Congenital Multiple Glomangiomas of the Breast Arranged in a Segmental Pattern

Abstract

An otherwise healthy 15-year-old female patient presented with multiple bluish skin papules and nodules located at right breast that had been present since birth. The lesions were slightly tender to palpation and had enlarged with body growth, especially after menarche. Her father presented several lesions with a similar appearance on the upper limbs and trunk. On physical examination, multiple soft, well-defined dark-blue and purple-red papules and nodules were observed, arranged in a segmental or band-like pattern, in the girl’s right breast and ipsilateral axilla (Figure 1a). Dermoscopy of lesions revealed reddish purple structureless areas, without specific features of any skin neoplasm (Figure 1b). A biopsy of a breast nodule was performed. The histological examination revealed a non encapsulated vascular tumor involving the mid and lower dermis. It was composed of multiple dilated, cavernous-like capillaries containing erythrocytes surrounded by endothelial cells, and one to several layers of uniform cuboidal cells with pale or faintly eosinophilic cytoplasm (glomus cells) (Figure 1c). These features were consistent with the diagnosis of glomangioma. Complete blood and platelet counts, coagulation tests and fecal occult blood test were within normal range. Informed about the nature of the lesions and treatment options the patient chose therapeutic abstention.