What are the other Names for this Condition? (Also known as/Synonyms)

• Sinusoidal Haemangioma

What is Sinusoidal Hemangioma? (Definition/Background Information)

• Hemangiomas are benign malformation of blood vessels that can occur in a number of tissues such as the brain, kidney, liver, lung, skin, and nasal cavity
• Sinusoidal Hemangiomas are benign lesions composed of small blood vessels that occur on the skin or deep inside the skin tissues, mostly in the trunk and upper limbs, usually in women
• The term ‘sinusoidal’ denotes a growth pattern of the hemangioma, which is observed during an examination of the tumor specimen under the microscope by a pathologist
• It is described as an uncommon variant of cavernous hemangioma. The cause of development of Sinusoidal Hemangioma is not well-established and no risk factors for its formation have been identified
• While Sinusoidal Hemangiomas are generally asymptomatic, they may be treated for cosmetic purposes, or in case of chronic bleeding. They are not known to cause any significant complications
• The treatment options include a surgical removal of the hemangioma. The prognosis of Sinusoidal Hemangioma is generally excellent

Who gets Sinusoidal Hemangioma? (Age and Sex Distribution)

• Sinusoidal Hemangiomas are common in young, middle-aged and older adults, though they may be found in children too
• A female predominance is observed, even though both males and females are affected
• It can affect individuals of all races and ethnic backgrounds across the world

What are the Risk Factors for Sinusoidal Hemangioma? (Predisposing Factors)

Specific risk factors for Sinusoidal Hemangioma have not been currently established. However, the following factors may contribute towards cavernous hemangioma development:

• Individuals with a positive family history of cavernous hemangioma
• Cavernous hemangiomas are known to be associated with rare bleeding conditions, namely Kasabach-Merritt syndrome and blue rubber bleb nevus syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Sinusoidal Hemangioma? (Etiology)

• The exact cause of development of Sinusoidal Hemangioma is unknown
• Cavernous hemangiomas may be caused by genetic mutations that are yet to be well-characterized

What are the Signs and Symptoms of Sinusoidal Hemangioma?

Sinusoidal Hemangiomas are generally asymptomatic and do not present any signs and symptoms.

• They may be present superficially (on the skin surface), subcutaneously (below the skin), or in deep skin tissues. A majority of them are found deep inside the skin
• Lesions under the skin may move freely when touched/pushed
• Most of the vascular tumors are observed on the arms or trunk (back and chest). However, these hemangiomas may be present anywhere on the body
• They can range in size from small to big; smaller hemangiomas are generally well-circumscribed, while larger ones may be poorly-circumscribed
• On the skin, they may appear as small, cherry-red papules or nodules
• Deep-seated tumors may present no skin color changes; occasionally, the skin may appear bluish
• Sometimes, these benign tumors may rupture and bleed, if they are injured

How is Sinusoidal Hemangioma Diagnosed?

A diagnosis for Sinusoidal Hemangioma includes evaluating the clinical history (physical exam) and a thorough family history. Other tools to help diagnose the condition may include:

• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• CT and MRI scan of the affected region: Deep-seated tumors may be incidentally discovered during imaging for other reasons
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: The diagnosis of Sinusoidal Hemangioma can be diagnostically challenging. In some cases, blood clot formation and calcification may be observed. If the tumor is partially biopsied, it may be confused with an angiosarcoma, which is a malignant tumor. Hence, a careful examination of the tumor is necessary to ensure an accurate diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Sinusoidal Hemangioma?

The complications of Sinusoidal Hemangiomas may include:

• Skin lesions may present cosmetic concerns in some cases
• Bleeding following an injury or trauma
• Damage to vital nerves, blood vessels, and surrounding structures during surgery to remove the tumor

How is Sinusoidal Hemangioma Treated?

Some Sinusoidal Hemangiomas may be asymptomatic and may not require any treatment.

• In case of frequent bleeding or cosmetic issues related to physical appearance, individuals may choose to remove them. In such cases, a complete surgical excision and removal of the tumor is the preferred treatment option
• Arterial embolization of the tumor may be used to provide temporary relief from the symptoms, and reduce blood loss during ‘tumor removal’ surgical procedure
• Post-operative follow-up care with regular screening and check-ups are important, especially to monitor for any recurrences

Other procedures for removing a cavernous hemangioma may include:

• Burning (electrosurgery/cautery)
• Freezing (cryotherapy)
• Laser excision

How can Sinusoidal Hemangioma be Prevented?

Currently, there are no specific methods or preventative techniques for the formation of Sinusoidal Hemangiomas.

What is the Prognosis of Sinusoidal Hemangioma? (Outcomes/Resolutions)

• Sinusoidal Hemangiomas are generally noncancerous and may be asymptomatic in many cases
• Tumors that are located in the superficial regions (such as the skin) have excellent prognosis with complete removal of the hemangioma

Additional and Relevant Useful Information for Sinusoidal Hemangioma:

• Cavernous hemangiomas are benign growths composed of small blood vessels that occur on skin tissues, anywhere in the body, usually in children. These benign tumors can sometimes rupture and bleed if injured

The following link may help you find useful additional information on cavernous hemangioma:

http://www.dovemed.com/diseases-conditions/cavernous-hemangioma/