Kaposiform hemangioendothelioma (KHE) is a rare vascular neoplasm of intermediate malignancy, typically diagnosed in infancy. However, it may mimic high-flow vascular malformations, resulting in misdiagnosis and delayed treatment. We describe a 10-year-old girl with a progressively enlarging swelling on the medial aspect of the right leg, initially diagnosed as an arteriovenous malformation (AVM). She underwent sclerotherapy and two sessions of staged embolization, which were complicated by inflammation, abscess formation, and a chronic non-healing ulcer. She underwent en-bloc wide local excision of a highly vascular lesion, followed by split-thickness skin grafting. Histopathological examination confirmed KHE. The patient had an uneventful postoperative recovery, with satisfactory graft uptake and no recurrence at three-month follow-up. This case illustrates the diagnostic challenges of KHE in older children, particularly when clinical and radiological findings overlap with AVMs. Embolization, though useful for debulking, failed to achieve durable control and complicated the clinical course. Histopathology remained the cornerstone of diagnosis. Multidisciplinary management enabled safe resection and functional wound coverage. KHE may closely mimic vascular malformations, delaying definitive therapy. Early consideration of KHE in atypical lesions, combined with a multidisciplinary approach, can facilitate timely diagnosis, and optimize outcomes.
This case report illuminates the pivotal role of 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) PET/CT (Positron emission tomography integrated with computed tomography) scan in diagnosing uncommon and elusive pathologies. Through the detailed exploration of a challenging case, we underscore the significance of this imaging modality in unravelling diagnostic mysteries, guiding clinical decisionmaking, and ultimately improving patient outcomes. This case highlights the importance of considering haematological malignancies in the differential diagnosis of pyrexia of unknown origin (PUO), especially when accompanied by cytopenia and bone abnormalities. PET/CT scan revealed extent of disease involvement, it also guided to determine the site of bone marrow biopsy and to decide treatment protocol as well as in response assessment.
Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of uncertain prognosis. Early diagnosis improves prognosis and lessens the chances of progression to pseudomyxoma peritonei (PMP). We hereby report three cases of LAMN diagnosed over a year at our tertiary center. The first case was incidentally detected in a patient who underwent right hemicolectomy for carcinoma of the ascending colon. Both the other cases showed disease progression with PMP. On imaging, the third case was suggestive of a mucinous ovarian neoplasm, and on cytoreduction surgery, it was found to have LAMN involving the ovary. LAMN is often misdiagnosed due to nonspecific symptoms with acute appendicitis, retroperitoneal tumor, or ovarian neoplasm. Mostly, an incidental finding as seen in our series should be suspected in patients presenting with PMP. LAMN may remain asymptomatic, but once it ruptures, it leads to the dissemination of mucin with tumor epithelial cells in the peritoneum, which worsens the prognosis and is associated with high morbidity and mortality.
A BSTRACT Pulmonary neuroendocrine neoplasms are rare malignancies, with typical carcinoid (TC) tumors accounting for 2% of lung cancers. Carcinoid heart disease is uncommon, and pericardial involvement without valvular heart disease is exceedingly rare. We present a 40-year-old male with TC tumor and extensive mediastinal involvement who developed retrosternal discomfort, ultimately diagnosed as carcinoid heart disease. Imaging and clinical evaluation confirmed acute pericarditis, which progressed to impending cardiac tamponade, necessitating emergency pericardiocentesis.
