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Irradiation Treatment of Cavernous Hemangioma with Special Reference to So-Called Contact Roentgen Irradiation

Irradiation Treatment of Cavernous Hemangioma with Special Reference to So-Called Contact... Irradiation Treatment of Cavernous Hemangioma with Special Reference to So-Called Contact Roentgen Irradiation 1 H. Dabney Kerr , M.D. Iowa City, Iowa Excerpt Cavernous hemangioma is usually treated by one or more of the following methods: (1) carbon dioxide snow, (2) electrocautery, (3) injection of sclerosing fluid, (4) excision, (5) some form of irradiation. Most writers on irradiation have preferred to use radium either in the form of a plaque or, less frequently, as interstitial implants of radium element needles or radon seeds (1, 4, 8, 9, 12, 15, 17, 18, to mention only a few). Relatively few have advocated the use of the roentgen ray (4, 6, 7, 10, 12, 14, 16, 18). Pressure ultraviolet irradiation is sometimes used in selected cases. Because we have had very satisfactory results in the treatment of cavernous hemangioma with roentgen irradiation at short distances, and since this method is simple, it seems worth while to record our technic and results as compared with the results obtained in a series of cases treated by us with radium. Hemangiomas may be divided into two main groups, capillary and cavernous. The former comprises the spider nevi and port wine marks; the latter includes the soft compressible masses which may be, first, intracutaneous or cutaneous with classical red color and atrophic overlying epithelium; second, deeper masses with no actual skin involvement but showing a blue color; third, deep subcutaneous, submucous, or intramuscular masses. This paper is confined to the cavernous group as it involves the skin or subcutaneous tissue. These lesions vary in size from a millimeter or two to 8 or 10 cm. in diameter and are raised above the surrounding normal skin. As noted above, they are red if the skin is involved and blue if they are completely subcutaneous. They are either present at birth or appear shortly thereafter. There is a tendency to early rapid increase in size, but peripheral advance is sometimes accompanied by sclerosis and blanching of the central portion. They may occur on almost any part of the body, but 50 per cent of our 177 lesions in 145 consecutive cases of hemangioma occurred about the head and neck. Eighty-six per cent of our patients were one year of age or younger when first seen. Girls were more often affected than boys, the proportion being roughly 3 to 1. In spite of the fact that some authors (13, 19) insist that cavernous hemangiomas are self-limited and may even regress spontaneously, we think that they should be treated as soon as detected. We have seen enough untreated cases in adults and rapidly spreading lesions in infants to justify this position. In our opinion, however, small superficial lesions up to 7 or 8 mm. in diameter can be treatedwith carbon dioxide snow. While thistreatmentismomentarily painful, good end-results are usually more quickly obtained than with irradiation. The larger lesions should be treated by irradiation. Our first series, consisting of 96 cases treated by radium, was seen between 1930 and 1937. The second group, comprising 49 cases, was treated solely by contact irradiation after 1937. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

Irradiation Treatment of Cavernous Hemangioma with Special Reference to So-Called Contact Roentgen Irradiation

Radiology , Volume 39 (4): 383 – Oct 1, 1942

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Publisher
Radiological Society of North America, Inc.
Copyright
Copyright © 1942 by Radiological Society of North America
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/39.4.383
Publisher site
See Article on Publisher Site

Abstract

Irradiation Treatment of Cavernous Hemangioma with Special Reference to So-Called Contact Roentgen Irradiation 1 H. Dabney Kerr , M.D. Iowa City, Iowa Excerpt Cavernous hemangioma is usually treated by one or more of the following methods: (1) carbon dioxide snow, (2) electrocautery, (3) injection of sclerosing fluid, (4) excision, (5) some form of irradiation. Most writers on irradiation have preferred to use radium either in the form of a plaque or, less frequently, as interstitial implants of radium element needles or radon seeds (1, 4, 8, 9, 12, 15, 17, 18, to mention only a few). Relatively few have advocated the use of the roentgen ray (4, 6, 7, 10, 12, 14, 16, 18). Pressure ultraviolet irradiation is sometimes used in selected cases. Because we have had very satisfactory results in the treatment of cavernous hemangioma with roentgen irradiation at short distances, and since this method is simple, it seems worth while to record our technic and results as compared with the results obtained in a series of cases treated by us with radium. Hemangiomas may be divided into two main groups, capillary and cavernous. The former comprises the spider nevi and port wine marks; the latter includes the soft compressible masses which may be, first, intracutaneous or cutaneous with classical red color and atrophic overlying epithelium; second, deeper masses with no actual skin involvement but showing a blue color; third, deep subcutaneous, submucous, or intramuscular masses. This paper is confined to the cavernous group as it involves the skin or subcutaneous tissue. These lesions vary in size from a millimeter or two to 8 or 10 cm. in diameter and are raised above the surrounding normal skin. As noted above, they are red if the skin is involved and blue if they are completely subcutaneous. They are either present at birth or appear shortly thereafter. There is a tendency to early rapid increase in size, but peripheral advance is sometimes accompanied by sclerosis and blanching of the central portion. They may occur on almost any part of the body, but 50 per cent of our 177 lesions in 145 consecutive cases of hemangioma occurred about the head and neck. Eighty-six per cent of our patients were one year of age or younger when first seen. Girls were more often affected than boys, the proportion being roughly 3 to 1. In spite of the fact that some authors (13, 19) insist that cavernous hemangiomas are self-limited and may even regress spontaneously, we think that they should be treated as soon as detected. We have seen enough untreated cases in adults and rapidly spreading lesions in infants to justify this position. In our opinion, however, small superficial lesions up to 7 or 8 mm. in diameter can be treatedwith carbon dioxide snow. While thistreatmentismomentarily painful, good end-results are usually more quickly obtained than with irradiation. The larger lesions should be treated by irradiation. Our first series, consisting of 96 cases treated by radium, was seen between 1930 and 1937. The second group, comprising 49 cases, was treated solely by contact irradiation after 1937.

Journal

RadiologyRadiological Society of North America, Inc.

Published: Oct 1, 1942

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