ObjectiveTo observe the effectiveness of radiotherapy for refractory choroidal hemangioma. MethodsEight patients (8 eyes) with choroidal hemangioma were enrolled in this retrospective study. All the patients had received laser or photodynamic therapy before without effectiveness. The patients included 7 males and 1 females. The age was ranged from 11 to 54 years old, with an average of (27.50±15.18) years. All the patients were affected unilaterally, including 3 right eyes and 5 left eyes. There were 5 eyes with circumscribed choroidal hemangioma, 3 eyes with diffused choroidal hemangioma. All eyes had extensively exudative retinal detachment. The vision was from light sensation to 0.01. The volume of the tumors was ranged from 1.96 to 5.35 cm3, with a mean of (3.37±1.06) cm3. All the patients were treated with X rays by conventional fractional radiotherapy. Four of 8 patients were applied 24Gy totally in 8 fractions, while the other 4 patients were applied 46Gy in 23 fractions. Follow-up period ranged from 7 to 95 months, with medium of 42 months. ResultsRetinas reattached in all the eyes while exudation being absorbed. No retinal detachment happened again. To the last follow-up, the vision was from light sensation to 0.6. Visual activity improved in 6 eyes while 2 eyes improved obviously. Visual acuity was stable in remaining 2 eyes. The volume of the tumors decreased to 1.24-2.16 cm3, with a mean of (1.68±0.30) cm3. The percentage of the tumor decreased by 14.6-72.7, with an average of (44.89±21.30)%. No radiotherapy-associated complication occurred. ConclusionRadiotherapy is an efficient and safe treatment for refractory choroidal hemangioma.
OBJECTIVE: To demonstrate the effectiveness of operative resection for patients with huge hemangioma. METHODS: Eight cases were adopted in this study, including 5 males and 3 females. Among them, 5 cases with hemangioma on the face and neck, 1 case on the back, 1 case on the buttock, and 1 case on the leg. The maximal size of the hemangioma was 31.2 cm x 9.1 cm and the minimal size was 27.3 cm x 6.0 cm. Before operation, angiography was taken to find out the size of tumor. During operation, intervention-embolism and circumferential suture were carried out to control bleeding so that resection of tumor was practicable. RESULTS: There had been successful result in all the cases with huge hemangioma. No recurrence were found with following up 8 months to 4 years(averaged 13 months). CONCLUSION: Angiography of the hemangioma is important in providing the informations for the operation design. The intervention-embolism and circumferential suture can control and reduce the bleeding in operation. Combine of these techniques is essential for the treatment of huge hemangioma.
ObjectiveTo evaluate the effect of the timing of surgery on treating refractory epilepsy caused by cavernomas. Method63 patients with refractory epilepsy caused by intracranial supratentorial cavernomas were retrospectively analyzed on the duration of epilepsy, epileptogenesis sitations, and epileptic seizure types. After resection surgeries of cavernomas, the surgical outcomes were compared between the patients with shorter duration of seizures and the longer ones. ResultThe durations of epilepsy were beteen 3 months and 25 years, median 4.5 years. The temporal epilepsies were 43, frontal 12, parietal 3, occipital 1, cingulate gyrus 1, and multiple lobe 3. The overall ILAE class 1 outcome was 71.4% in 63 patients at 2-year-followup, and ILAE class 1 and 2 outcome was 81.6%. The seizure free rate in the group with epilepsy duration shorter than 5 years was 92.1%, better than the 56.0% in the group with epilepsy duration longer than 5 years. ConclusionOnce the diagnosis of medical refractory epilepsy caused by cavernoma was confirmed, the early surgical operation should be considered seriously.
Giant cavernous hemangioma of max-illofacial region and central hemangioma ofthe mandible were a rare,benign conditionthat was characterized by the proliferationof blood vessels. Surgical treatment has beenadvocated by many authors, although thedanger of bleeding must be taken into consid-eration in every cases. This article reported11 successful cases. Management of these cas-es may be accomplished by open- ligationof inferior alveolar vessels and repaired withfree forearm flap (7 cases). The results weres satisfactory.