Treatment

Under local anesthesia, an excisional biopsy was performed and the lesion was conservatively but completely excised.

Excisional Biopsy

Histologic examination reveals a hemisected piece of soft tissue composed of surface epithelium with underlying fibrous connective tissue almost all occupied by blood vessels surrounded by multiple layers of smooth muscle cells (Figure 2-4). The surface shows evidence of healing ulceration. The vascular spaces have lumens containing erythrocytes and lined by one layer of flat endothelial cells. The vascular spaces are of variable shapes. The granulation tissue below the healing ulcer containing small clusters of hemosiderin pigment and is infiltrated by lymphocytes.

Figure 2 Low power (x40) the H & E histology reveals a neoplasm made up of blood vessels surrounded by layers of spindle-shaped cells. The surface epithelium shows evidence of healing ulceration.

Figure 3 Low power (x100) the H & E histology with a closer look at the neoplasm with blood vessels surrounded by layers of spindle-shaped cells.

Figure 4 High power (x200) the H & E histology with a closer look at the blood vessels surrounded by layers of spindle-shaped cells.