hemangioma of subcutaneous tissue

Hemangioma of Subcutaneous Tissue: A Benign Vascular Tumor

A hemangioma of subcutaneous tissue is a type of benign vascular tumor that occurs in the layer of fat beneath the skin, also known as the subcutaneous layer. This condition is characterized by an abnormal growth of blood vessels, resulting in red or purple-colored lesions on the skin.

Appearance and Characteristics

Deep hemangiomas, also referred to as subcutaneous hemangiomas, arise from the reticular dermis and/or the subcutis layer, and appear as a bluish-hued nodule, plaque or tumor. These growths can vary in size and shape, and may be flat or raised.

Symptoms and Diagnosis

Hemangiomas of subcutaneous tissue are typically painless and may grow rapidly after birth. They can manifest as a single lesion or multiple lesions of different sizes. A biopsy may be needed to confirm a diagnosis of hemangioma, in which a tissue sample is taken from the tumor and examined under a microscope.

Treatment Options

Surgical excision involves removing the residual fibrofatty tissue and this improves treatment outcomes. Pulsed dye laser therapy may also be used to treat hemangiomas of subcutaneous tissue.

References:

• [5] Hemangioma of the skin and subcutaneous tissue is a benign vascular tumor that commonly occurs in infants and young children.
• [9] A deep hemangioma, also called a subcutaneous hemangioma, is located in the layer of fat beneath the skin. These have a bluish, lumpy appearance.
• [12] Deep hemangiomas, also called subcutaneous hemangiomas, arise from the reticular dermis and/or the subcutis layer, and appear as a bluish-hued nodule, plaque or tumor.
• [10] The remainder of this article uses the terms 'soft tissue hemangioma' and 'soft tissue venous malformation' interchangeably.

Signs and Symptoms of Hemangioma of Subcutaneous Tissue

Hemangiomas of the subcutaneous tissue, also known as deep hemangiomas, are a type of vascular birthmark that grows under the skin. The symptoms and signs of this condition can vary depending on the size and location of the hemangioma.

Common Symptoms:

• Raised Lesion: A deep hemangioma appears as a raised lump or bulge under the skin, which can be soft to the touch.
• Blue or Purple Tint: The affected area may have a blue or purple color due to the presence of blood vessels.
• Painless: Deep hemangiomas are usually painless, but in some cases, they may cause discomfort or tenderness.

Other Signs and Symptoms:

• Bulging Skin: As the hemangioma grows under the skin, it can cause the surrounding skin to bulge outward.
• Visible Blood Vessels: The affected area may have visible blood vessels, which can be a sign of the underlying vascular anomaly.
• Size and Shape: Deep hemangiomas can vary in size and shape, ranging from small, flat patches to large, raised lumps.

References:

• [10] Deep hemangiomas grow under the skin, making it bulge, often with a blue or purple tint. Deep hemangiomas are also called subcutaneous ("under the skin") hemangiomas.
• [10] The affected area may have visible blood vessels, which can be a sign of the underlying vascular anomaly.
• [9] Most often flush with the skin or slightly raised, soft to the touch, and usually painless.

Based on the provided context, here are the diagnostic tests for hemangiomas of subcutaneous tissue:

• Ultrasound: An ultrasound is an imaging test that uses sound wave technology to examine the size of the hemangioma and allows your doctor to see how much blood is flowing through it [8]. This can be useful in differentiating hemangiomas from other deep dermal or subcutaneous structures, such as cysts, pilomatrixomas, or lipomas [7].
• Magnetic Resonance Imaging (MRI): MRI with contrast can be used to diagnose hemangiomas of the skin and subcutaneous tissue. This test is particularly useful for diagnosing deep lesions [9].
• Angiogram: An angiogram involves injecting dye into the surrounding bloodstream, which makes the hemangioma show up in an X-ray image. This test can help visualize the blood vessels within the hemangioma [3].
• Biopsy: In some cases, a biopsy may be necessary to confirm the diagnosis of a hemangioma. However, this is typically not needed for subcutaneous hemangiomas, as they can often be diagnosed based on clinical presentation and imaging studies [4].

It's worth noting that in most cases, a health care provider can diagnose a hemangioma by looking at it, and tests are typically not needed [1].

Differential Diagnosis of Hemangioma of Subcutaneous Tissue

Hemangiomas of subcutaneous tissue can be challenging to diagnose, as they may resemble other soft tissue masses. The differential diagnosis for subcutaneous hemangiomas includes:

• Granulation tissue: This is a common condition that occurs in response to trauma or inflammation. It can appear similar to a hemangioma on imaging studies.
• Infantile hemangioma: Although infantile hemangiomas are typically found in the skin, they can also occur in subcutaneous tissue. They are characterized by their rapid growth and eventual involution.
• Vascular malformations: These are congenital anomalies of blood vessels that can appear as soft tissue masses. They may be similar to hemangiomas on imaging studies but have distinct histological features.
• Lipomas: These are benign tumors composed of fat cells that can occur in subcutaneous tissue. They may be mistaken for hemangiomas due to their similar appearance on imaging studies.

Key Features to Distinguish Hemangioma from Other Conditions

To accurately diagnose a subcutaneous hemangioma, it is essential to consider the following features:

• Clinical presentation: Subcutaneous hemangiomas typically present as a soft, compressible mass that may be painful or tender.
• Imaging studies: On MRI, subcutaneous hemangiomas appear as well-circumscribed masses with characteristic "flow voids" within. They are usually isointense on T1-weighted images and hyperintense on T2-weighted images.
• Histological examination: The definitive diagnosis of a subcutaneous hemangioma requires histological examination, which reveals the presence of vascular channels lined by endothelial cells.

References

[4] Of the 22 hemangiomas, the diagnosis was made histologically in 10 patients, on angiography in six, and by the characteristic clinical findings and follow-up in the remaining six patients. [6] A case of lobular capillary hemangioma (pyogenic granuloma), localized to the subcutaneous tissue, and a review of the literature. [11] The diagnosis of a hemangioma is best made by clinical history and physical exam. In cases of unclear diagnosis, the best radiographic modalities to use are MRI and angiography. [14] Soft tissue venous malformations, commonly known as soft tissue hemangiomas, are location-dependent benign vascular soft tissue tumors.

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