Cavernous hemangioma resembling lymphangioma circumscriptum: The central role of dermoscope in diagnosis

Vascular tumors and malformations are often called “angiomas.” Cavernous hemangiomas are more commonly found in adolescents, often on the face and rarely on the extremities. Surgery may be pursued for cosmesis in cases of cutaneous lesions that do not involute. A 12-year-old girl presented with a lump on her right knee 4 years ago. Initially, the lump was flat and appeared like a bluish bruise but then slowly enlarged. There were no complaints of itching, pain, and other discomfort. Physical examination showed a 3.2 cm × 2.1 cm mobile violaceous tumor composed of dark red or blue-black vesicles in the right knee, clinically resembling lymphangioma circumscriptum. Dermoscopic examination showed a pattern composed of central dark, red-blue lacunae, white structures, and a peripheral brownish homogeneous area, which was consistent for cavernous hemangioma. The patient underwent biopsy excision and the diagnosis was confirmed through histopathological examination.