J Korean Bone Joint Tumor Soc.  2010 Dec;16(2):74-79. 10.5292/jkbjts.2010.16.2.74.

Analysis of the Recurrence after Surgical Treatment of the Hemangioma in the Extremities

• Kim YS
• Choi HL
• Lee JM
• Lee HS
• Kim JR

• KMID: 1456321
• DOI: http://doi.org/10.5292/jkbjts.2010.16.2.74

Abstract

PURPOSE
To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk.
MATERIALS AND METHODS
120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis.
RESULTS
Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk.
CONCLUSION
Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.

Keyword

extremity; trunk; hemangioma; surgical treatment; recurrence

MeSH Terms

Extremities
Foot
Forearm
Hand
Head
Hemangioma
Logistic Models
Neck
Recurrence
Risk Factors

Figure

• 

  Figure 1. 19-year-old man presented with painful swelling on left calf area. MRI shows low signal intensity in soleous muscle on TI weigted image (A, D) and high signal intensity on T2 weigted image (B, E) and irregular slightly high signal enhancement in the mass (C, F).

• 

  Figure 2. The gross specimen after wide resection shows large masses consisting of congeries of venous vessels (A). The histologic diagnosis was made venous type of intramuscular hemangioma. Skeletal muscle fibers are separated by proliferating vessel. Organized thrombus is within the vacular lumen (H&E stain, ×40) (B). The vessels are lined by bland, markedly attenuated endothelial cells (H&E stain, ×200) (C).

Reference

1. Enzinger FM, Weiss SW. Soft tissue tumors. 5th ed.St Louis: Mosby;2008. p. 837–87.

2. Allen PW, Enzinger FM. Hemangioma of skeletal muscle: an analysis of 89 cases. Cancer. 1972; 29:8–22.

3. Hajdu SI. Pathology of soft tissue tumors. Philadelphia: Lea and Febiger;1979. p. 367–82.

4. Goidanich IF, Campanacci M. Vascular harmatoma and infantile angioctatic osteohyperplasia of the extremities. J Bone Joint Surg Am. 1962; 44:815–42.

5. Beham A, Fletcher CD. Intramuscular angioma: a clinicopathological analysis of 74 cases. Histopathology. 1991; 18:53–9.

6. Bellina JH. Cavernous hemangioma of left axilla and breast. A new surgical approach with the carbon dioxide laser. J Reprod Med. 1982; 27:146–8.

7. Horowitz SM, Epstein RE, Dalinka MK, Ayala G. Knee pain in a 20-year-old women, Clin Orthop. 1996; 329:337–8.

8. Coffin CM. Vascular tumors. In: Coffin CM, Dehner LP, O'Shea A, ed. Baltimore: William and Wilkins;1997. p. 40–79.

9. Tang P, Francis JH, Mark CG, Justin C, Henry JM. Surgical treatment of hemangiomas of soft tissue. Clin Orthop. 2002; 399:205–10.

10. Lee HK, Lee SH, Kim HS, Lee DH, Yang MS. Hemangioma in soft tissue of trunk and extremities. J Korean Bone Joint Tumor Soc. 1996; 2:178–85.

11. Lee SH, Shin KH, Yang WI, Suh JS, Hahn SB. Surgical treatment of hemangioma in the extremities, J Korean Orthop Assoc. 2004; 39:215–21.

12. Conners JJ, Khan G. Hemangiomas of the striated muscle. South Med J. 1977; 70:1423–4.

13. Rosai J. Vascular neoplasm. Am J Surg Pathol. 1986; 10:26–31.

14. Enneking WF, Campanacci M. Bone and soft tissue tumors. 2nd ed.New York: Springer-Verlag;2000. p. 1051–81.