Intravascular papillary endothelial hyperplasia (Masson's hemangioma) of the face

Abstract

Intravascular papillary endothelial hyperplasia or Masson's hemangioma is a rare vascular tumor. The reactive proliferation of endothelial cells in this disease mimics other benign or malignant vascular proliferation such as angiosarcoma or Kaposi's sarcoma. It is important to make an accurate distinction to avoid confusion with these malignant tumors. This would facilitate a proper diagnosis, which is essential so that the patient is not subjected to unnecessarily aggressive or inappropriate treatment.

Keywords: Benign tumor; Intravascular papillary endothelial hyperplasia; Masson’s hemangioma.

Fig. 1.

Preoperative image of the lesion on the left nasolabial fold. It presented as a telangiectatic, soft and painless swelling.

Fig. 2.

Gross finding of a resected tissue. It was well-demarcated and moderately firm mass.

Fig. 3.

The nodule showed a thick-walled blood vessel filled with papillary structures and blood. Dilated vessel with multiple papillary structures projecting into the lumen was seen (H&E, ×100).

Fig. 4.

The papillary structures were lined by a single layer of flattened endothelial cells and supported with fibrous stroma. Endothelial proliferation with papillary projection and capillaries with blood cells inside were also seen (H&E, ×200).

Fig. 5.

The endothelial cells were positive for CD34 (arrows). Immunohistochemically, brown cytoplasmic staining of the endothelial cells of CD34 is considered a positive reaction (×200).