A 75 y.o. woman presents with hoarseness and coughing up blood.

She has a T2 weighted MRI which shows a mass on the vocal cord

vocal cordf.jpg
But the lesion surrounds the carotid without compressing it and also extends into the mediastinum. What is it?

But the lesion surrounds the carotid without compressing it and also extends into the mediastinum. What is it?

Our patient had a hemangioma.  This is an abnormal proliferation of blood vessels and can occur anywhere in the body.

Hemangiomas occur in 5 to 10% of children  and usually disappear by age 3-5. Hemangiomas that appear at birth are thought to be caused by placental trophoblastic proteins and indeed are more common in infants born after chorionic villus sampling.

hemangioma in a child

hemangioma in a child

Another group of hemangiomas appears in adults usually between the ages of 30 and 50. They occur in 10% of the world’s population. Symptomatic hematomas, like in our pt, occur in less than 1% of these individuals. Cherry hemangiomas are common in the skin of adults.

common cherry hemangiomas

common cherry hemangiomas

The brain, liver and spine can also be sites of hemangiomas.

the “corduroy sign” of spinal hemangiomas

the “corduroy sign” of spinal hemangiomas

cross section of the spinal hemangioma “the polka dot sign”

cross section of the spinal hemangioma “the polka dot sign”

RANDOM HEMANGIOMA FACTS-Hemangiomas tend to be prevalent in a specific condition called Von Hippel Lindau.  Estrogen is a trigger for hemangioma growth and pregnant women may have increase in the size of their hemangiomas.

Because our patient was having bleeding from her vocal cord, she underwent successful embolization.

Drolet B, Esterly N, Frieden I.  New England Journal of Medicine—Hemangiomas in Children 1999. 

Bree A, Siegfried E, Sotel-Avila,  C et al. Infantile Hemangiomas Speculation on Placetal Trophoblastic Origin. Arch Dermatol. 2001; 137(5): 573-577. 

Alfawareh M, Alotaibi T, Labeeb A, et al. A symptomatic case of thoracic vertebral hemangioma causing lower limb spastic paresis. 2016 Am J Cas Rep ;17:805-809.