Vascular Tumors

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 proliferationmost commonly, these neoplasms manifest cutaneously

Benign Vascular Neoplasms

Strawberry hemangioma clinical definitionbenign capillary hemangioma of infancyalso known as infantile hemangiomaregresses spontaneously within a few years treatment is typically not necessarilyCherry angioma clinical definitionbenign capillary hemangioma of adulthoodmore frequent in elderly patients does not regress spontaneouslytreatment is typically not necessarilyCavernous hemangiomaclinical definitionbenign tumor of liver and spleenrisk of rupture with increasing sizeassociated conditionsvon-Hippel-Lindau syndrometreatment is typically not necessarilyPyogenic granulomaclinical definitionpolypoid lobulated capillary hemangioma of the skin and mucosa
easily ulcerates and bleedsoften occurs on the gingivaassociated conditionstraumapregnancytreatment
the lesion can be surgically removed if it causes excessive discomfort

Malignant Vascular Neoplasms

Kaposi sarcoma clinical definitionendothelial malignancy that most commonly affects the skin, characterized by purple papules and nodules can also affect the mouth, gut, and lungscharacterized by a lymphocytic infiltrateassociated conditionshuman herpesvirus-8 infectionhuman immunodeficiency virus infectiontreatmentantiretroviral therapy if refractoryadriamycinvinblastineAngiosarcomaclinical definitionmalignant vascular neoplasm affecting the head, neck, chest, and livermore common in sun-exposed areas in the elderly populationvery aggressive malignancyassociated conditionsradiation therapyhepatic angiosarcoma is specifically associated with a “VAT of chemicals”Vinyl chlorideArsenicThorotrastlymphangiosarcoma is associated withchronic post-mastectomy lymphedema treatmentsurgical excision

Other Neoplasms

Glomus tumorclinical definitionpainful benign red-blue tumor of the glomus bodyglomus body is a thermoregulatory agent, which can shunt blood towards or away from the skin surfacefound under the fingernailstreatmentsurgical excisionCystic hygroma clinical definitioncavernous lymphangioma of the neck“webbed neck”associated conditionsTurner syndromeBacillary angiomatosis clinical definitionbenign capillary skin lesions caused by Bartonella henselae infectionscharacterized by neutrophilic infiltrateassociated conditionsacquired immunodeficiency disease syndrome (AIDS)cat-scratch diseasetreatmentantibiotic therapy

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