Spindle Cell Hemangioma-A Case Report and Literature Review

梭狀細胞血管瘤－一病例報告及文獻回顧

曾凱邦(Kae-Bang Tzeng) ； 顏榮信(Jung-Hsing Yen) ； 王約翰(John Wang) ； 簡文祥(Wen-Hsiang Chien) ； 林雍球(Yung-Chiou Lin) ； 陳伊呈(I-Chen Chen) ； 唐友文(Yu-Wen Tang)

《臺灣整形外科醫學會雜誌》 21卷2期 (2012/06) Pp. 127-134

https://doi.org/10.7096/TJTSPS.201206.0127

摘要

背景：梭狀細胞血管瘤是一罕見的血管病變。它的病理組織學與卡波西氏肉瘤及血管瘤非常相似，且其切除復發率高達50%，因此過去認為它是一種低惡性的血管肉瘤。目的及目標：由於以往對梭狀細胞血管瘤的了解不清楚，因此我們報告一例梭狀細胞血管瘤並回顧相關文獻，增加外科醫師對這個良性腫瘤的熟悉度並避免不必要的治療。材料及方法：一位四十八歲的男性，發現右足內側及腳底出現多個突起病灶。最大的病灶位於內側並呈現藍紫色。我們以五公厘為安全距離進行廣泛切除並直接縫合傷口。結果：病理組織及特殊染色報告證實為梭狀細胞血管瘤。右腳傷口癒合良好，經過十一個月的追蹤無復發情形。結論：梭狀細胞血管瘤常以遠端肢體的數個皮膚及皮下結節來表現，需要與卡波西氏肉瘤做鑑別診斷。局部廣泛切除是一適當的治療。雖然有文獻指出放射治療能降低復發率，但可能會導致惡性血管肉瘤的產生，因此應該儘量避免放射治療。

並列摘要

Background: Spindle cell hemangioma is a rare vascular lesion. The histopathologic findings of it resemble Kaposi's sarcoma and hemangioma features. The recurrent rate after excision is up to 50%. Thus, spindle cell hemangioma was recognized as a ”low-grade angiosarcoma” in the past. Aim and Objectives:We report a case which brings attention to surgeons of the need to recognize spindle cell hemangioma because of the previous misunderstanding. We described the histopathologic finding and compared it with Kaposi's sarcoma. We remind surgeons to avoid unnecessary treatments in the recurrent or multiple spindle cell hemangioma. Materials and Methods:A 48-year-old male noted multiple skin lesions over the right medial foot for several years. The largest lesion is a purplish nodule about 2 x 1.3 cm^2. A wide excision with 5 mm safe margin of this lesion was done in May 2010. The wound was closed directly. Results:The pathologic diagnosis is spindle cell hemangioma. The wound over the right foot healed well. There is no recurrence after the 11 months follow up.Conclusion:Clinically, spindle cell hemangioma is presented as multiple nodules involving the skin and subcutaneous tissue in the distal extremities. The main differential diagnosis of the spindle cell hemangioma is Kaposi's sarcoma. An adequate treatment is by using the wide local excision. Radiation therapy should be avoided due to the potentiality of malignant change. Accurate diagnosis is critical in deciding what the most appropriate therapy is for the patients.

並列關鍵字

spindle cell hemangioma ； spindle cell hemangioendothelioma ； kaposi's sarcoma ； pithelioid hemangioendothelioma ； kaposiform hemangioendothelioma