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Updated: Feb 1 2020

Vascular Tumors

Images hemangioma.jpg
  • Snapshot
    • A 34-year-old man presents with a rash. He states he recently started feeling fatigued and a purple rash appeared a few weeks ago. On physical exam, there are dozens of purple papules and nodules on the skin and on the oral mucosa. A biopsy reveals lymphocytic infiltration. Additional viral testing is sent for further workup. (Kaposi sarcoma)
  • Introduction
    • Benign or malignant vascular proliferation
      • most commonly, these neoplasms manifest cutaneously
  • Benign Vascular Neoplasms
    • Strawberry hemangioma
      • clinical definition
        • benign capillary hemangioma of infancy
          • also known as infantile hemangioma
      • regresses spontaneously within a few years
      • treatment is typically not necessarily
    • Cherry angioma
      • clinical definition
        • benign capillary hemangioma of adulthood
        • more frequent in elderly patients
      • does not regress spontaneously
      • treatment is typically not necessarily
    • Cavernous hemangioma
      • clinical definition
        • benign tumor of liver and spleen
          • risk of rupture with increasing size
      • associated conditions
        • von-Hippel-Lindau syndrome
      • treatment is typically not necessarily
    • Pyogenic granuloma
      • clinical definition
        • polypoid lobulated capillary hemangioma of the skin and mucosa
          • easily ulcerates and bleeds
          • often occurs on the gingiva
      • associated conditions
        • trauma
        • pregnancy
      • treatment
        • the lesion can be surgically removed if it causes excessive discomfort
  • Malignant Vascular Neoplasms
    • Kaposi sarcoma
      • clinical definition
        • endothelial malignancy that most commonly affects the skin, characterized by purple papules and nodules
        • can also affect the mouth, gut, and lungs
        • characterized by a lymphocytic infiltrate
      • associated conditions
        • human herpesvirus-8 infection
        • human immunodeficiency virus infection
      • treatment
        • antiretroviral therapy
        • if refractory
          • adriamycin
          • vinblastine
    • Angiosarcoma
      • clinical definition
        • malignant vascular neoplasm affecting the head, neck, chest, and liver
        • more common in sun-exposed areas in the elderly population
        • very aggressive malignancy
      • associated conditions
        • radiation therapy
        • hepatic angiosarcoma is specifically associated with a "VAT of chemicals"
          • Vinyl chloride
          • Arsenic
          • Thorotrast
        • lymphangiosarcoma is associated with
          • chronic post-mastectomy lymphedema
      • treatment
        • surgical excision
  • Other Neoplasms
    • Glomus tumor
      • clinical definition
        • painful benign red-blue tumor of the glomus body
          • glomus body is a thermoregulatory agent, which can shunt blood towards or away from the skin surface
        • found under the fingernails
      • treatment
        • surgical excision
    • Cystic hygroma
      • clinical definition
        • cavernous lymphangioma of the neck
          • “webbed neck”
      • associated conditions
        • Turner syndrome
    • Bacillary angiomatosis
      • clinical definition
        • benign capillary skin lesions caused by Bartonella henselae infections
        • characterized by neutrophilic infiltrate
      • associated conditions
        • acquired immunodeficiency disease syndrome (AIDS)
        • cat-scratch disease
      • treatment
        • antibiotic therapy
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