Spindle Cell Hemangioma-A Case Report and Literature Review

Background: Spindle cell hemangioma is a rare vascular lesion. The histopathologic findings of it resemble Kaposi's sarcoma and hemangioma features. The recurrent rate after excision is up to 50%. Thus, spindle cell hemangioma was recognized as a ”low-grade angiosarcoma” in the past. Aim and Objectives:We report a case which brings attention to surgeons of the need to recognize spindle cell hemangioma because of the previous misunderstanding. We described the histopathologic finding and compared it with Kaposi's sarcoma. We remind surgeons to avoid unnecessary treatments in the recurrent or multiple spindle cell hemangioma. Materials and Methods:A 48-year-old male noted multiple skin lesions over the right medial foot for several years. The largest lesion is a purplish nodule about 2 x 1.3 cm^2. A wide excision with 5 mm safe margin of this lesion was done in May 2010. The wound was closed directly. Results:The pathologic diagnosis is spindle cell hemangioma. The wound over the right foot healed well. There is no recurrence after the 11 months follow up.Conclusion:Clinically, spindle cell hemangioma is presented as multiple nodules involving the skin and subcutaneous tissue in the distal extremities. The main differential diagnosis of the spindle cell hemangioma is Kaposi's sarcoma. An adequate treatment is by using the wide local excision. Radiation therapy should be avoided due to the potentiality of malignant change. Accurate diagnosis is critical in deciding what the most appropriate therapy is for the patients.