Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2020; 8(20): 4986-4992
Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4986
Anastomosing hemangioma arising from the left renal vein: A case report
Li-Ping Zheng, Wei-Ai Shen, Chun-Hua Wang, Chun-Dong Hu, Xu-Jian Chen, Yi-Yu Shen, Jing Wang
Li-Ping Zheng, Chun-Dong Hu, Xu-Jian Chen, Yi-Yu Shen, Jing Wang, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Wei-Ai Shen, University of Ningbo, Ningbo 315000, Zhejiang Province, China
Chun-Hua Wang, Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Zheng LP and Wang J designed the case report; Zheng LP and Shen WA collected the clinical data of the patient; Wang CH provided and explained the pathological pictures; Hu CD and Chen XJ analyzed the data; Zheng LP wrote the manuscript.
Supported by the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City, No. 2019AD32201.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jing Wang, MD, Associate Chief Physician, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. drzlping@126.com
Received: July 27, 2020
Peer-review started: July 27, 2020
First decision: August 7, 2020
Revised: August 14, 2020
Accepted: September 9, 2020
Article in press: September 9, 2020
Published online: October 26, 2020
Processing time: 91 Days and 3.8 Hours
Abstract
BACKGROUND

Anastomosing hemangioma (AH) is a rare subtype of benign hemangioma that is most commonly found in the genitourinary tract. Due to the lack of specific clinical and radiologic manifestations, it is easily misdiagnosed preoperatively. Here, we report a case of AH arising from the left renal vein that was discovered incidentally and confirmed pathologically, and then describe its imaging characteristics from a radiologic point of view and review its clinicopathologic features and treatment.

CASE SUMMARY

A 74-year-old woman was admitted to our department for a left retroperitoneal neoplasm measuring 2.6 cm × 2.0 cm. Her laboratory data showed no significant abnormalities. A non-contrast-enhanced computed tomography (CT) scan showed a heterogeneous density in the neoplasm. Non-contrast-enhanced magnetic resonance imaging (MRI) revealed a heterogeneous hypointensity on T1-weighed images and a heterogeneous hyperintensity on T2-weighed images. On contrast-enhanced CT and MRI scans, the neoplasm presented marked septal enhancement in the arterial phase and persistent enhancement in the portal phase, and its boundary with the left renal vein was ill-defined. Based on these clinical and radiological manifestations, the neoplasm was initially considered to be a neurogenic neoplasm in the left retroperitoneum. Finally, the neoplasm was completely resected and pathologically diagnosed as AH.

CONCLUSION

AH is an uncommon benign hemangioma. Preoperative misdiagnoses are common not only because of a lack of specific clinical and radiologic manifestations but also because clinicians lack vigilance and diagnostic experience in identifying AH. AH is not exclusive to the urogenital parenchyma. We report the first case of this neoplasm in the left renal vein. Recognition of this entity in the left renal vein can be helpful in its diagnosis and distinction from other neoplasms.

Keywords: Anastomosing hemangioma; Angiosarcoma; Computed tomography; Magnetic resonance imaging; Case report; Pathology

Core Tip: Anastomosing hemangioma (AH) is difficult to recognize because of its rarity and atypia. Herein, we report a case of AH in an old woman that was discovered incidentally and confirmed pathologically. To the best of our knowledge, this is the first case of AH reported in the left renal vein. Recognizing that AH may occur in the left renal vein will help improve doctors' vigilance and reduce the probability of misdiagnosis.