Subcutaneous hemangiomas of the hand

Subcutaneous hemangiomas, the fourth most common tumor of the hand, consist primarily of proliferating blood vessels within the soft tissue. One hundred and sixty consecutive patients with the histologic diagnosis of subcutaneous hemangiomas were reviewed. Patients with diffuse hemangiomas, strawberry nevi, and arteriovenous fistulae were not included in the study. The median age was 32 years, the youngest being 2 years old and the oldest 68. Sixty-two percent of the patients were female. None had a history of trauma. The palm was the most common location. Progressive enlargement of the lesion and throbbing pain were the most common symptoms. As is characteristic of hemangiomas, they were readily compressible, poorly defined, bluish, subcutaneous masses that distended when the venous return was obstructed and contracted when the extremity was elevated. Roentgenographic evaluation rarely showed the typical calcification of phleboliths, but a soft tissue mass was almost always present. All of these hemangiomas were surgically excised, with the tributory vessels being identified and ligated as far distant from the tumor as possible in order to diminish the chances of recurrence.