Final Diagnosis -- Diffuse Angiomatosis

FINAL DIAGNOSIS:

DIFFUSE ANGIOMATOSIS (ANGIOMATOSIS OF SOFT TISSUE, DIFFUSE HEMANGIOMA)

DISCUSSION:

Diffuse angiomatosis is defined by Weiss as a "benign vascular lesion which extensively involves a region of the body or several different tissue types in a contiguous fashion." Thus defined, the majority of these cases have the distinctive histology seen in the present case. It is comprised of large venous channels dispersed among abundant fat, which is also considered to be a part of the lesion. Most characteristic is the presence of smaller channels within the walls of these vessels. These lesions tend to present in children or adolescents, though 8/51 cases in Rao and Weiss' series presented after the age of 30. This site is consistent with the diagnosis, with 10/51 cases presenting in the chest wall or abdomen. None of the reported cases have been shown to evolve or progress histologically. However, greater than 90% of cases with reasonably long follow-up recurred. Given the lack of histologic progression, the goal of surgical management should be to conservatively balance morbidity of agressive resection with the possibility of complete resection from the outset.

REFERENCES:

1. VK Rao and SW Weiss, Angiomatosis of Soft Tissue, An Analysis of the Histologic features and Clinical Outcome in 51 Cases, AJSP 16(8):764-771, 1992.

Contributed by Richard Whisnant, MD