Kaposiform haemangioendothelioma presentation in hand in a paediatric patient

SummaryKaposiform haemangioendothelioma (KHE) is a rare, locally aggressive vascular tumour typically presenting in infancy and early childhood. We report the case of a female child of early school age who presented with progressive swelling and discolouration of the pulp of the right middle finger. The lesion originated from the pulp of the finger and was initially misdiagnosed as chronic osteomyelitis at another centre. Subsequent evaluation established the diagnosis of primary KHE and the patient underwent wide local excision.However, the patient developed local recurrence 10 months following the index procedure. The recurrence was managed with amputation through the middle phalanx. At the 3-month follow-up post-amputation, the patient remains asymptomatic with no evidence of recurrence and reports a satisfactory functional outcome, being pain-free and well adapted.This case highlights the diagnostic challenges and potential for recurrence in KHE arising from the distal phalanx pulp. It underscores the importance of considering KHE in the differential diagnosis of persistent digital swellings in children, particularly when conventional treatment fails, and emphasises the need for close follow-up and appropriate surgical planning to achieve optimal outcomes.