Treatment

Under IV sedation, the area was biopsied.  The lesion was described as solid and hemorrhagic.  The specimen was submitted for histologic evaluation. 

Incisional and excisional biopsy

Histological examination revealed multiple large pieces of vascular granulation tissue with many giant cells (Figures 2 & 3).  The latter were of variable shapes and sizes; some were closely associated with small blood vessels while most were haphazardly arranged.  Small clusters of extravasated erythrocytes and hemosiderin pigment were identified (Figure 3). 

 

Figure 2 Low power (x100) histology shows a mass of vascular granulation tissue with many multinucleated giant cells of variable shapes and sizes, clusters of hemosiderin pigment and some extravasated erythrocytes.

Figure 3 Higher power (x200) demonstrating many giant cells, granulation tissue background, hemosiderin pigment and extravasated erythrocyte.