Tumors and Tumorlike Lesions of Blood Vessels

  • F. Ramon


Tumors and tumorlike conditions of the vascular system are divided into three categories according to their degree of malignancy: benign vascular lesions, lesions of intermediate malignancy, and malignant vascular tumors. The vast majority of the lesions belong to the benign group. These are found predominantly in younger children and adolescents. They may involve either the skin and subcutis or the deep soft tissues. Classification of these lesions is still the source of much controversy and is based on clinical appearance, pathology, embryology, and endothelial cell growth characteristics [12, 41, 42]. There are two major classification schemes for vascular tumors. That of Enzinger et al [12] relies on pathologic criteria and includes clinical and radiologic features when appropriate. On the other hand, the classification of Mulliken and Glowacki [42] is based on endothelial growth characteristics and distinguishes hemangiomas from vascular malformations. The latter classification shows good correlation with the clinical picture and imaging findings.


High Signal Intensity Cavernous Hemangioma Glomus Tumor Capillary Hemangioma Deep Soft Tissue 
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  1. 1.
    Allen PW, Enzinger FM (1982) Hemangioma of skeletal muscle: an analysis of 89 cases. Cancer 31:8–26Google Scholar
  2. 2.
    Buetow PC, Kransdorf MJ, Moser RP, Jelinek JS, Berrey BH (1990) Radiologic appearance of intramuscular hemangioma with emphasis on MR imaging. AJR Am J Roentgenol 154:653–567CrossRefGoogle Scholar
  3. 3.
    Cohen EK, Kressel HY, Perosio T, Lawrence Burk D, Dalinka MK, Kanal E, Schiebler ML, Fallon MD (1988) MR imaging of soft tissue hemangiomas: correlation with pathologic findings. AJR Am J Roentgenol 154:1079–1081CrossRefGoogle Scholar
  4. 4.
    Cohen J, Weinreb J, Redman H (1986) Arteriovenous malformations of the extremities: MR imaging. Radiology 158:555–559Google Scholar
  5. 5.
    Coldwell DM, Baron RL, Charnsangavej C (1989) Angiosarcoma: diagnosis and clinical course. Acta Radiol 32:631–631Google Scholar
  6. 6.
    Collins PS, Han W, Williams LR, Rich N, Lee JF, Villavicencio JL (1992) Maffucci’s syndrome [hemangiomatosis osteolytica] : a report of four cases. J Vasc Surg 16: 544–551CrossRefGoogle Scholar
  7. 7.
    Derchi LE, Balconi G, De Flavii L, Oliva A, Rosso F (1989) Sonographic appearances of hemangiomas of skeletal muscle. J Ultrasound Med 8:263–267PubMedGoogle Scholar
  8. 8.
    De Schepper A, Ramon F, Degryse H (1992) Statistical analysis of MR parameters predicting malignancy in 155 soft tissue tumors. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 155:587–593CrossRefGoogle Scholar
  9. 9.
    Dubois J, Patriquin HB, Garel L, Powell J, Filiatrault D, David M, Grignon A (1998) Soft tissue hemangiomas in children and infants: diagnosis using doppler ultrasonography. AJR Am J Roentgenol 171:247–252PubMedCrossRefGoogle Scholar
  10. 10.
    Ehara S, Sone M, Tamakowa Y, Nishida J, Abe M, Hachiya J (1994) Fluid-fluid levels in cavernous hemangioma of soft tissue. Skeletal Radiol 26:107–109CrossRefGoogle Scholar
  11. 11.
    Enjolras O, Riche MC, Merland JJ, Escande JP (1990) Management of alarming hemangiomas in infancy: a review of 26 cases. Pediatrics 85: 551–558Google Scholar
  12. 12.
    Enzinger FM, Weiss SW (1995) Benign tumors and tumorlike lesions of blood vessels. In: Enzinger FM, Weiss SW (eds) Soft tissue tumors, 3rd edn. Mosby, St. Louis, pp 579–626Google Scholar
  13. 13.
    Enzinger FM, Weiss SW (1995) Hemangioendothelioma: vascular tumors of intermediate malignancy. In: Enzinger FM, Weiss SW (eds) Soft tissue tumors, 3rd edn. Mosby, St. Louis, pp 631–654Google Scholar
  14. 14.
    Enzinger FM, Weiss SW (1995) Malignant vascular tumors. In: Enzinger FM, Weiss SW (eds) Soft tissue tumors, 3rd edn. Mosby, St. Louis, pp 655–677Google Scholar
  15. 15.
    Enzinger FM, Weiss SW (1995) Perivascular tumors. In: Enzinger FM, Weiss SW (eds) Soft tissue tumors, 3rd edn. Mosby, St. Louis, pp 701–755Google Scholar
  16. 16.
    Flickinger FW, Corey-Wright J (1994) Angiosarcoma of the extremity: preoperative evaluation with CT, MR imaging, ultrasonography and angiography. South Med J 87: 926–931CrossRefGoogle Scholar
  17. 17.
    Fornage BD (1988) Glomus tumor in the fingers: diagnosis with US. Radiology 167:183–185PubMedGoogle Scholar
  18. 18.
    Grant EG, Growal S, Sarosi TE, Birts FT, Holm HH, Schellinger D (1982) Sonographic findings in four cases of hemangiopericytoma. Radiology 154:547–551Google Scholar
  19. 19.
    Greenspan A, MC Gahan JP, Vogelsang P, Szabo RM (1992) Imaging strategies in the evaluation of soft-tissue hemangiomas of the extremities: correlation of the findings of plain radiography, angiography, CT, MR imaging, and ultrasonography in 12 histologically proven cases. Skeletal Radiol 21:11–18PubMedCrossRefGoogle Scholar
  20. 20.
    Greenspan A, Azouz EM, Matheus J II, Decarie JC (1995) Synovial hemangioma: imaging features in eight histologically proven cases, review of the literature, and differential diagnosis. Skeletal Radiol 24:583–590PubMedGoogle Scholar
  21. 21.
    Hawnaur JM, Whitehouse RW, Jenkins JP, Isherwood I (1990) Musculoskeletal hemangiomas: comparison of MR imaging with CT. Skeletal Radiol 21:261–268Google Scholar
  22. 22.
    Hill JH, Mafee MF, Chow JM, Applebaum EL (1985) Dynamic computerized tomography in the assessment of hemangioma. Am J Otolaryngol 6:26–31CrossRefGoogle Scholar
  23. 23.
    Jabra AA, Taylor GA (1993) MR imaging evaluation of superficial soft tissue lesions in children. Pediatr Radiol 26:546–551Google Scholar
  24. 24.
    Kaplan PA, Williams SM (1987) Mucocutaneous and peripheral soft tissue hemangiomas: MR imaging. Radiology 163:163–166PubMedGoogle Scholar
  25. 25.
    Kasabach HH, Merritt KK (1954) Capillary hemangioma with extensive purpura: report of a case. Am J Dis Child 59:1063–1070Google Scholar
  26. 26.
    Kato N, Kato S, Ueno H (1990) Hemangiopericytoma: characteristic features observed by magnetic resonance imaging and angiography. J Dermatol 17:701–706PubMedGoogle Scholar
  27. 27.
    Kazeroni E, Hessler C (1991) CT appearance of angiosarcoma associated with chronic lymphedema. AJR Am J Roentgenol 156:554–555CrossRefGoogle Scholar
  28. 28.
    Kneeland JB, Middleton WD, Matlaub HS (1987) High resolution MR imaging of glomus tumor. J Comput Assist Tomogr 11:551–552Google Scholar
  29. 29.
    Kransdorf MJ, Jelinek JS, Moser RP (1993) Imaging of soft tissue tumors. Radiol Clin North Am 31:552–559Google Scholar
  30. 30.
    Lai FM, Allen PW, Yuen PM, Leung PC (1991) Locally metastasizing vascular tumor: spindle cell, epithelioid, or unclassified hemangioendothelioma. Am J Clin Pathol 96:660–663PubMedGoogle Scholar
  31. 31.
    Larsen EC, Zinkham WH, Eggleston JC, Zitelli BJ (1987) Kasabach-Merritt syndrome: therapeutic considerations. Pediatrics 79:971–980PubMedGoogle Scholar
  32. 32.
    Llauger J, Monill JM, Palmer J, Clotet M (1995) Synoval hemangioma of the knee: MR imaging findings in two cases. Skeletal Radiol 24: 579–581PubMedCrossRefGoogle Scholar
  33. 33.
    Levin D, Gordon D, McSweeney J (1976) Arteriography of peripheral hemangiomas. Radiology 121:626–632Google Scholar
  34. 34.
    Lorigan JG, David CL, Evans HL, Wallace S (1989) The clinical and radiologic manifestations of hemangiopericytoma. AJR Am J Roentgenol 155:545–549Google Scholar
  35. 35.
    McCarville MB, Kaste SC, Pappo AS (1999) Soft tissue malignancies in infancy. AJR Am J Roentgenol 173:973–977PubMedCrossRefGoogle Scholar
  36. 36.
    Meis-Kindblom JM, Kindblom LG (1998) Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol 22:683–697PubMedCrossRefGoogle Scholar
  37. 37.
    Meyer JS, Hoffer FA, Barnes PD, Mulliken JB (1991) Biological classification of Soft-Tissue vascular anomalies: MR correlation. AJR Am J Roentgenol 157:559–564PubMedCrossRefGoogle Scholar
  38. 38.
    Milikow E, Ash T (1970) Hemangiomatosis, localized growth disturbance and intravascular coagulation disorder presenting with an unusual arthritis resembling hemophilia. Radiology 97:547–548Google Scholar
  39. 39.
    Mitty HA (1993) Musculoskeletal neoplasms: role of angiography in diagnosis and intervention. Semin Intery Radiol 10:313–317Google Scholar
  40. 40.
    Montgomery SP, Guillot AP, Barth RA (1990) MR imaging of disseminated neonatal hemangiomatosis: case report. Pediatr Radiol 21:214–215Google Scholar
  41. 41.
    Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69: 541–552CrossRefGoogle Scholar
  42. 42.
    Mulliken JB, Zetter BR, Folkman J (1982) In vitro characteristics of endothelium from hemangiomas and vascular malformations. Surgery 92:548–553Google Scholar
  43. 43.
    Munk PL, Helms CA (1999) Deep soft tissue hemangiomas. Skeletal Radiol 28:57–58PubMedCrossRefGoogle Scholar
  44. 44.
    Murphey MD, Fairbairn KJ, Parman LM, Baxter KG, Pasa B, Smith WS (1995) Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics 15:893–917PubMedGoogle Scholar
  45. 45.
    Naka N, Ohsawa M, Tomita Y, Kanno H, Uchida A, Aozasa K (1995) Angiosarcoma in Japan: a review of 99 cases. Cancer 75:989–996PubMedCrossRefGoogle Scholar
  46. 46.
    Nelson MC, Stull MA, Teitelbaum GP, Patt RH, Lack EE, Bogumill GP, Freedman MR (1990) Magnetic resonance imaging of peripheral soft tissue hemangiomas. Skeletal Radiol 21:542–557Google Scholar
  47. 47.
    Paltiel HJ, Burrows PE, Kozakewich HP, Zurakowski D, Mulliken JB (2000) Soft tissue vascular anomalies: utility of US for diagnosis. Radiology 214:747–754PubMedGoogle Scholar
  48. 48.
    Peiss VJ, Füzesi L, Bohndorf K, Neuerburg J, Urhahn R, Günther RW (1993) MR-Morphologie von Hemangiomen und Lymphangiomen der peripheren Weichteile — Korrelation mit Angiographie und Histologie. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 158:543–550CrossRefGoogle Scholar
  49. 49.
    Rak KM, Yakes WF, Ray RL, Dreisbach WF, Parker SH, Luethke JM, Stavros AT, Slater DD, Burke BJ (1992) MR Imaging of symptomatic peripheral vascular malformations. AJR Am J Roentgenol 159:107–112PubMedCrossRefGoogle Scholar
  50. 50.
    Ramon F, Degryse H, De Schepper A (1992) Vascular soft tissue tumors: medical imaging. J Belge Radiol 75:323–330Google Scholar
  51. 51.
    Rauch RF, Silverman PM, Korobkin M, Dunnick NR, Moore AV, Wertman D, Martinez S (1984) Computed tomography of benign angiomatous lesions of the extremities. J Comput Assist Tomogr 8:1154–1155CrossRefGoogle Scholar
  52. 52.
    Rodriguez-Galindo C, Ramsey K, Jenkins JJ, Poquette CA, Kaste SC, Merchant TE, Rao BN, Pratt CB, Pappo AS (2000) Hemangiopericytoma in children and infants. Cancer 88:198–204PubMedCrossRefGoogle Scholar
  53. 53.
    Saks AM, Paterson FC, Irvine AT, Ayers BA, Burnand KG (1995) Improved MR venography: use of fast short inversion time inversion recovery technique in evaluation of venous angiomas. Radiology 214: 908–911Google Scholar
  54. 54.
    Silverman RA (1991) Hemangiomas and vascular malformations. Pediatr Dermatol 54:811–854Google Scholar
  55. 55.
    Stout AP, Murray MR (1942) Hemangiopericytoma: a vascular tumor featuring Zimmerman’s pericytes. Am Surg 116:26–30Google Scholar
  56. 56.
    Suh JS, Hwang G, Hahn SB (1994) Soft tissue hemangiomas: MR manifestations in 26 patients. Skeletal Radiol 26:621–626Google Scholar
  57. 57.
    Sung MS, Kang HS, Lee HG (1998) Regional bone changes in deep soft tissue hemangiomas: radiographic and MR features. Skeletal Radiol 27:205–210PubMedCrossRefGoogle Scholar
  58. 58.
    Taylor GA, Perlman EJ, Scherer LR, Gearhart JP, Leventhal BG, Wiley J (1991) Vascularity of tumors in children: evaluation with color-doppler imaging. AJR Am J Roentgenol 157:1267–1311PubMedCrossRefGoogle Scholar
  59. 59.
    Taylor KJW, Ramos I, Carter D, Morse SS, Snower D, Fortune K (1988) Correlation of Doppler US tumor signals with neovascular morphologic features. Radiology 166:57–62PubMedGoogle Scholar
  60. 60.
    Teo EHJ, Strause PJ, Hernandez RJ (2000) MR Imaging differentiation of Soft Tissue Hemangiomas from malignant soft tissue masses. AJR Am J Roentgenol 174:1623–1628PubMedCrossRefGoogle Scholar
  61. 61.
    Tung GA, Davis LM (1993) The role of magnetic resonance imaging in the evaluation of the soft tissue mass. Crit Rev Diagn Imaging 54:269–329Google Scholar
  62. 62.
    Verstraete KL, De Deene Y, Roels H, Dierick A, Uyttendaele D, Kunnen M (1994) Dynamic contrast-enhanced MR Imaging of benign and malignant musculoskeletal lesions: parametric ‘first-pass’ images depict tissue vascularization and perfusion. Radiology 212:854–855Google Scholar
  63. 63.
    Yagmai I (1978) Angiographic features of soft tissue and osseous hemangiopericytomas. Radiology 155:655–659Google Scholar
  64. 64.
    Yakes WF, Luethke JM, Parker SH, Stavros AT, Rak KM, Hopper KD, Dreisbach JN, Griffin DJ, Seibert CE, Carter TE, Guilliband JD (1990) Ethanol embolization of vascular malformations. Radiographics 10:787–796PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2001

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  • F. Ramon

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