Venous Haemangioma on Neck

Abstract

Hemangiomas are benign vascular tumors. They are categorized histologically as capillary, cavernous, and venous. Both cavernous and venous hemangiomas contain large dilated vessels. However, the vascular channels in venous hemangiomas are characterized by thick fibrous walls containing smooth muscle. On the other hand, cavernous hemangiomas consist of thin-walled vascular spaces lined by flattened endothelial cells. The extremities, head, and neck are the most usual localisations. Various treatments have been discussed in literature such as surgery, medical therapy, sclerotherapy, and cryoablation in case of pain, organ dysfunction or cosmetic reason. The case is here reported of a patient with a venous hemangioma on the neck and the treatment applied. CASE REPORTA 28-year-old female patient was admitted to the hospital due to a smooth mass on the right side of the neck. The mass had been present since childhood and started to become more obvious at the age of 13 years. Throughout the adolescent growing period, the mass continued to enlarge. During pregnancy the growth of the smooth mass accelerated reaching dimensions of 8×5 cm. The mass did not decrease in size after giving birth. The patient presented with aesthetic complaints and pain when bowing her head (Figure 1A,1B).Physical examination showed the mass to be smooth and non-pulsatile. Doppler ultrasound showed that mass was a lobulated vascular malformation. Computed tomography revealed that it contained a lobulated venous mass. There was no sign of arterio-venous fistula (Figure 1C). Informed consent was taken from the patient. Surgery was planned for both the cosmetic and pain symptoms. The patient was evaluated for cardiac pathology with echocardiography, and cranial computed tomography revealed no cerebral vascular pathology.Under general anaesthesia, a skin incision was made anterior of the m. sternocleidomastoideus. The skin and m. platisma were very thin. After wide tissue dissection, 5 thick veins related to the v. jugularis