Tufted angioma in ear auricle: importance of the differential diagnosis

Abstract

Tufted angioma is an acquired vascular proliferation with specific histological characteristics. The most common clinical features are erythematous macules. It occurs predominantly in children and young adults, especially in the chest and neck. We report the case of a male patient, 12 years old, with an increased right ear auricle associated with erythematous macules and increased local temperature, referred with a diagnosis of lepromatous leprosy; however, this diagnosis was questioned. Histopathology was consistent with tufted angioma.

Ultrasonography and magnetic resonance imaging features of kaposiform hemangioendothelioma and tufted angioma

“…10 Most TA persists and worsens slightly over time, 11 although some also spontaneously regress. 12,13 KHE is invasive, with a mortality rate as high as 30%. 14 Therefore, increased knowledge of imaging findings associated with KHE and TA may be helpful in determining appropriate diagnoses because TA and KHE without KMP can be easily mistaken for other hemangiomas.…”

“…Clinically, there is considerable clinical and histopathological overlap between TA and the more aggressive KHE . Most TA persists and worsens slightly over time, although some also spontaneously regress . KHE is invasive, with a mortality rate as high as 30% .…”

Tufted angioma

“…In 1976, Wilson Jones used for the first time the term tufted angioma to name an acquired vascular proliferation. 2 , 3 TA can be congenital or acquired but, in approximately 50% of reports, the lesion appears within the first year of life. 1 Its pathogenesis has not been established; however, the increase in endothelial and vascular growth factors is involved in its angiogenesis, allowing for the development of capillary lobes.…”

“… 1 Lesions are usually asymptomatic, but can be very painful and present with hypertrichosis and hyperhidrosis. 2 It must be differentiated from other conditions, such as congenital hemangioma, infantile hemangioma, vascular malformations, pyogenic granuloma and, in adults, kaposiform hemangioendothelioma and Kaposi sarcoma. To differentiate between other tumors or to assess the area involved, imaging as ultrasound or magnetic resonance can be used.. 3 Histopathology of TA shows many lobules of tufts spread across the dermis with a "cannonball" appearance, crescent-shaped spaces around the vascular tufts and similar spaces in the tumor stroma.…”

“…To differentiate between other tumors or to assess the area involved, imaging as ultrasound or magnetic resonance can be used.. 3 Histopathology of TA shows many lobules of tufts spread across the dermis with a "cannonball" appearance, crescent-shaped spaces around the vascular tufts and similar spaces in the tumor stroma. 2 , 4 , 5 Immunohistochemistry can be strongly positive for Ulex uropaeus I lectin and EN4, besides CD31 and CD34, and rarely positive for smooth muscle actin and negative staining for GLUT1. 3 , 4 The main treatment option for tufted angioma is surgical excision.…”