Enlarging Congenital Soft-Tissue Mass: Venous Malformation Mimicking Hemangioma Vs Sarcoma.

Background: [L1] Venous Malformations are not uncommon, usually solitary and are often symptomatic.Differential diagnosis includes: infantile hemangioma, other vascular/lymphatic malformation, other vascular tumor, and as this case illustrates, fibrosarcoma or rhabdomyosarcoma. The characteristic physical finding of this vascular birthmark is a soft, blue-purple and easily compressible soft-tissue mass,. Materials and Methods: The presentation described in this case was worrisome because of rapid growth and the possibility of a vascular tumor. After multidisciplinary evaluation and review of the literature, the decision was made to proceed with surgical debulking and obtain a tissue diagnosis.Results: After a combined and coordinated evaluation by plastic surgery and dermatology, as well as ultrasound/MRI evaluation, the patient underwent surgical debulking. [L2] Conclusion: In this case, clinical history was alarming and the physical exam was not diagnostic. Thus imaging studies were employed which aided, but did not make the diagnosis. Due to the sensitive location of this patient’s lesion, as well as the unusual behavior and concerning clinical characteristics, surgical intervention was determined to be the appropriate course of treatment. [L1]This is used incorrectly. Cavernous hemangioma is an old term and is confusing, usually it refers to a deep hemangioma of infancy, not a venous malformation. [L2]I would take this out at this point b/c it confuses the picture.