Baş Boyun Bölgesi Yerleşimli Kavernöz Hemanjioma Eşlik Eden Flebolit Olgusu

Yıl 2021, Cilt: 47 Sayı: 3, 461 - 463, 01.12.2021

Selin Yirmibeş , Özlem Saraydaroğlu , Mehmet Yenidünya

https://doi.org/10.32708/uutfd.981775

Öz

Flebolitler, kalsifiye trombüsleri ifade eden lezyonlardır. Baş boyun bölgesinde nadiren rastlanırlar ve sıklıkla bir vasküler malformasyona ya da benign vasküler tümöre eşlik ederler. 4 yaşından beri sol çene altında şişlik şikayeti olan 7 yaşında kız hasta merkezimize başvurdu. Fizik muayenesinde sol submental bölgede 4x3 cm çapında, immobil kitle saptanan hastaya kitle eksizyonu uygulandı. Lezyonun mikroskobik incelemesinde santralinde kalsifikasyon barındıran, konsantrik yapıya sahip multipl nodüler lezyonlar ve lezyonlara bitişik alanlarda, genişlemiş damarlarla karakterize kavernöz hemanjiom izlendi. Bu bulgularla olguya kavernöz hemanjioma eşlik eden flebolit tanısı verildi. Flebolitler, vasküler lezyonlardan en sık hemanjiomlara eşlik eder. Flebolitlerin etiyolojisinde vasküler malformasyon veya travma kaynaklı periferik kan akımındaki yavaşlamanın yer aldığı düşünülmektedir. Klinik olarak karışabilen sialolitiazis, travmatik myozitis ossifikans, kalsifiye lenf nodülleri ve bazı neoplaziler ayırıcı tanı içinde ele alınmalıdır.

Anahtar Kelimeler

Baş boyun, Flebolit, Hemanjiom, Trombüs, Vasküler

A Case of Phlebolith with Cavernous Hemanjioma of The Head and Neck Region

Öz

Phleboliths are lesions that define calcified thrombi. They are rarely encountered in the head and neck region and often accompany a vascular malformation or a benign vascular tumor. A 7-year-old female patient with the complaint of swelling of the submental area since the age of 4, was admitted to our center. In the physical examination, a 4x3 cm immobile mass was detected, and excisional biopsy was performed. Microscopic evaluation of the lesion revealed multiple concentric nodular lesions with central calcification. Cavernous hemangioma characterized by dilated vessels in adjacent area was observed. The patient was diagnosed with phlebolith and cavernous hemangioma. Phleboliths most often accompany hemangiomas. The etiology of phleboliths is considered to be a slowdown in peripheral blood flow caused by a vascular malformation or trauma. Sialolithiasis, traumatic myositis ossificans, calcified lymph nodes and some neoplastic lesions that can be confused with phleboliths clinically, should be considered in the differential diagnosis.

Anahtar Kelimeler

Head and neck, Hemangioma, Phlebolith, Trombus, Vascular

Kaynakça

• 1. Altuğ HA, Büyüksoy V, Okçu KM, Doğan N. Hemangiomas of the head and neck with phleboliths: clinical features, diagnostic imaging, and treatment of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(3):e60-4.
• 2. Mandel L, Perrino MA. Phleboliths and the vascular maxillofacial lesion. J Oral Maxillofac Surg 2010;68:1973-6.
• 3. Dempsey EF, Murley RS. Vascular malformations simulating salivary disease. Br J Plast Surg 1970;23:77–84.
• 4. Gouvêa Lima Gde M, Moraes RM, Cavalcante AS, Carvalho YR, Anbinder AL. An Isolated Phlebolith on the Lip: An Unusual Case and Review of the Literature. Case Rep Pathol 2015;2015:507840.
• 5. Karslıoglu H, Sumer AP. Hemangioma Presenting with Multiple Phleboliths: Case Report with CBCT Finding. Cumhuriyet Dental Journal 2018;21(3):263-7.
• 6. Kato H, Ota Y, Sasaki M, Arai T, Sekido Y, Tsukinoki K. A phlebolith in the anterior portion of the masseter muscle. Tokai J Exp Clin Med 2012;37(1):25-9.
• 7. Chuang CC, Lin HC, Huang CW. Submandibular cavernous hemangiomas with multiple phleboliths masquerading as sialolithiasis. Journal of the Chinese Medical Association 2005;68(9):441-3.
• 8. Orhan K, Icen M, Aksoy S, Avsever H, Akcicek G. Large arteriovenous malformation of the oromaxillofacial region with multiple phleboliths. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:e147–58.
• 9. Tucci FM, De Vincentiis GC, Sitzia E, Giuzio L, Trozzi M, Bottero S. Head and neck vascular anomalies in children. Int J Pediatr Otorhinolaryngol. 2009 Dec;73:S71-6.
• 10. O’Riordan B. Phleboliths and salivary calculi. Br J Oral Surg 1974;12:119-31.
• 11. Kanaya H, Saito Y, Gama N, Konno W, Hirabayashi H, Haruna S. Intramuscular hemangioma of masseter muscle with prominent formation of phleboliths: a case report. Auris Nasus Larynx 2008;35:587-91.
• 12. Park JW, Kim CH, Moon CW. Intramuscular hemangioma in buccal cheek: a case report. J Korean Assoc Oral Maxillofac Surg 2017 Aug;43(4):262-6.
• 13. Cui B, Wang DH, Wang GJ, et al. Cavernous hemangiomas of the temporalis muscle with prominent formation of phleboliths. Case report and review of the literature. Medicine 2017;96(48):e8948.
• 14. Zengin AZ, Celenk P, Sumer AP. Intramuscular hemangioma presenting with multiple phleboliths: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:e32-6.
• 15. Jun CH, Chul LJ, Hyuk KJ, Man LY, Joo LH. Cavernous Hemangioma With Large Phlebolith of the Parotid Gland. Journal of Craniofacial Surgery 2013;24(6):e621-3.
• 16. Gooi Z, Mydlarz WK, Tunkel DE, Eisele DW. Submandibular venous malformation phleboliths mimicking sialolithiasis in children. Laryngoscope 2014;124(12):2826-8.
• 17. Alami B, Lamrani Y, Addou O, et al. Presumptive intramuscular hemangioma of the masseter muscle. Am J Case Rep 2015;16:16-9.
• 18. Ramesh R, Sadasivan A, Sathyan P. Incidental Finding of Phlebolith in a Patient with Chronic Inflammatory Gingival Enlargement – A Case Report. Advances in Dentistry & Oral Health 2018;9(1):45-48.