reticular infantile hemangioma
The reticular variant of infantile hemangioma occurs in the extremity, and are associated with intractable ulceration, anogenito-urinary-sacral anomalies, and sometimes cardiac overload. (#17845155#)
SYnopsis
stained, enlarged, pulsatile lower extremity
cardiac failure
soft tissue necrosis
bony destruction
infiltrative (not lobular) pattern
involvment of fascia, muscle, and bone
lower limb, buttock, and perineum
Associations (#17845155#)
- hepatic hemangiomas
ambiguous genitalia
ventral-caudal anomaly
- omphalocele
- recto-vaginal fistula
- solitary/duplex kidney
- imperforate anus
- tethered cord
Differential diagnosis
capillary malformation
cutis marmorata telangiectasia congenita
diffuse arteriovenous malformation (Parkes Weber syndrome)
capillary-lymphatico-venous malformation (Klippel-Trenaunay syndrome).
NB: The macular network-like appearance of the tumor and coexisting ventral-caudal structural anomalies is analogous to the association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities association in the craniofacial region.
References
Mulliken JB, Marler JJ, Burrows PE, Kozakewich HP. Reticular infantile hemangioma of the limb can be associated with ventral-caudal anomalies, refractory ulceration, and cardiac overload. Pediatr Dermatol. 2007 Jul-Aug;24(4):356-62. PMID: #17845155#