questions 3

Vascular Tumors

Topic updated on 09/01/17 3:19pm

  • Strawberry hemangioma 
    • benign capillary hemangioma of infancy
      • will first grow and then will spontaneously regress by age 8
  • Cherry hemangioma  
    • benign capillary hemangioma 
    • ↑ in frequency with age  
      • permanent
  • Cavernous hemangioma
    • benign tumor of liver and spleen
      • risk of rupture with ↑ size
    • can also be found in the brain and retina with Von-Hippel-Lindau syndrome
  • Pyogenic granuloma  
    • pedunculated capillary hemangioma
      • easily ulcerates and bleeds
    • associated with trauma and pregnancy
      • regress post-partum with ↓ estrogen
  • Angiosarcoma
    • liver malignancy with poor prognosis
    • associated with vinyl chloride, arsenic, and ThO2 (Thorotrast) exposure
      • remember: exposure to a VAT of chemicals
  • Lymphangiosarcoma
    • lymphatic malignancy
    • associated with long-standing lymphedema
      • e.g., post-radical mastectomy 
  • Kaposi's sarcoma  
    • endothelial (as well as primitive mesenchymal) malignancy of the skin
    • associated with HHV-8 and HIV
    • progression
      • flat red/purple lesion → raised lesion → ulcerating nodule
Other Vascular Tumors
  • Cystic hygroma  
    • lymphangioma of the neck
      • responsible for the "webbed-neck" in Turner's syndrome
  • Glomus tumor  
    • benign, painful, red-blue tumor formed from arteriovenous shunts
      • found under the fingernails
    • derived from smooth muscle cells of glomus body
      • involved in temperature regulation which can shunt blood towards or away from the superficial skin
  • Bacillary angiomatosis 
    • benign capillary skin papules resulting from a cutaneous Bartonella henselae infection
      • gram negative bacteria also responsible for Cat-scratch disease
    • seen in AIDS patients
      • frequently mistaken for Kaposi's sarcoma


Qbank (3 Questions)

(M1.CV.52) A 45-year-old woman presents to your clinic concerned about changes in her skin over the past few years as shown in Figure A. The lesions do not hurt or bleed and she is not bothered by their appearance but she is somewhat concerned that the lesions may be a sign of a more serious underlying medical condition. She is interested in reviewing a treatment plan that will prevent the lesions from causing adverse long-term effects. What treatment is required for this patient's skin lesions? Topic Review Topic
FIGURES: A          

1. Immediate removal
2. Biopsy
3. Topical corticosteroids
4. Regular follow-up to monitor regression of lesions
5. No treatment required

(M1.CV.67) A 51-year-old woman presents to the dermatologist with concern for a new skin lesion (Image A). You note two similar lesions on her back. Which of the following is a true statement about these lesions? Topic Review Topic
FIGURES: A          

1. They will likely grow rapidly.
2. They will likely regress spontaneously.
3. They may be associated with von Hippel-Lindau disease.
4. They will likely increase in number over time.
5. They must be followed closely for concern of malignancy.

(M1.CV.91) A 68-year-old female presents after noting the onset 3 months ago of an area of erythema on the anterior aspect of her left upper arm. Over the next several months, this lesion progressed to include numerous purple papules with areas of apparent necrosis as well as an enlarging underlying mass. Figure A depicts the patient's arm at her current presentation. She reports that her left arm has felt "heavy" and appeared swollen in the past. Which of the following elements of this patient's history would have most likely contributed to the development of her current condition? Topic Review Topic
FIGURES: A          

1. Multiple recurrent staphylococcal skin abscesses treated with IV antibiotics and serial I&Ds
2. Progressively debilitating polyarticular osteoarthritis
3. Modified radical mastectomy with subsequent radiation therapy 12 years ago
4. Remote anterior shoulder subluxation after an accidental injury 30 years ago
5. Former 1 pack-per-day smoker, who quit 10 years ago


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