Sclerosing hemangioma of the lung: an analysis of 44 cases

Abstract

Background: Sclerosing hemangioma is a rare benign lung tumor. Preoperative diagnosis of this tumor is difficult, and sometimes even intraoperative frozen sections cannot differentiate it from malignant tumors. Herein, we present our experiences in investigating its characteristics.

Methods: The medical records and pathological examinations of patients diagnosed with sclerosing hemangioma from 1982 to 2001 at the Division of Thoracic Surgery in Taipei-VGH were retrospectively reviewed.

Results: The incidence of sclerosing hemangioma in benign lung tumors resected during that period was 32.8%. There were 44 patients (7 male and 37 female) aged from 16 to 72 years, with a peak at fifth decade, and 72.7% of them were asymptomatic. Accurate preoperative diagnosis by chest CT could be achieved in only 20% (4/20) of patients, and malignancy could not be ruled out in 40% (8/20) of tumors. Histologically, this tumor exhibits four major patterns: solid, sclerotic, papillary and hemorrhagic. Five patients in this series had predominantly one pattern. At least two patterns existed in the remaining 39 patients, including eight patients who had tumors with all four patterns. There was no operative mortality or tumor recurrence despite that different operative methods were undertaken.

Conclusions: Although rare, sclerosing hemangioma still accounts for the second common benign lung tumor in the current series. Chest CT and bronchoscopic examinations could not make accurate diagnosis preoperatively, and thoracotomy is usually indicated for definite diagnosis and treatment. Limited resection is warranted in view of uncommon tumor recurrence. In addition, multiple nodular lesions could not exclude the possibility of sclerosing hemangioma.