Biopsy is not necessary for the diagnosis of soft tissue hemangiomas

Objective To describe the clinical and ultrasonography (US) findings of soft tissue hemangiomas, and to compare with the results of histologic diagnosis after US-guided biopsy.

and materials We retrospectively studied the files of 97 patients (48 female, 49 male; mean age, 34 years; range 4–84 years) with soft tissue hemangiomas diagnosed from 2004 to 2011. Mean follow-up was 9 years (range 7–13 years). Clinical presentation included intermittent mild pain associated with a soft tissue swelling/palpable mass in all patients, chronic pain and increased local heat in 29 patients, local swelling and decreased range of motion of the adjacent joint in 45 patients, and all the above symptoms in 23 patients. B-mode and color Doppler US evaluation included the site, location, size, shape, margins, presence of calcifications, echo structure and echogenicity. All patients had US-guided biopsy for histologic analysis.

US-guided biopsy and histology confirmed the diagnosis of soft tissue hemangioma in 92 of the 97 lesions (94.8%). Histologic examination of the remaining five lesions showed nodular fasciitis (two lesions), endometriosis (one lesion), hemangioendothelioma (two lesions); US of these lesions showed variable size, irregular margins, and deep-seated location. Histologically documented soft tissue hemangiomas were most commonly superficial (74 lesions) and arteriovenous (45 lesions). Shape was most commonly oval (fusiform), margins were most commonly not well defined (irregular, hazing but circumscribed), phleboliths were more common in deep-seated lesions, echo structure was heterogeneous, and echogenicity was most commonly hyperechogen and involuting.

Clinical presentation and typical B-mode and color Doppler US findings are adequate for the diagnosis of soft tissue hemangiomas without the need for biopsy and histologic analysis. If any clinical or US doubt, an US-guided biopsy should be performed. Similar content being viewed by others

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Author Costantino Errani declares that he has no conflict of interest. Author Teresa Calabrò declares that she has no conflict of interest. Author Alberto Bazzocchi declares that he has no conflict of interest. Author Giancarlo Facchini declares that he has no conflict of interest. Author Salvatore Donatiello declares that he has no conflict of interest. Author Paolo Spinnato declares that he has no conflict of interest. Author Daniel Vanel declares that he has no conflict of interest. Author Ugo Albisinni declares that he has no conflict of interest. Author Patrizia Pelotti declares that she has no conflict of interest. Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Research involving human participants and/or animals All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent Informed consent was obtained from all individual participants included in the study. Rights and permissions About this article Cite this article Rimondi, E., Mavrogenis, A.F., Errani, C. et al. Biopsy is not necessary for the diagnosis of soft tissue hemangiomas. Radiol med 123, 538–544 (2018). https://doi.org/10.1007/s11547-018-0862-y Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11547-018-0862-y