggested to him the finger amputation, to which the patient agreed. conclusions. Upper extremity is a rare location of hemangiomas and other vascular malformations requiring surgery. hemangiomas are more common in women, and the occurrence of AVMs in both males and females is similar. Surgical treatment of hemangiomas and AVMs of the upper extremities is doubtlessly an arduous task, which calls for great microsurgical skills.

Early symptoms and long‐term clinical outcomes of distal limb's cutaneous arterio‐venous malformations: a retrospective multicentre study of 19 adult patients

“…Distal AVMs are composed of many aneurismal pouches, badly systemized, so that embolotherapy result in frequent distal ischaemic necrosis compared to other AVM. 3,4,[11][12][13]17,19,20 Our report is limited due to being a small retrospective study, with losing contact with several patients and recruitment bias from our care centres. Nevertheless, this is a longterm follow-up study, and to our knowledge, this is the first study concerning early clinical symptoms of distal limb cutaneous AVM.…”

“…Treatment complications are frequent in our study: 40% for surgery compared with 28% in the literature, and 60% for embolotherapy. Distal AVMs are composed of many aneurismal pouches, badly systemized, so that embolotherapy result in frequent distal ischaemic necrosis compared to other AVM …”

Benign Hand Tumors (Part II): Soft Tissue Tumors

“…Two hemangiomas (5.9%) recurred after surgery at our institution after 21 and 36 months, which falls within a previously reported range. 28 The patient that had a recurrence at 36 months also developed a metastasis of his epithelioid hemangioma to the axilla and received radiotherapy. Unlike a typical hemangioma, epithelioid hemangioma has a low potential to metastasize.…”

A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet

“…Although diagnostic techniques now give us precise information, treatment of AVF in the extremities is still limited and has a high recurrence rate. Surgical eradication is considered to be the key treatment method 3 ) . Catheterization and embolization comprise a valuable therapy for AVF and should be used as the primary technique for treatment in most cases 8 ) .…”

“…It is a rare anomaly that may occur anywhere in the body. Those in the upper limb account for 30–60% of all cases 3 ) . They can be found incidentally without any symptoms or show multiple symptoms such as compression of the adjacent nerves, life-threatening hemorrhage, high output heart failure, ischemic necrosis or even psychiatric problems.…”