Hemangioma fusocelular en las fosas nasales y los senos etmoidales en un lactante de 4 meses de edad / Spindle cell hemangioma of nasal passage and ethmoidal sinus in a 4-month old infant

El hemangioma fusocelular es una neoplasia vascular benigna infrecuente. Afecta la dermis y la hipodermis de la parte distal de las extremidades; la afectación de la cabeza y el cuello es muy poco frecuente y nunca se informó compromiso de los senos paranasales. Este es el caso de un lactante de 4 meses con obstrucción nasal desde las 2 semanas debido a un tumor en los senos etmoidales que obstruía las fosas nasales. Se diagnosticó hemangioma fusocelular y se extirpó parcialmente el tumor. A los seis meses de seguimiento, se observó una regresión mínima con lesiones residuales. A los 30 meses, se observó que el tumor residual había desaparecido. El hemangioma fusocelular es infrecuente en cabeza y cuello y, a veces, la presentación no es indicativa del diagnóstico. El examen histopatológico ayuda con el diagnóstico diferencial y el tratamiento. La sensibilización sobre el hemangioma fusocelular podría aumentar los casos informados.

Spindle cell hemangioma (SCH) is a benign unusual vascular neoplasm. It does not have gender predilection and can occur at all ages. The disease affects dermis and subcutis of distal extremities predominantly; head and neck involvement is very rare, paranasal sinus involvement has not been reported before. Herein we present a 4-month-old infant with nasal obstruction since two weeks of age due to a mass in ethmoid sinus obliterating the nasal passage. After the histopathological diagnosis of SCH, the tumor was partially resected. In the sixth month follow-up, there was minimal regression of residual lesions. In the imaging studies performed 30 months after the surgery, the residual mass was found to be disappeared. SCH is not frequent in the head and neck, and presentation of some patients may not suggest the diagnosis. Histopathology is important for differential diagnosis and to orientate treatment. Awareness of SCH may increase the reported cases

A Case of Spindle Cell Hemangioma / 대한피부과학회지

Spindle cell hemangioma is an uncommon variant of vascular tumor, and it was first described as a unique vascular lesion that's characterized by cavernous blood vessels separated by spindle cells. It is recently thought to be a benign hemangioma with a reactive process. It mostly affects the distal extremities and it present as single or multiple lesions that are often painful. Histologically, thin-walled cavernous vessels are seen to be intermixed with varying proportions of bland spindle cells with vesicular nuclei. We report here on an interesting case of spindle cell hemangioma in a 39-year-old woman.

A Case of Spindle Cell Hemangioma / 대한피부과학회지

Spindle cell hemangioendothelioma was first described in 1986 to characterize a particular angiomatous lesion which shows different clinical features, however, it has recently been designated as spindle cell hemangioma (SCH) due to its benign nature. Microscopically, this peculiar vascular tumor consists of cavernous blood vessels intermixed with solid areas predominantly composed of spindle cells, resembling Kaposi sarcoma. A 39-year-old woman presented with a bean-sized, tender, bluish nodule on the pulp of her right thumb. The 1 year old lesion had increased slowly in size over this time. Histologic examination of the lesion showed that it was composed of large irregularly-dilated, thin-walled cavernous blood spaces containing organizing thrombi, numerous red blood cells, and a spindle cell mass which was partially connected with the vessel wall and invaded the stroma. A diagnosis of SCH was made based on histologic and immunohistochemical findings. After the lesion was totally excised, there has been neither recurrence nor occurence of new lesions to date.