Introduction:
Capillary hemangiomas and pyogenic granulomas are benign vascular neoplasms that are usually identified clinically by their characteristic features. Capillary hemangiomasmost commonly develop in infancy on the head and neck and nearly all spontaneously ingress by the teenage years. Pyogenic granulomas, however, typically present in adults and can be induced by trauma. It is exceedingly rare for capillary hemangiomas to present in adulthood or after trauma. We present an extremely unusual case of capillary hemangioma on the tip of the finger of an adult male presenting immediately after a burn. The mass was clinically diagnosed as pyogenic granuloma but histopathologically diagnosed as a capillary hemangioma. To our knowledge, this is the only presentation of its kind.
Case report:
A 29-year-old African American, right-hand-dominant male laborer presented to the outpatient orthopedic hand clinic with a 2--week-old growing mass on the tip of the right small finger. A clinical diagnosis of pyogenic granuloma was made. Silver nitrate therapy was ineffective, though surgical excision resulted in complete resolution of the mass. Surprisingly, the histopathological diagnosis was instead consistent with capillary hemangioma.
Conclusion:
Clinicians should maintain a high clinical suspicion for both pyogenic granulomas and capillary hemangiomas in children and adults with a vascular soft tissue mass, even after trauma. With this in mind, health-care providers should maintain a low clinical threshold to send soft tissue masses for histopathology to obtain an accurate diagnosis and to provide the best care possible.