Benign Vascular and Malignant Vascular Tumors

Earl W. Brien and Stuart H. Kuschner

History and Clinical Presentation

Case A. A 35-year-old right hand dominant woman complains of a painful mass about the tip of the index finger of 6 months’ duration. She states that the pain is aggravated by cold and often radiates proximally after tactile stimulation. She denies any history of trauma, puncture wounds, or fever.

Case B. A 55-year-old right hand dominant woman with a history of swelling about the left upper extremity after radical mastectomy and lymph node dissection 10 years prior complains of a painless, enlarging mass in the left hand of 4 months’ duration. She denies any history of trauma, puncture wounds, or fever.

Physical Examination

Case A. The patient has 1.5-cm, firm, nonmobile mass about the tuft of the index finger. The lesion revealed a blue-red hue subungual. She has lancinating pain proximally upon pinprick about the digit. She has no proximal adenopathy and the remainder of her examination is within normal limits.

Case B. The patient has 2.5-cm dorsoradial wrist mass superimposed on a nonpitting, brawny edema. It is firm, superficial, nontender, and nonmobile, without any warmth or erythema. The lesion did not transilluminate and there was a purple hue about the skin. She has full range of motion of the wrist and hand and is neurovascularly intact to all digits. She has no proximal adenopathy and the remainder of her examination is within normal limits.

Diagnostic Studies