title: Novel application of percutaneous cryotherapy for the treatment of recurrent oral bleeding from a noninvoluting congenital hemangioma involving the right buccal space and maxillary tuberosity.
abstract: Cryotherapy is the application of varying extremes of cold temperatures to destroy abnormal tissue. The intent of this article is to describe a novel technique using percutaneous cryotherapy for treating a noninvoluting congenital craniofacial hemangioma (NICH). An 18-year-old woman with type 1 von Willebrand's disease, as well as a qualitative platelet aggregation disorder, presented with multiple recurrent episodes of oral bleeding from a NICH involving the right buccal space and maxillary tuberosity. The patient was initially treated with a combination of endovascular particulate embolization, percutaneous sclerotherapy, tissue cauterization, and laser therapy between the ages of 4 and 8 years of age. At 18 years of age, the patient presented with recurrent episodes of oral bleeding related to the NICH. Endovascular embolization was performed using particulate and a liquid embolic agent with limited success. Due to the refractory nature of this bleeding, the patient underwent successful lesion ablation using percutaneous cryotherapy. At 9-month follow-up, the patient is asymptomatic with no episodes of recurrent bleeding.
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI 48109, USA. sepand@med.umich.edu
authors.forename: Sepand
authors.initials: S
authors.lastname: Salehian
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gemmete
authors.forename: Steven
authors.initials: S
authors.lastname: Kasten
authors.forename: Sean P
authors.initials: SP
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D001791:Blood Platelet Disorders / Q000150:complications / Q000151:congenital; D002610:Cheek; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008441:Maxillary Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D009062:Mouth Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D006472:Oral Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D010974:Platelet Aggregation; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D056725:von Willebrand Disease, Type 1 / Q000150:complications