Appiah-Thompson Peter, Hanson Nana Andoh M, Quansah Kofi, Edzie Emmanuel Kobina Mesi, Babatunde Jimah Bashiru
Surgery/Otolaryngology, School of Medical Sciences, University of Cape Coast, Cape Coast, GHA.
Surgery/Otolaryngology, Cape Coast Teaching Hospital, Cape Coast, GHA.
Cureus. 2023 Feb 9;15(2):e34814. doi: 10.7759/cureus.34814. eCollection 2023 Feb.
Pediatric vascular anomalies are classified into vascular malformations and vascular tumors. While vascular malformations are generally anomalous vessels, vascular tumors arise from endothelial cells characterized by abnormal proliferation. Vascular tumors, also called hemangiomas, are subdivided into infantile and congenital hemangiomas. The differentiation of these anomalies can be challenging, and immunohistochemical staining is often employed for this purpose. The GLUT-1 (erythrocyte-type glucose transporter protein) stain is positive for the infantile type. Hemangiomas are usually found in the head and neck region. Their occurrence in the laryngeal region in infants tends to manifest in the subglottic region. Hemangiomas in the larynx mostly do not cause any symptoms until they are large enough to cause dyspnea, stridor, or hoarseness of voice. They are mostly treated in infants with propranolol or surgical excision. We report a case of an eight-day-old female infant who presented with a mass that recurrently protruded out of the mouth when she cried. The mass stopped protruding out of the mouth when the baby became restless, had respiratory distress, and refused feeds. Endoscopy of the pharynx and larynx showed a pedunculated hemorrhagic mass attached by a stalk to the left arytenoid. With cautery, the stalk of the lesion was severed from its attachment. The baby was discharged on the fourth postoperative day and histology reported a cavernous hemangioma. Seven months after the surgery, the baby is growing normally. Yearly follow-up endoscopies have been scheduled to evaluate for recurrence or residual disease.
小儿血管异常分为血管畸形和血管肿瘤。血管畸形一般是异常血管，而血管肿瘤则起源于以内皮细胞异常增殖为特征的肿瘤。血管肿瘤，也称为血管瘤，可细分为婴儿型和先天性血管瘤。这些异常的鉴别可能具有挑战性，为此常采用免疫组织化学染色。GLUT-1（红细胞型葡萄糖转运蛋白）染色对婴儿型呈阳性。血管瘤通常见于头颈部区域。婴儿喉部的血管瘤往往表现在声门下区域。喉部血管瘤在足够大导致呼吸困难、喘鸣或声音嘶哑之前大多不会引起任何症状。婴儿期血管瘤大多采用普萘洛尔治疗或手术切除。我们报告一例8日龄女婴病例，该女婴哭闹时口腔反复有肿物突出。当婴儿烦躁不安、出现呼吸窘迫和拒食时，肿物停止从口腔突出。咽喉部内镜检查显示一个带蒂的出血性肿物，通过蒂附着于左侧杓状软骨。通过烧灼，病变的蒂部与其附着处分离。术后第4天婴儿出院，组织学报告为海绵状血管瘤。手术后7个月，婴儿生长正常。已安排每年进行随访内镜检查以评估是否复发或有残留疾病。
