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Review Question - QID 305

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QID 305 (Type "305" in App Search)
A 17-year-old male presents to your office with hand swelling and intermittent pain. His pain occurs when his hand is held in a dependent position or when he is swimming. While he was born with a birthmark on his hand, he has noticed it is progressively getting bigger. Clinical photograph, radiographs, and histology are shown. What is the most likely diagnosis?
  • A
  • B
  • C
  • D

Synovial sarcoma

1%

25/3478

Epitheliod sarcoma

5%

177/3478

Angiosarcoma

19%

672/3478

Benign hemangioma

74%

2563/3478

Giant cell tumor of tendon sheath

1%

30/3478

  • A
  • B
  • C
  • D

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The clinical history, photograph, radiographs, and histology are all consistent with a benign hemangioma. Hemangiomas are very common benign tumors which can become painful when engorged with blood secondary to dependent positions or physical activity. The clinical photograph shows the associated skin changes which occur when hemangiomas are located in subcutaneous locations. The radiographs show classic phleboliths (calcifications within blood vessels) on the ulnar side of the radiograph. The histology photograph shows no cellular atypia or malignant features. Rather, multiple large endothelial-lined vascular dilations are seen each filled with erythrocytes.

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