A cavernous hemangioma located in the axillary area: Challenges in preoperative diagnosis and operation

Axillary cavernous hemangiomas are extremely rare benign neoplasms, with only two cases reported in the English literature to date. In the first case, in 1982, a 22-year-old Caucasian woman presented with a large tender mass in the left axilla [1]. Although its exact size was not mentioned, the mass filled the axilla and the lateral thoracic surface of the long thoracic nerve, invading the hemisphere of the left breast. Owing to massive bleeding, surgery was unsuccessful, and the remnant hemangioma was treated by using a carbon dioxide laser. In the second case, in 2008, a 43-year old Brazilian woman presented with an axillary mass and adjacent lymphadenomegaly, raising suspicion of a malignant breast neoplasm [2]. Core needle biopsy was contraindicated owing to the high vascularity of the mass and its proximity to the thoracic wall and axillary vessels. Excisional biopsy, however, was successful since the hemangioma was relatively small (3 cm). A salient point of the 2008 report was that axillary cavernous hemangiomas can mimic malignant cancers. Herein, we describe a surgically treated axillary cavernous hemangioma in a Korean woman and review the pertinent literature. The Institutional Review Board of the Korea Cancer Center Hospital approved the protocol version 1.0 (KIRAMS 2018-03-011).