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Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report
Background: Mediastinal hemangiomas are rare, and their etiology remains unclear. Most patients affected have no pathognomonic clinical symptoms, and the diagnosis is often incidental. Due to the paucity of the available literature regarding the management of this disease, the choice and timing of t...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863118/ https://www.ncbi.nlm.nih.gov/pubmed/36676715 http://dx.doi.org/10.3390/medicina59010091 |
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author | Ferrari, Paolo Albino Fusaro, Federico Ferrari, Antonio Tamburrini, Alessandro Grimaldi, Giulia Santoru, Massimiliano Zappadu, Sara Tanda, Elisabetta Nemolato, Sonia Comelli, Simone Cherchi, Roberto |
author_facet | Ferrari, Paolo Albino Fusaro, Federico Ferrari, Antonio Tamburrini, Alessandro Grimaldi, Giulia Santoru, Massimiliano Zappadu, Sara Tanda, Elisabetta Nemolato, Sonia Comelli, Simone Cherchi, Roberto |
author_sort | Ferrari, Paolo Albino |
collection | PubMed |
description | Background: Mediastinal hemangiomas are rare, and their etiology remains unclear. Most patients affected have no pathognomonic clinical symptoms, and the diagnosis is often incidental. Due to the paucity of the available literature regarding the management of this disease, the choice and timing of treatment remains controversial. Case presentation: Herein, we report the case of a hemangioma of the azygos vein arch in a 66-year-old woman who presented with dyspnea, chest discomfort, dysphagia, and weight loss. A simultaneous right chylothorax refractory to conservative management was found. A CT-guided biopsy of the mass was performed, and it confirmed the vascular nature of the lesion. Therefore, the patient underwent an angiography followed by endo-vascular embolization. Three days later, thoracoscopic surgical resection of the mass and the repair of the chyle leakage were performed safely. The patient was discharged uneventfully on postoperative day seven, with complete resolution of all the presenting symptoms. Conclusions: Treatment of symptomatic mediastinal hemangiomas could be mandatory, but a thorough multidisciplinary approach to these rare malformations is essential. Despite the risk of intraoperative bleeding, selective endovascular embolization followed by thoracoscopic surgery allowed for a complete and safe resection with a good outcome. |
format | Online Article Text |
id | pubmed-9863118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98631182023-01-22 Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report Ferrari, Paolo Albino Fusaro, Federico Ferrari, Antonio Tamburrini, Alessandro Grimaldi, Giulia Santoru, Massimiliano Zappadu, Sara Tanda, Elisabetta Nemolato, Sonia Comelli, Simone Cherchi, Roberto Medicina (Kaunas) Case Report Background: Mediastinal hemangiomas are rare, and their etiology remains unclear. Most patients affected have no pathognomonic clinical symptoms, and the diagnosis is often incidental. Due to the paucity of the available literature regarding the management of this disease, the choice and timing of treatment remains controversial. Case presentation: Herein, we report the case of a hemangioma of the azygos vein arch in a 66-year-old woman who presented with dyspnea, chest discomfort, dysphagia, and weight loss. A simultaneous right chylothorax refractory to conservative management was found. A CT-guided biopsy of the mass was performed, and it confirmed the vascular nature of the lesion. Therefore, the patient underwent an angiography followed by endo-vascular embolization. Three days later, thoracoscopic surgical resection of the mass and the repair of the chyle leakage were performed safely. The patient was discharged uneventfully on postoperative day seven, with complete resolution of all the presenting symptoms. Conclusions: Treatment of symptomatic mediastinal hemangiomas could be mandatory, but a thorough multidisciplinary approach to these rare malformations is essential. Despite the risk of intraoperative bleeding, selective endovascular embolization followed by thoracoscopic surgery allowed for a complete and safe resection with a good outcome. MDPI 2022-12-31 /pmc/articles/PMC9863118/ /pubmed/36676715 http://dx.doi.org/10.3390/medicina59010091 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Ferrari, Paolo Albino Fusaro, Federico Ferrari, Antonio Tamburrini, Alessandro Grimaldi, Giulia Santoru, Massimiliano Zappadu, Sara Tanda, Elisabetta Nemolato, Sonia Comelli, Simone Cherchi, Roberto Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title | Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title_full | Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title_fullStr | Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title_full_unstemmed | Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title_short | Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report |
title_sort | refractory chylothorax secondary to sizeable azygos vein hemangioma: tailored multimodal treatment of a challenging case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863118/ https://www.ncbi.nlm.nih.gov/pubmed/36676715 http://dx.doi.org/10.3390/medicina59010091 |
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