Abstract

Papillary hemangioma (PH) is a rare and likely underrecognized entity. PH is a predominantly intravascular tumor that can be confused with glomeruloid hemangioma, intravascular lobular capillary hemangioma, retiform hemangioendothelioma, and angiosarcoma. Herein we present a clinicopathologic review of 15 cases of PH. They were more common in males (M:F, 11:4) with a median age of 58 years (range: 31 – 89 years). Most were located on the head and neck (8/15) with the remainder on the trunk (7/15), most commonly the back. The clinical differentials included were basal cell carcinoma, angioma, epidermal cysts, nevi and lipomas. They all demonstrated intravascular papillary fronds lined by a single layer of endothelial cells. Hobnail morphology was relatively common (7/15), but nuclear pleomorphism and mitotic activity was absent. PAS was utilized in (5/15) cases all of which highlighted the intracytoplasmic hyaline globules. In one case, the tumor extending outside the vascular lumen and was associated with fatty metaplasia. Although PH is reported to be a head and neck tumor, almost half of our cases involved the trunk, expanding the clinicopathologic spectrum of this rare tumor. In summary, we present the largest series of PHs to date to highlight the clinicopathologic features and increase recognition of a rare entity.