Table of Contents  
CASE REPORT
Year : 2012  |  Volume : 5  |  Issue : 1  |  Page : 60-61  

A rare case of large verrucous hemangioma on the scalp


Department of Plastic Surgery, Dr D. Y. Patil Hospital and Research Centre, Nerul, Navi Mumbai, India

Date of Web Publication20-Jun-2012

Correspondence Address:
Ananta A Kulkarni
Department of Plastic Surgery, Padmashree Dr. D. Y. Patil Hospital and Research Centre, Sector -5, Nerul, Navi Mumbai - 400 706, Maharasthra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.97516

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  Abstract 

Verrucous hemangioma is an uncommon vascular malformation commonly seen in the lower limbs, histologically characterized by vascular proliferation and dilatation from dermis to subcutaneous tissue and proliferative reaction of the epidermis. Here we report a rare case of large verrucous hemangioma on the scalp which was excised and grafted. In a 6-month follow-up, the patient had no recurrence.

Keywords: Scalp swelling, vascular malformation, verrucous hemangioma on scalp


How to cite this article:
Kulkarni AA, Abhyankar SV, Singh RR, Bhatia SH. A rare case of large verrucous hemangioma on the scalp. Med J DY Patil Univ 2012;5:60-1

How to cite this URL:
Kulkarni AA, Abhyankar SV, Singh RR, Bhatia SH. A rare case of large verrucous hemangioma on the scalp. Med J DY Patil Univ [serial online] 2012 [cited 2021 Dec 6];5:60-1. Available from: https://www.mjdrdypu.org/text.asp?2012/5/1/60/97516


  Introduction Top


Verrucous hemangiomas are usually congenital, localized vascular malformations which typically present as warty, bluish, vascular papules, plaques, or nodules, mainly on the lower limbs of children. [1],[2] They show no tendency to spontaneous resolution, and tend to spread and recur after inadequate treatment. Although invariably present at birth, they are usually on lower extremities and resemble a hemangioma. [3] Later it becomes verrucous and tends to enlarge and spread. It may appear even in adult life. Relapse is common after conventional treatment with cryotherapy or laser and electrocoagulation. This is due to its extension down to the subcutaneous tissue, which requires deep and wide excision or, in cases with larger lesions, excision followed by skin grafting. [2]


  Case Report Top


We would like to report a case of a large verrucous hemangioma of the scalp on the left temporal region in a 35-year-old male who presented with complains of a small swelling on the left temporal region since birth. The lesion was slowly increasing in size. There was no history of bleeding from the swelling. On examination, the swelling was large, about 8 cm × 8 cm in size, verrucous, well demarcated, dark pink-bluish in color, partially compressible, soft, no blanching, warm, and non-pulsatile [Figure 1]. The swelling was excised and the defect was grafted [4] [Figure 2]. In a 6-month follow-up, the patient had no recurrence.
Figure 1: Preoperative photograph

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Figure 2: Post operative photograph

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Histopathology showed an epidermis with hyperkeratosis, parakeratosis, and acanthosis. The underlying dermis was occupied by dilated blood vessels, with occasional blood lakes, some located between lengthened dermal papillae and extending to the reticular dermis, and subcutaneous tissue although in some parts of the specimen there was no continuity between the superficial and deep components. [5] There were no thrombi observed [Figure 3].
Figure 3: Microscopic view showing epithelium and dilated blood vessel

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  Discussion Top


Verrucous hemangioma is an uncommon condition which has been described in the literature under various names, including unilateral neviform hemangioma, unilateral verrucous hemangioma, unilateral vascular nevus, and angiokeratotic nevus. The hyperkeratotic aspect of the nevus is considered to be a reaction to injuries, such as trauma or infection. The presence of small satellite lesions is typical. The course of verrucous hemangiomas is generally characterized by peripheral slow spread, no tendency to spontaneous involution, development of satellite lesions, and recurrences after excision, especially when the lesions are larger than 2 cm in diameter. [1]

 
  References Top

1.Calduch L, Ortega C, Navarro V, Martínez E, Molina I, Jordá E. Verrucous hemangioma: Report of two cases and review of the literature. Pediatr Dermatol 2000;17:213-7.  Back to cited text no. 1
    
2.Clairwood MQ, Bruckner AL, Dadras SS. Verrucous hemangioma: A report of two cases and review of the literature. J Cutan Pathol 2011;38:740-6.  Back to cited text no. 2
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3.Jain VK, Aggarwal K, Jain S. Linear verrucous hemangioma on the leg. Indian J Dermatol Venereol Leprol 2008;74:656-8.  Back to cited text no. 3
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4.Bhat S, Pavithra S, Mallya H, Pai G. Verrucous Hemangioma: An optimized surgical approach. J Cutan Aesthet Surg 2010;3:170-3.  Back to cited text no. 4
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5.Yasar A, Ermertcan AT, Bilac C, Bilac DB, Temiz P, Ozturkcan S. Verrucous hemangioma. Indian J Dermatol Venereol Leprol 2009;75:528-30.  Back to cited text no. 5
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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