Cavernous Hemangioma

Diagnosis: Cavernous Hemangioma

Blue spongy tumor mass of tissue filled with blood on thigh.

Clinical Presentation

Blue spongy tumor mass of tissue filled with blood on thigh.

Clinical History

Submitted by Alaa Saad. Originally posted October 10, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Vascular malformation • Kaposiform hemangioendothelioma • Tufted angioma • Pyogenic granuloma • Kaposi sarcoma • Neuroblastoma (metastatic) • Myofibroma

Key Learnings

• Infantile hemangioma: most common tumor of infancy — GLUT1 positive • Classic phases: proliferative (0-12 months) → plateau → involution (years) • Complete involution in ~50% by age 5, ~90% by age 9 • PHACES syndrome: large facial hemangiomas with posterior fossa, hemangioma, arterial, cardiac, eye, sternal defects • Alarming locations requiring treatment: periocular (amblyopia), airway (subglottic), ulcerated, large facial • Propranolol is the first-line treatment for problematic infantile hemangiomas — revolutionary since 2008 • Timolol 0.5% gel (topical) for small, superficial lesions

Tags: cavernous, hemangioma, alaa saad