Cavernous Hemangioma

For 3 years, a gradually enlarging, raised, purple, cystic lesion had been present on the left upper lip vermilion of a 51-year-old man. The asymptomatic lesion measured 0.5 cm in diameter. The patient was given a local anesthetic, and the lesion was excised by wedge resection in the office; pathologic examination confirmed the diagnosis of benign cavernous hemangioma.

Robert P. Blereau, MD, Morgan City, La, reports that microscopic examination of the hemangioma revealed an unusual feature. This lesion had only a single dilated vascular channel, whereas most hemangiomas are characterized by a grouping of several less dilated vascular channels.

Cavernous hemangiomas usually arise in childhood and only rarely occur in adults. The dilated vessels lie in the dermis and subcutaneous tissues. Thrombosis, phlebolith-like calcifications within the lumen, and calcification within the vessel walls can occur as complications. Hemangiomas may be associated with various clinical syndromes, including diffuse neonatal hemangiomatosis, blue rubber bleb nevus syndrome, and Maffucci syndrome.

Although surgery is the simplest and most expedient treatment of hemangioma, other therapies are available, including irradiation, intralesional corticosteroid injections, oral corticosteroids, and subcutaneous interferon alfa-2a.