Challenges in chronic pelvic pain: Diffuse uterine capillary haemangioma simulating a clinical picture of adenomyosis

Introduction: Adenomyosis is a heterogeneous condition of difficult diagnosis that stands out in our patients for causing abundant menstrual bleeding, dyspareunia and dysmenorrhoea. However, in chronic pelvic pain units it is important to consider other conditions of similar symptomatologies, such as vascular malformations. These include capillary haemangiomas which, although rare in the reproductive tract, can produce serious symptoms. Case description: We present the case of a 31-year-old woman under observation by the chronic pelvic pain unit for dysmenorrhoea and dyspareunia since menarche. Ultrasound and magnetic resonance findings were compatible with adenomyosis. The patient showed no improvement with hormonal treatment. Upon failure of the medical treatment and taking into account the patient’s lack of gestational desire, a laparoscopic hysterectomy was performed. The pathological report revealed a diffuse capillary haemangioma as the cause of the symptoms. Given the completely curative nature of surgery for this type of condition, the patient was discharged from our unit. Conclusion: The preoperative diagnosis of adenomyosis is still a challenge and units specializing in chronic pelvic pain must consider all possible diagnostic options so as not to overlook rarer conditions such as vascular malformations.

Conjunctival granulomatous capillary haemangioma in children: case report and review of the literature

Background Granulomatous capillary haemangioma refers to a benign vascular tumour that commonly affects the skin, with occasional involvement of the mucosa. Reports of conjunctival granulomatous capillary haemangioma in children are uncommon. In this article, we present a case of granulomatous capillary haemangioma and a brief review of the relevant literature. Case presentation An 11-year-old girl presented with a conjunctival mass. An excision of the entire lesion was performed. Histopathology showed a granulomatous capillary haemangioma. Conclusions The clinical manifestations of granulomatous capillary haemangioma lack specificity; pathological characteristics and immunohistochemistry are the main basis for diagnosis. We retrospectively analysed the diagnosis and treatment of a patient with conjunctival granulomatous capillary haemangioma to deepen the understanding and facilitate the diagnosis and treatment of this disease.

Lobular Capillary Haemangioma of the Oral Cavity in a 11-Year-Old Child - A Case Report

Lobular capillary haemangiomas are benign vascular neoplasms that typically affect the skin or mucous membrane. Majority of the cases reporting lobular capillary haemangioma commonly involve the gingiva. There are rare cases presenting involvement of other parts of the oral cavity like buccal mucosa. The management of vascular lesions is more complex in children due to fear of uncontrollable bleeding. The case presented here reports a successful management of lobular capillary haemangioma of the buccal mucosa in an 11 - year - old child. Vascular lesions are one of the rare disorders affecting the overall quality of life of a child. American Academy of Paediatric Dentistry (AAPD) has presented numerous lesions, masses, or tumour-like conditions of hard and soft tissues within the oral and maxillofacial regions of children and young adults; most of these lesions being mucosal conditions. Oral vascular tumours encompass a wide spectrum of anomalies in children. In spite of the fact that a few cases are congenital, most of them arise during childhood.1 The vascular lesions of childhood are classified into two categories: haemangiomas (proliferating or involuting) and vascular malformations. Haemangioma is a term that envelops a heterogeneous gathering of clinical benign vascular lesions that share similar histologic features and presents as a proliferating mass of blood vessels. Haemangiomas are classified on the basis of their histological1 appearance as capillary, mixed or cavernous haemangiomas depending on the size of the vascular spaces or a sclerosing variety that tends to undergo fibrosis. Capillary haemangiomas are of two types; lobular capillary haemangioma and non-lobular capillary haemangioma depending on their histological features. Lobular capillary haemangioma (LCH) is a common reactive angiomatous proliferation of skin and mucous membranes.2,3 LCH (Mills et al. 1980 ) represents an essential, underlying lesion of pyogenic granuloma (PG).4,5 Based on the available literature and case reports, several clinical and histological differences were seen between PG and LCH, yet there is no clear distinction between the two and still remains a topic of debate. The peak prevalence of LCH is in paediatric population and young adults, with a female predilection. Although LCH is one of the most common soft tissue tumours of head and neck accounting for almost 6 % of all cases, there is a striking predilection for lesions on the gingiva. The occurrence of intraoral haemangiomas at sites such as lips, tongue, buccal mucosa, and palate are extremely rare. LCH is a tumour-like growth of the oral cavity or skin that is considered to be non-neoplastic in nature. The purpose of this paper is to report a case of lobular capillary haemangioma in a paediatric patient and describe the successful treatment of this case.

Lobular capillary haemangioma of nasal septum with remodelling of bony lateral wall

The diagnosis of intranasal masses can often be confusing due to the diversity of inflammatory and neoplastic lesions affecting the sinonasal tract, and the ambiguity of symptoms. Haemangiomas have been described in head and neck. However, uncommon findings such as bony remodelling and unusual clinical appearance of mass were noted in the present case. The description of such non-classical presentations is essential in deciding further management and preventing plausible hemodynamic imbalance.

Compound haemangioma of lower lip: an interesting and rare case report

Haemangiomas are common benign vascular tumours of infancy and childhood. Haemangiomas occur in 10-12% of children of 1 year of age and most of them are self-resolving within 9 years of age. Most common sites are head and neck (around 90%) and lip is one of the preferred sites. Sometimes persistence of haemangiomas may require surgical intervention. Capillary haemangiomas generally located superficially and cavernous haemangiomas located deep. Mixed capillary-cavernous haemangiomas or compound haemangiomas are one of the rarer types and location at lip rarest. Here we report a 14-years-old boy presented to paediatric surgery outdoor with swelling in lower lip for last 3 years. The excisional biopsy done with a clinical diagnosis of granuloma and sent for histopathological study. On microscopy of tissue sections given from lesion showed stratified squamous epithelium with sub epithelium revealing two distinct areas of capillary haemangioma component and cavernous haemangioma component within the lesion. So, final diagnosis of capillary-cavernous haemangioma (compound haemangioma) was made without any granuloma or malignant component. Patient followed up for six months and he was completely asymptomatic without any residual disease and recurrence.

Lobular capillary haemangioma arising from a vascular malformation

<p class="abstract">Lobular capillary haemangioma also known as granuloma pyogenicum or pyogenic granuloma, refers to a common, acquired, benign, vascular tumor that arises in tissues such as the skin and mucous membranes. The occasional eruption of a lobular capillary haemangioma from vascular lesions like haemangiomas or existing port-wine stains suggests abnormalities in blood flow.</p>