Dear Editor,Retinal capillary hemangioma(RCH)is a benign vascular tumor that poses significant challenges due to its potential to cause vision impairment and retinal detachment(RD).We present a comprehensive case report of a largediameter RCH treated with vitreous surgery,underscoring the importance of selecting appropriate treatment strategies based on the individual characteristics of RCH patients to minimize their impact on vision and future well-being.
目的探讨新生儿肝血管瘤伴动静脉瘘(hepatic hemangioma with arteriovenous fistula,HH-AVF)的临床特征及诊疗情况。方法选择2020年1月至2024年1月郑州大学附属儿童医院新生儿科收治的HH-AVF患儿临床资料进行回顾性分析。结果共纳入HH-AVF患儿4例,男3例,女1例,出生体重(3430±221)g,起病日龄(16.8±13.1)d,均有肝脏占位病变。2例患儿呼吸困难需呼吸机支持,其中1例心影增大,并发心力衰竭、肺动脉高压,另1例并发肺动脉高压;1例患儿并发全身皮肤多发血管瘤;1例患儿并发颈血管瘤并反复出血。4例均接受介入治疗,介入治疗时日龄(34.0±22.5)d,同时口服普萘洛尔,随访4~16个月,复查CT均显示病灶较确诊时显著减小,未再出现呼吸困难、心力衰竭、肺动脉高压等表现,监测肝功能、凝血功能等未发现异常。结论新生儿期起病的HH-AVF多为先天性,临床表现不一,发生心力衰竭、肺动脉高压等并发症时极为凶险,介入治疗效果显著,可有效降低病死率。
Renal anastomotic hemangioma(AH)is a rare,benign vascular tumor with unique histopathological features,a disease that is clinically rare,and existing clinical cases offer different treatment options.As reported in the text,this is a very unusual case of renal AH with AH secondary to residual renal tissue after renal clear cell carcinoma,describing a rare renal AH and a history of renal clear cell carcinoma,including ultrasound,computed tomography and magnetic re-sonance imaging.However,the available imaging data and the literature do not provide an effective basis for the diagnosis of the disease,raising the lack of un-derstanding and misdiagnosis,where the patient eventually underwent neph-rectomy,but the author is not the most appropriate surgical treatment.The po-stoperative pathological results of the patient are benign lesions,and it is unde-niable that nephrectomy is suspected to be overtreated.By reading the literature,we provide different insights into the treatment of the patient,and we hope that this paper can provide some help for the future clinical diagnosis and treatment.
In this manuscript,I comment on the article by Pospisilova et al published in the recent issue of the journal,in which selective embolization was used to treat anorectal hemangioma,a rare disease causing lower gastrointestinal bleeding.Anorectal hemangioma can easily be mistaken;for example,the patient in this case was previously misdiagnosed with ulcerative colitis.Choosing the appropriate tests and understanding the typical manifestations of anorectal hemangioma under colonoscopy,computerized tomography,magnetic resonance imaging and other tests are beneficial for diagnosis.The patient presented with intermittent rectal bleeding despite treatment with azathioprine and mesalazine and required blood transfusions since the degree of rectal bleeding worsened.Selective embolization successfully alleviated the patient’s bleeding symptoms and avoided the need for repeated blood transfusions.Tranexamic acid may be useful,considering that the patient still has bleeding symptoms and requires parenteral iron supplementation.
