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Soft-Tissue Cavernous Hemangioma¹

¹ From the Departments of Radiology (K.I.O., G.S.S.) and Pathology (A.M.), University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637. Received July 15, 2003; revision requested September 12 and received October 23; accepted October 28. Address correspondence to K.I.O. (e-mail: kolsen25@hotmail.com).

View larger version (155K): [in a new window]   Figure 1a.  (a) Nonenhanced axial CT scan of the right thigh shows an intramuscular soft-tissue mass circumscribed by fat attenuation. The central soft-tissue component is isoattenuating relative to muscle. A small focus of calcification (arrow) is noted close to the periphery of the mass. (b) Contrast material-enhanced axial CT scan shows marked enhancement of the lesion, which is composed of a cluster of tubular structures that represent discrete vessels. The fatty rim does not enhance (arrow). The calcified focus is unchanged.

View larger version (153K): [in a new window]   Figure 1b.  (a) Nonenhanced axial CT scan of the right thigh shows an intramuscular soft-tissue mass circumscribed by fat attenuation. The central soft-tissue component is isoattenuating relative to muscle. A small focus of calcification (arrow) is noted close to the periphery of the mass. (b) Contrast material-enhanced axial CT scan shows marked enhancement of the lesion, which is composed of a cluster of tubular structures that represent discrete vessels. The fatty rim does not enhance (arrow). The calcified focus is unchanged.

View larger version (154K): [in a new window]   Figure 2.  Gray-scale US image shows the mass (arrow), which is isoechoic and intramuscular. It is delineated by a hyperechoic margin, which appears to arise from the surrounding intermuscular fat planes.

View larger version (94K): [in a new window]   Figure 3a.  Axial (a), coronal (b), and sagittal (c) T1-weighted MR images show the fatty rim (arrow), which has high signal intensity. The mass is isointense with a diameter of 2 cm.

View larger version (169K): [in a new window]   Figure 3b.  Axial (a), coronal (b), and sagittal (c) T1-weighted MR images show the fatty rim (arrow), which has high signal intensity. The mass is isointense with a diameter of 2 cm.

View larger version (148K): [in a new window]   Figure 3c.  Axial (a), coronal (b), and sagittal (c) T1-weighted MR images show the fatty rim (arrow), which has high signal intensity. The mass is isointense with a diameter of 2 cm.

View larger version (92K): [in a new window]   Figure 4a.  Axial (a), coronal (b), and sagittal (c) fat-saturated T2-weighted MR images show that the mass is made up of enhancing tubular structures (arrow in b and c), which are compatible with vessels. The surrounding fat has been successfully saturated. A feeding serpentine vessel is seen on the axial image (arrow in a).

View larger version (151K): [in a new window]   Figure 4b.  Axial (a), coronal (b), and sagittal (c) fat-saturated T2-weighted MR images show that the mass is made up of enhancing tubular structures (arrow in b and c), which are compatible with vessels. The surrounding fat has been successfully saturated. A feeding serpentine vessel is seen on the axial image (arrow in a).

View larger version (136K): [in a new window]   Figure 4c.  Axial (a), coronal (b), and sagittal (c) fat-saturated T2-weighted MR images show that the mass is made up of enhancing tubular structures (arrow in b and c), which are compatible with vessels. The surrounding fat has been successfully saturated. A feeding serpentine vessel is seen on the axial image (arrow in a).

View larger version (135K): [in a new window]   Figure 5.  Sagittal fat-saturated T2-weighted MR image shows a relatively large vessel (arrow) connecting the angiomatous cluster and the femoral vein.

View larger version (174K): [in a new window]   Figure 6.  Photograph of the gross specimen shows the lesion, which is hemorrhagic and surrounded by adipose tissue.

View larger version (161K): [in a new window]   Figure 7.  Photomicrograph (original magnification, x100; hematoxylin-eosin stain) shows a calcified thrombus in the cavernous hemangioma.