24 Hemangioma of Infancy

CASE 24

Clinical Presentation

A 6-month-old baby girl presents with growing right facial mass.

Figure 24A

Figure 24B (See Color Plate 24B.)

Figure 24C

Figure 24D

Figure 24E

Radiologic Findings

Ultrasonographic images show a large, soft tissue mass of heterogeneous echogenicity (Figs. 24A and 24B). Color Doppler evaluation shows high flow and high vessel density (Fig. 24B). MRI including axial unenhanced T1-weighted image (Fig. 24C), coronal fat-suppressed T2-weighted image (Fig. 24D), and fat-suppressed T1-weighted image following gadolinium enhancement (Fig. 24E) show a large mass initially isointense to muscle within the right parotid gland extending to the right parapharyngeal region with multiple internal flow voids. The lesion shows high T2 signal intensity and intense enhancement following gadolinium administration.

Diagnosis

Hemangioma of infancy

Differential Diagnosis

Other vascular anomalies and tumors

Kaposiform hemangioendothelioma
Noninvoluting congenital hemangioma
Rapidly involuting congenital hemangioma
Vascular malformations
- Venous malformation
- Lymphatic malformation
- Arteriovenous malformation
Rhabdomyosarcoma
Neuroblastoma
Fibrosarcoma
Lipoblastoma