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verrucous hemangioma

Monday 14 March 2005

Definition: The term verrucous hemangioma has been used to describe a congenital vascular anomaly with a progressive verrucous epidermal surface persisting throughout life unless surgically excised.

Verrucous hemangioma are reminiscent of infantile hemangioma with GLUT1 immunopositivity, particularly in its involutive phase. No firm conclusion seems possible as to whether verrucous hemangioma is a malformation or an indolent tumor, but clinical evidence favors the former category. (16780464)

Recent evidence suggests that some of these lesions may share histologic features of both hemangiomas and malformations, thereby causing nosologic confusion.

Synopsis

- combined vascular malformations composed of capillaries, lymphatics, and veins
- hyperkeratotic epidermis
- small, thick-walled, blood-filled vessels with multilamellated basement membrane involving the entire dermis as well as the subcutis.
- thick vascular walls
- multilamellated basement membrane
- relatively uniform channel size

Immunochemistry

- +/- focal GLUT1 endothelial positivity
- low-level MIB-1 reactivity

Variants

- congenital verrucous hemangioma

Differential diagnosis

- hyperkeratotic vascular lesions

  • capillary-lymphatic malformation
  • capillary-venous malformation
  • angiokeratoma circumscriptum
  • angiokeratoma
  • angiokeratoma circumscriptum

See also

- vascular tumors

  • congenital hemangioma
    • RICH
    • NICH

References

- Brown A, Warren S, Losken HW, Morrell DS. Verrucous lymphovascular malformation versus verrucous hemangioma: controversial nomenclature. Cutis. 2008 May;81(5):390-6.PMID: 18543587

- Tennant LB, Mulliken JB, Perez-Atayde AR, Kozakewich HP. Verrucous hemangioma revisited. Pediatr Dermatol. 2006 May-Jun;23(3):208-15. PMID: 16780464