Case report
Pleural hemangioma: A case report and review of the literature

https://doi.org/10.1016/j.prp.2021.153650Get rights and content

Highlights

  • Pleural hemangioma is a rare entity.

  • To our knowledge, this is the sixth case to be published in the literature.

  • Pleural hemangioma may be distinguished from the more common pulmonary hemangioma and the more aggressive pleural epithelioid hemangioendothelioma.

  • In the present case, the hemangioma presented with recurrent pleural effusions which resolved after surgery.

Abstract

A middle-aged female with history of multinodular goiter, Hashimoto disease, and chronic vitamin B12 deficiency presented with palpitations and subsequent exertional dyspnea. Initial radiographic analysis suggested mediastinal cavernous hemangioma, but biopsy showed features consistent with pleural hemangioma. Pleural hemangioma should be considered among the differential diagnoses for recurrent unilateral pleural effusion. Pleural hemangioma should be distinguished from other more common entities including the similarly benign pulmonary hemangioma and the more aggressive pleural hemangioendothelioma.

Introduction

Hemangiomas are benign tumors of the vasculature, usually seen in early childhood, commonly presenting on skin, subcutaneous tissue and liver [1]. Pleural hemangiomas are exceedingly rare and tend to present with recurrent pleural effusions. Reviewing the existing literature, we have identified 2 cases of pleural hemangioma and 3 cases that would also meet the definition of pleural hemangioma. Here we report one additional case of a middle-aged female with recurrent pleural effusion caused by a pleural hemangioma. In addition, we have compiled this data to observe shared features of presentation.

Section snippets

Case report

A 47-year-old nonsmoker female with a history of total thyroidectomy due to multinodular goiter and Hashimoto disease, as well as chronic vitamin B12 deficiency, presented with four months of palpitations during exercise followed by two months of frank exertional dyspnea. There was no history of heart disease or tuberculosis. Additionally, there was no family history of autoimmunity. Her only medications were levothyroxine and parenteral cyanocobalamin.

On physical examination, her vitals were

Discussion

Hemangiomas are benign neoplasms of vascular origin, putatively due to genetic abnormalities leading to an imbalance of proangiogenic factors and inhibitors to vascular genesis, proliferation and development [2]. Upon biopsy, they can be distinguished by size of the increased vasculature between capillary and cavernous hemangiomas, as well presence of abnormal endothelial cells and mitoses [3].

A PubMed search for articles pertaining to pleural hemangioma was performed (Fig. 4). Articles with

CRediT authorship contribution Statement

The authors have no relevant conflicts of interest to declare. No funding was received for the preparation of the manuscript. BMJ: Writing – original draft, Investigation; GB: Resources, Writing – review & editing, Supervision, Visualization; BS: Resources, Writing – review & editing, Conceptualization, Supervision; AAA: Writing – review & editing, Conceptualization, Resources, Supervision.

References (13)

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Cited by (0)

1

ORCID 0000–0003-3127–4293

2

ORCID 0000–0003-3862–2086

3

ORCID 0000–0002-0202–9486

4

ORCID 0000–0002-6612–3279

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