Anastomosing Hemangioma of the Larynx: A Unicorn among Head and Neck Tumors

Abstract

Objective: Anastomosing hemangioma (AH) is a novel tumor of vascular origin. Though well-documented in the kidney and retroperitoneum, only a single case has been documented in the head and neck, and AH in larynx has not been described. Methods: A 37-year-old male presented with difficulty in breathing, and hoarseness. Imaging revealed a lesion involving left paraglottic and cricothyroid spaces with destruction of cricoid cartilage, suggestive of a malignant cartilageneous neoplasm. Multiple biopsies were non-diagnostic. Results: Intraoperative frozen section during transcervical resection showed a vascular tumor devoid of nuclear atypia. Histopathological examination revealed a vasoformative tumor comprised of anastomosing capillary-sized vessels lined by flat and hobnail endothelial cells, consistent with AH. The patient was disease-free at 12 months. Conclusion: AH are rare neoplasms that may mimic a malignancy on imaging, especially in sites where they have not been documented. Due to their vascular nature, biopsies are often non-diagnostic, making preoperative diagnosis difficult. Frozen section may assist in decision-making on the extent of resection required.

Spermatic cord anastomosing hemangioma mimicking a malignant inguinal tumor: A case report and literature review

“…Extramedullary hematopoiesis and intraluminal thrombi are occasionally observed (10,32,45). Some uncommon features, such as focally infiltrative patterns (6,46) and hyaline globules (18,28), might raise concerns about some aggressive malignant tumors, such as angiosarcoma and Kaposi sarcoma. Differential diagnosis of well-differentiated low-grade angiosarcoma required the most careful recognition (39).…”

Multimodal imaging features of retroperitoneal anastomosing hemangioma: a case report and literature review

“…AH primarily appears in the urogenital tract, particularly in the kidney (2), and exhibits histopathological similarities to highly differentiated angiosarcoma. AH has been observed in various organs, including the renal and adrenal glands, liver, spleen, ovary, testicle, bladder, breast, gastrointestinal tract, retroperitoneum, mesentery/peritoneum, nasal cavity, larynx, left atrium, soft tissue, and bone (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The 2020 WHO classification of Soft Tissue Tumors recognizes AH as a distinct benign vascular neoplasm (15).…”