This dark maroon, cystic, dome-shaped, 8-mm lesion on a 75-year-old man’s back had been present for 2 years (A). It would occasionally bleed after minor trauma, such as when the patient dried his back with a bath towel. He had no history of skin cancer.
The lesion was elliptically excised in the office. Pathological diagnosis was sinusoidal hemangioma. This uncommon acquired vascular tumor may develop on the trunk, including the breasts, and on the limbs in adults. It is more common in women.1
As with any other skin lesion, when a diagnosis is not obvious, a tissue pathology examination should be performed. Histologically, these hemangiomas have a lobular architecture with thin-walled vessels, small intervening stroma, and a sinusoidal pattern (hematoxylin and eosin stain, x20, B).
Other acquired hemangiomas include cherry angioma, angiokeratoma, venous lake, pyogenic granuloma, bacillary angiomatosis, and Kaposi sarcoma.
Treatment of sinusoidal hemangioma includes surgical excision and destruction by cryotherapy, electrodesiccation, and laser therapy.
1. Weedon D, Strutton G, eds. Skin Pathology. 2nd ed. London: Churchill Livingstone; 2002:110.