Hemangioma microvenular: reporte de caso / Microvenular hemangioma: case report

El hemangioma microvenular corresponde a una neoplasia infrecuente de origen vascular y estirpe benigno. Su etiología es desconocida; sin embargo, se han reportado casos asociados a la inmunosupresión y factores hormonales. Suele aparecer en adultos jóvenes con ligera predominancia en mujeres y en la mayoría de los casos se presenta como un nódulo asintomático en extremidades. Clínicamente, puede imitar lesiones vasculares benignas y malignas. Dentro de su diagnóstico diferencial debe considerarse el Sarcoma de Kaposi y otros tipos de hemangiomas. Debido a su inespecificidad clínica, el diagnóstico debe ser realizado histológicamente. Se han descrito múltiples alternativas terapéuticas además del seguimiento periódico. Algunos casos han sido tratados con una escisión completa sin recurrencias a 5 años de seguimiento y otros tratados con láser pulsado con excelente respuesta. Se presenta el caso de una mujer de 44 años con una placa eritematoviolácea asintomática de aproximadamente 8 centímetros en su antebrazo derecho de 1 mes de evolución, con biopsia compatible y control clínico a 10 meses sin cambios significativos.

Microvenular hemangioma is a rare neoplasm of vascular origin and benign lineage. Its etiology is unknown; however, there are some cases associated with immunosuppression and hormonal factors. It usually appears in young adults with a slight predominance in women and in most cases, it presents as an asymptomatic nodule on the extremities. Clinically, it can mimic benign and malignant vascular lesions. Its differential diagnosis includes Kaposi's sarcoma and other types of hemangiomas. The diagnosis must be made histologically. Multiple therapeutic alternatives have been described. Some cases have been treated with complete excision without recurrence at 5 years, and others with pulsed laser with excellent response. We present the case of a 44 year old woman with a 1 month history of an asymptomatic erythematous plaque of approximately 8 centimeters in her right forearm with compatible biopsy. The lesion had no significant changes at 10 months followup.

A microvenular hemangioma with a rare expression of progesterone receptor immunocreativity and a review of the literature.

Microvenular hemangioma (MVH) is a rare benign vascular tumor with a controversial etiology, but hormone receptor alterations might be involved. We report a case of MVH in a 41-year-old Taiwanese woman who presented with a 1.5 × 1 cm violaceous plaque on left thigh that had appeared 1 year previously. She had taken oral contraceptives for several years and stopped 1 year prior to presentation. Histologically, the tumor was composed of small and compressed venous structures infiltrating in the dermis and subcutis. Immunohistochemically, the tumor cells displayed negative immunoreactivity for human herpesvirus-8 and positive immunoreactivity for smooth muscle actin and progesterone receptor (PR). Taken together with the patient's medical hormone therapy history and the evidence of PR immunoreactivity, our findings support that progesterone may be associated with the tumorigenesis of MVH.

Multiple Microvenular Hemangioma Clinicopathologically Mimicking Early Stage Kaposi Sarcoma: A Case Report / 대한피부과학회지

Microvenular hemangioma (MVH) is a rare acquired benign vascular neoplasm, which presents commonly as a solitary purple-to-red nodule or plaque measuring approximately 10 mm in diameter. MVH occurs primarily on the extremities or the trunk. Most lesions are solitary, and multiple lesions are rare. Histopathological features of MVH include numerous, scattered, thin and irregularly branching small vessels in the dermis and endothelial cells without atypia. Owing to similarities in clinical morphology and histopathological features, MVH may often be indistinguishable from the early patch stage of Kaposi sarcoma. Immunohistochemical (IHC) analysis helps differentiate between the 2 diseases. The results of IHC tests in patients with MVH show positive staining for CD31 and smooth muscle actin and typically, negative staining for the human herpes virus 8 antigen. We report a rare case of multiple MVH clinically mimicking the early patch stage of Kaposi sarcoma in a 63-year-old woman who presented with a 3-year history of slowly growing, compressible, soft, bluish-purple macules and plaques on the trunk and right arm.

A Case of Microvenular Hemangioma on the Chin / 대한피부과학회지

No abstract available.

Microvenular hemangioma: a clinicopathologic review of 13 cases.

BACKGROUND: Microvenular hemangioma is an uncommon benign vascular tumor that can potentially be mistaken for malignancy. METHODS: We reviewed the histopathologic and clinical features of 13 microvenular hemangiomas, which represents the largest series reported to date. RESULTS: The patients [female (F) = 8 and male (M) = 5] had a mean age of 39 years (range: 16 months-69 years). All presented with a similar history of a new, asymptomatic, stable or slow-growing, red to purple plaque or nodule. The lesions were located on the extremities, chest, back or abdomen. Two patients had multiple lesions. In six, a vascular tumor was not suspected clinically. Histologically, all were composed of a dermal proliferation of thin-walled, often branching, vascular channels dissecting through collagen fibers. The vessels were surrounded by a conspicuous layer of pericytes. Immunohistochemistry showed that all were positive for a vascular marker. Stains for WT-1 were positive in 9 of 10. None of the lesions tested (0/12) were positive for podoplanin or human herpesvirus-8 (HHV-8) (0/9). Follow-up available on six patients showed no recurrences. CONCLUSION: The histomorphology of microvenular hemangioma frequently raises concern for a malignant vascular lesion, especially Kaposi sarcoma. Identification of characteristic features, particularly the pericyte layer in routinely stained sections or with an SMA immunostain, allows an accurate diagnosis.

Multiple microvenular hemangioma: A case report.

The current study reports a case of multiple microvenular hemangioma (MH). A 35-year-old male presented with dark red maculopapules on the trunk and limbs that had been apparent for 5 years. The number of lesions exceeded 100 in total. A histological examination demonstrated multiple, irregular, branching venules in the dermis, without any endothelial atypia. On immunohistochemical analysis of the vascular structures, the endothelial cells stained positive for CD31, CD34 and factor VIII, and the perivascular cells stained positive for SMA and HHF-35. These observations were consistent with a diagnosis of MH, and should be differentiated from the most common differential diagnosis of patch-stage Kaposi's sarcoma. There was no clear effect following topical application of recombinant human interferon α-2b gel.

A Case of Microvenular Hemangioma on the Scalp / 대한피부과학회지

Microvenular hemangioma is a relatively rare, acquired, and slow-growing benign vascular lesion that usually arises as a small, reddish papule or plaque in young to middle-aged individuals. It commonly occurs on the arms, trunk, or legs. Histologically, it consists of irregular branching capillaries and venules involving the full thickness of the reticular dermis. A 38-year-old woman presented for 3 years with a solitary reddish nodule on the scalp. Histological examination showed irregular venules throughout the dermis. We report this case of microvenular hemangioma developing on the scalp, an unusual location.

Clinical and pathological analysis of six cases of eruptive microvenular hemangioma / 中华皮肤科杂志

Objective To analyze the clinical and histopathologic features of eruptive microvenular hemangioma (EMVH). MethodsThe clinical and histological findings in six patients with EMVH were retrospectively reviewed.Results The patients were young or middle-aged,with a median age of onset of 34 years.The ratio of males to females was 1 ∶ 1.Clinically,all the patients experienced a sudden development of widespread,asymptomatic,brunneus,flat-topped papules and plaques measuring from 0.1 to 2.0 cm in diameter.Histopathologic examination revealed a poorly circumscribed proliferation of small,irregularly branched,thin-walled blood vessels haphazardly arranged between collagen fiber bundles in the dermis.The lumina of the blood vessels were often collapsed.There was no cellular atypia or mitosis.A variable degree of sclerosis was noted in the surrounding stroma.Immunobistochemical study revealed that the endothelial cells stained positive for CD34,CD31,and factor Ⅷ-related antigen.Conclusions The diagnosis of EMVH is proposed,and awareness of this disease may benefit its early diagnosis and avoidance of unnecessary treatment.

A Case of Microvenular Hemangioma Clinically Mimicking Kaposi's Sarcoma / 대한피부과학회지

Microvenular hemangioma is an uncommon aquired vascular tumor, occurring in young to middle-aged adults of both genders. It usually presents as a small, solitary, purple-to-red papule, nodule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickeness of the reticular dermis. Herein, we report a case of microvenular hemangioma, clinically mimicking Kaposi's sarcoma, on the toe of the right foot in a 44-year old male.

A Case of Microvenular Hemangioma / 대한피부과학회지

Microvenular hemangioma is an uncommon acquired vascular tumor of young to middle-aged adults of both genders. It usually presents as a small, solitary, purple to red papule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickness of the reticular dermis. Because of histological similarity to a Kaposi's sarcoma, the awareness of microvenular hemangioma is important. We report a case of microvenular hemangioma in a 9-year-old girl.

A Case of Microvenular Hemangioma / 대한피부과학회지

A case of microvenular hemangioma in a 38-year-old female is described. The patient presented with a slowly growing, solitary reddish nodule on Lt. posterior thigh, which measured 1x1 cm. Histologically, the tumor was an infiltrative growth throughout the dermis. It consisted of thin-walled, small sized, irregularly branched vessels. The vascular lumina were narrow. The flattened endothelial cells had oval to spindle-shaped nuclei and scant cytoplasm that were immunohistochemically positive for factor VIII-related antigen and smooth muscle actin. The tumor cells lacked cellular atypia, pleomorphism, and mitotic figures. We diagnosed this case as microvenular hemangioma.

Two Cases of Microvenular Hemanogioma / 대한피부과학회지

Microvenular hemangioma (MH) is a recently described, uncommon, acquired vascular, tumor presenting clinically as a small reddish nodule in young and middle, aged individuals of either gender. Histologically, thin and irregularly branching small venules with inconspicouous lumia and without cellular atypia are found widely throughout the dermis. The presence of histologic features of the collagen dissection and vascular tufts makes it necessary to differentiate MH with Kaposi's sarcoma and angioblastoma. As we are aware, the description of these two cases which showed the characteristic clinical and histologic features of MH, is the first report of MH in Korea.