Soft tissue hemangioma

Posted By Wael Nemattalla
Soft tissue hemangioma

39 years old male with right upper leg swelling.

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  • Wael Nemattalla 2014-01-04 17:06:20

    Soft tissue haemangioma

    Soft tissue haemangiomas are location-dependent haemangiomas (a benign vascular soft tissue tumour). They are the most common angiomatous lesion and represent up to 7% of all benign soft-tissue tumours 2.


    There may be an greater female predilection.In the paediatric population, heamangiomas tends to be the most frequently diagnosed soft-tissue neoplasm.


    Sub types

    Soft tissue haemangiomas may be classified in to five histological sub types.

    This classification is dependent on the predominant type of vascular channel identified within them. They include

    • capillary : commonest type and tend to predominate in the paediatric population.

    • cavernous

    • arteriovenous

    • venous

    • mixed


    They can arise in various anatomic locations, including striated muscle, skin, subcutaneous tissue, and synovial tissue (synovial haemangioma).

    Radiographic features

    Plain film

    Small lesions may be occult of plain film which large lesions may show evidence of a focal soft tissue swelling + / - associated phleboliths.


    On unenhanced CT, it may appear as an ill-defined mass of similar attenuation to muscle may be identified. CT may also identify the presence of associated phleboliths.


    Haemangiomas are typically well defined, lobulated and heterogeneous with no features of local invasion.

    While many sequences show a rather heterogeneous signal mass certain signal characterisitcs tend to dominate.

    • T1 -

    o overall signal is often intermediate to slightly high signal (relative to skeletal muscle) 6

    o some focal high signal areas may be present in a large proportion of lesions (up to 70 % 5,9).

    • T2 - high signal intensity tends to dominate on T2-weighted images

    • gradient echo - the presence of pheboliths may show blooming artefact 10

    • T1 C+ (Gd) - lesions show marked signal enhancement in parts of the areas, which were both of high and low T2 8.

    Some intramuscular haemangiomas may also associated atrophic changes in muscles