We present a rare case of INTRAMUSCULAR HAEMANGIOMA of the forearm with periosteal reaction of radius and ulna. A 38-year-old female presented with a tumefaction in distal and dorsoulnar side of the right forearm. She had 1.5 years history of tumor which was painful during resent 2 months. Plain xray and MRI was done and the diagnosis of HAEMANGIOMA was proved by open biopsy. The tumor plus periosteal reaction and enlarged bone was respected. After 4 years follow-up no recurrence was seen.

Background: Hemangiomas are the most common vascular tumor in infancy. Systemic corticosteroids are the first choice of treatment although they have many side effects. Recent studies show Propranolol efficacy on hemangiomas treatment. It has rapid effect and few side effects. These reasons make us to review its effect.Methods: This interventional study was done on 20 children refer to Bu-Ali hospital. Treatment indications were multiple hemangiomas, organ malfunction and enlarging hemangioma. Treatment on those was started by 1mg/kg/day and increased to 3 mg/kg/day and continued for 6 month. After treatment completion 6 month follow up was done.Findings: Patients mean age was 23.15±11.24 months.65% of them were female and 35% was male. Mean size of lesion was 4.85±3.26 Cm.70% patients had acceptable respond (more than 50% decrease in size) and 30% had partial respond (less than 50%). This effect was similar to corticosteroid effect (about 84%), but with less side effects. In this study there was significant relationship between mean lesion size decrease and propranolol usage, but no significant relationship between size of lesion, age, sex and regression.Conclusion: This study shows that propranolol has acceptable effect on hemangiomas regression and could be suggested as first choice of hemangimas treatment.

Introduction: HAEMANGIOMA or hemangioendothelioma is amongst the commonest developmental, vascular lesions of infancy and childhood. Hemangioendothelioma of the salivary glands, however, is extremely rare. Due to their rarity, they may be misdiagnosed as lymphangiomas or other cystic lesions found more commonly in the region. This may lead to surgical complications including torrential hemorrhage that may have dire consequences for the patient. Case Report: Herein we present the case of a nine-year-old male with a cavernous HAEMANGIOMA involving the left submandibular gland which was diagnosed on-table due to inconclusive pre-operative radiological and pathological diagnosis. Fortunately, due to meticulous dissection and care the lesion was excised in toto without any significant blood loss. Conclusions: HAEMANGIOMA of the submandibular gland is so uncommon that often it isn't even considered a differential diagnosis for cystic swellings and lesions in this region. Mistaken diagnoses preoperatively may prove disastrous for the patient. Excision of HAEMANGIOMAs requires planning for hemostasis and blood loss if it occurs. Even minor iatrogenic manipulation of vascular lesions may completely obscure the field due to bleeding, making dissection and recognition of anatomical landmarks very difficult. This is especially dangerous in the submandibular region due to the proximity of various vital vascular and neural elements. A differential of HAEMANGIOMA should therefore always be considered by surgeons and radiologists alike for lesions with suspicious or indeterminate features, in this region.

Cardiac HAEMANGIOMAs (CH) are rare benign primary tumours of the heart and constitute nearly 2. 8% of primary cardiac tumours. In a-48-year-old female, a cardiac tumour mass over right ventricular out flow area and main pulmonary artery was detected during diagnostic workup for aetiology of recurrent pericardial effusion. Echocardiograhy and pericardial fluid findings were non conclusive. Contrast enhanced Computed tomography (CECT) and Positron emission tomography (PET) scan imaging found the exophytic, moderately hypermetabolic, heterogeneous mass lesion posterolateral to main pulmonary trunk. We did partial resection of lesion without cardiac reconstruction and open incisional biopsy through midline sternotomy incision. Histopathological analysis confirmed this as a case of Capillary type of HAEMANGIOMA of heart.

Hemangiomas are tumors of blood vessels identified by rapid endothelial cell proliferation in early infancy followed by involution over time. All other abnormalities are malformations resulting from anomalous development of vascular plexuses. This lesion in the oral cavity is not common. Despite its benign origin and behaviour, it is always of clinical importance to the dental profession and requires appropriate management. This paper reports a rare case of cavernous hemangiomaof base of tongue, buccal mucosa and floor of mouth with extensive phleboliths in a 64-year-old male.

A 40-year-old male patient referred with a chief complaint of swelling in the right cheek for 5 years. The swelling showed a gradual increase in size for over 6 months. No other relevant history in terms of habit, medication or systemic disease was given by the patient. On extra-oral examination (Figure 1a), mild swelling was observed in the cheek region that extended posteriorly towards the angle of the mandible. The skin over the swelling was normal and no other abnormalities were noted.

Background Computed tomography (CT) scan is one of the most frequent tests among children in which they should be completely calm and immobilized for a correct patient test. In this study, we aimed to investigate the effects of INTRAMUSCULAR dexmedetomidine (DEX) with INTRAMUSCULAR ketamine in children undergoing CT imaging. Materials and Methods This double-blind clinical trial study was conducted in Golestan and Imam Khomeini hospitals of Ahvaz, Iran, in 2017 and 2018. In the first and second groups, INTRAMUSCULAR ketamine and INTRAMUSCULAR DEX were injected with doses of 4 mg/kg and 3 μ g/kg, respectively. The objective of the drug injection was to reach the patient at a level of sedation of 4. During the entire period of sedation, heart rate and blood pressure were measured and recorded at the start of the study as well as after 5, 10, 15, 20, 25, 35, 45, and 55 minutes. Results In this study, 94 children needing sedation in CT-scan were included. The mean age of the children was 3. 87 ± 1. 70 years old and 54. 3% of them were girls. Mean time of onset of sedation in ketamine group (8. 82 ± 3. 86 minutes) was significantly lower compared to that of the DEX group (20. 46 ± 10. 9 minutes) (p < 0. 001). In addition, the mean duration of sedation effect in ketamine group was significantly lower than that of the DEX group (p = 0. 002). There was no significant difference in the mean discharge time in the two groups. In the ketamine group, 8 cases had side effects, however, no side effects were observed in the DEX group (p = 0. 006). Conclusion Based on the results, although DEX has a slower onset of effect and a longer duration of effect compared to ketamine, due to its lower side effects, it can be an appropriate alternative to commonly used sedative medications.

Background: The liver which is a vascular organ can easily be lacerated or crushed, depending on the severity of trauma.Case Report: A 55 year-old lady who fell down was taken to a hospital within one hour and died two hours post-trauma. An autopsy revealed rupture a large sub capsular vascular lesion situated on the right lobe of liver with hemoperitoneum. There was a deep contusion on the abdominal wall adjacent to the costal margin on the right side, roughly overlying the rupture, but the skin showed no evidence of injury on external examination. Histopathology revealed that the lesion was a giant cavernous HAEMANGIOMA of the liver which was undetected prior to the incident.Conclusion: Certain conditions like fatty liver disease, polycystic disease and cavernous HAEMANGIOMA can predispose liver injury, even with considerably less amount of force than is ordinarily required.