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Treatment of tongue cavernous haemangioma with direct puncture and sclerotization with ethanol.

Seruga T, Lucev J, Jevsek M - Radiol Oncol (2015)

Bottom Line: After the sclerotization the planed surgery was abandoned.In our case the direct puncture of haemangioma and sclerotherapy with ethanol proved to be a safe and effective method to achieve preoperative devascularization of the lesion.Direct puncture of the lesion is not limited by the anatomy of the vessels or vasospasm, which can occur during the intra-arterial approach.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department, University Medical Centre Maribor, Slovenia.

ABSTRACT

Background: Haemangiomas of tongue are rare type of malformations. They can be treated mostly conservatively but in some cases they need more aggressive treatment with preoperative intra arterial embolization and surgical resection. Lesions of tongue that are localized superficially can also be treated with direct puncture and injection of sclerosing agent (absolute ethanol).

Case report: We present a case of a 48 years old female patient, where we performed embolization of cavernous haemangioma with mixture of absolute ethanol and oil contrast. After the procedure the patient received analgetics and antioedematous therapy. After the sclerotization the planed surgery was abandoned. Control MRI examinations 6 and 12 months after the procedure showed only a small remnant of haemangioma and no signs of a larger relapse.

Conclusions: In our case the direct puncture of haemangioma and sclerotherapy with ethanol proved to be a safe and effective method to achieve preoperative devascularization of the lesion. Direct puncture of the lesion is not limited by the anatomy of the vessels or vasospasm, which can occur during the intra-arterial approach.

No MeSH data available.


Related in: MedlinePlus

Digital, nonsubtracted, image of tongue parenchimography during sclerotization with opened mouth with distractor and cannula (white arrow) placed in haemangioma (black arrow).
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f4-rado-49-01-75: Digital, nonsubtracted, image of tongue parenchimography during sclerotization with opened mouth with distractor and cannula (white arrow) placed in haemangioma (black arrow).

Mentions: We performed parenchimography of the lesion using several projections to reach an optimal view of the lesion and to evaluate the potential extravasation of contrast from haemangioma (Figure 4, Figure 5). This enabled us a more controlled injection of ethanol and gave us a possibility to avoid the reflux to the venous side. For the puncture we used 10 to 12 G needle (Terumo, Tokyo, Japan). After the puncture the proper position of the needle was verified with a continuous reflux of blood. Then the cannula was flushed with a 5% glucose solution. Under fluoroscopy control 96% alcohol diluted with Lipiodol (ratio 1:5) was injected. The cannula was removed and next puncture was performed. All together we performed six punctures and injected approximately 6 ml of ethanol. There were no technical complications during the procedure (Figure 3). No major bleeding was observed after the procedure. After the procedure the patient received analgetics and antioedematous therapy. After the sclerotization the planed surgery was abandoned. Control MRI examinations 6 and 12 months after the procedure showed only a small remnant of haemangioma and no signs of a larger relapse (Figure 6).


Treatment of tongue cavernous haemangioma with direct puncture and sclerotization with ethanol.

Seruga T, Lucev J, Jevsek M - Radiol Oncol (2015)

Digital, nonsubtracted, image of tongue parenchimography during sclerotization with opened mouth with distractor and cannula (white arrow) placed in haemangioma (black arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4362610&req=5

f4-rado-49-01-75: Digital, nonsubtracted, image of tongue parenchimography during sclerotization with opened mouth with distractor and cannula (white arrow) placed in haemangioma (black arrow).
Mentions: We performed parenchimography of the lesion using several projections to reach an optimal view of the lesion and to evaluate the potential extravasation of contrast from haemangioma (Figure 4, Figure 5). This enabled us a more controlled injection of ethanol and gave us a possibility to avoid the reflux to the venous side. For the puncture we used 10 to 12 G needle (Terumo, Tokyo, Japan). After the puncture the proper position of the needle was verified with a continuous reflux of blood. Then the cannula was flushed with a 5% glucose solution. Under fluoroscopy control 96% alcohol diluted with Lipiodol (ratio 1:5) was injected. The cannula was removed and next puncture was performed. All together we performed six punctures and injected approximately 6 ml of ethanol. There were no technical complications during the procedure (Figure 3). No major bleeding was observed after the procedure. After the procedure the patient received analgetics and antioedematous therapy. After the sclerotization the planed surgery was abandoned. Control MRI examinations 6 and 12 months after the procedure showed only a small remnant of haemangioma and no signs of a larger relapse (Figure 6).

Bottom Line: After the sclerotization the planed surgery was abandoned.In our case the direct puncture of haemangioma and sclerotherapy with ethanol proved to be a safe and effective method to achieve preoperative devascularization of the lesion.Direct puncture of the lesion is not limited by the anatomy of the vessels or vasospasm, which can occur during the intra-arterial approach.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department, University Medical Centre Maribor, Slovenia.

ABSTRACT

Background: Haemangiomas of tongue are rare type of malformations. They can be treated mostly conservatively but in some cases they need more aggressive treatment with preoperative intra arterial embolization and surgical resection. Lesions of tongue that are localized superficially can also be treated with direct puncture and injection of sclerosing agent (absolute ethanol).

Case report: We present a case of a 48 years old female patient, where we performed embolization of cavernous haemangioma with mixture of absolute ethanol and oil contrast. After the procedure the patient received analgetics and antioedematous therapy. After the sclerotization the planed surgery was abandoned. Control MRI examinations 6 and 12 months after the procedure showed only a small remnant of haemangioma and no signs of a larger relapse.

Conclusions: In our case the direct puncture of haemangioma and sclerotherapy with ethanol proved to be a safe and effective method to achieve preoperative devascularization of the lesion. Direct puncture of the lesion is not limited by the anatomy of the vessels or vasospasm, which can occur during the intra-arterial approach.

No MeSH data available.


Related in: MedlinePlus