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喉部吻合性血管瘤:头颈部肿瘤中的独角兽。

Anastomosing Hemangioma of the Larynx: A Unicorn among Head and Neck Tumors.

机构信息

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Ann Otol Rhinol Laryngol. 2021 Mar;130(3):298-303. doi: 10.1177/0003489420943640. Epub 2020 Jul 17.

Abstract

OBJECTIVE

Anastomosing hemangioma (AH) is a novel tumor of vascular origin. Though well-documented in the kidney and retroperitoneum, only a single case has been documented in the head and neck, and AH in larynx has not been described.

METHODS

A 37-year-old male presented with difficulty in breathing, and hoarseness. Imaging revealed a lesion involving left paraglottic and cricothyroid spaces with destruction of cricoid cartilage, suggestive of a malignant cartilageneous neoplasm. Multiple biopsies were non-diagnostic.

RESULTS

Intraoperative frozen section during transcervical resection showed a vascular tumor devoid of nuclear atypia. Histopathological examination revealed a vasoformative tumor comprised of anastomosing capillary-sized vessels lined by flat and hobnail endothelial cells, consistent with AH. The patient was disease-free at 12 months.

CONCLUSION

AH are rare neoplasms that may mimic a malignancy on imaging, especially in sites where they have not been documented. Due to their vascular nature, biopsies are often non-diagnostic, making preoperative diagnosis difficult. Frozen section may assist in decision-making on the extent of resection required.

摘要

目的

吻合性血管细胞瘤(AH)是一种新型的血管源性肿瘤。尽管在肾脏和腹膜后已得到充分证实,但仅在头部和颈部有一例报道,而喉部的 AH 尚未描述。

方法

一名 37 岁男性因呼吸困难和声音嘶哑就诊。影像学检查显示累及左侧会厌旁和声门下部,环状软骨破坏,提示为恶性软骨源性肿瘤。多次活检均未能明确诊断。

结果

经颈切除术的术中冷冻切片显示为无核异型性的血管性肿瘤。组织病理学检查显示吻合性的血管形成性肿瘤,由吻合的毛细血管大小的血管组成,由扁平状和钉突状内皮细胞排列,符合 AH 的表现。患者在 12 个月时无疾病复发。

结论

AH 是罕见的肿瘤,在影像学上可能类似于恶性肿瘤,尤其是在尚未有记录的部位。由于其血管性质,活检通常无法明确诊断,因此术前诊断较为困难。冷冻切片有助于决策所需的切除范围。

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