Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor): Diagnosis the Plastic Surgeon Should Be Aware of

Abstract

Intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is a rare benign entity commonly found on the head, neck, and upper extremities. It usually arises within a blood vessel but is considered to be a nonneoplastic reactive process often associated with vascular injury. Typically, IPEHs cause no symptoms and present as slowly growing soft-tissue masses. Given their prevalent location and indolent clinical presentation, the plastic surgeon should be familiar with this rare entity. We are presenting a case of IPEH of the forehead with unusual clinical and pathologic characteristics. Differential diagnosis, special considerations regarding preoperative work-up, and treatment options are discussed.

Fig. 1.

Preoperative image of the lesion measuring 2.5 × 2 × 1.75 cm on the left lateral forehead.

Fig. 2.

Another view of the lesion preoperatively.

Fig. 3.

Intraoperative picture of the lesion consistent with Masson’s tumor.

Fig. 4.

Histological features of IPEH showing endothelial cell proliferation, fibrinous deposits, and dilated vascular spaces (H&E, low and magnified high power).

Fig. 5.

Postoperative image at 4-week follow-up with excellent aesthetic outcome.