Tufted Angioma Differential Diagnoses

Updated: Apr 26, 2017
  • Author: Alexandra R Vaughn; Chief Editor: Dirk M Elston, MD  more...
  • Print
DDx

Diagnostic Considerations

A proper diagnosis of tufted angioma requires careful clinical and histological examination. Laboratory evaluation is required for the diagnosis of Kasabach-Merritt syndrome (KMS).

Also consider the following information with regard to differential diagnoses:

  • Arteriovenous malformations: Often present at birth, these lesions are usually blue, soft, and compressible vascular masses. Doppler ultrasound and MRI are helpful for differentiating venous malformations and tufted angiomas. [33]
  • Congenital hemangioma: These include rapidly involuting congenital hemangiomas and noninvoluting congenital hemangiomas; they may involve thrombocytopenia and coagulopathy.
  • Dermatologic manifestations of Kaposi sarcoma: This is an extremely rare tumor reported in children in Africa. The human herpesvirus 8 (HHV-8) is detected in all Kaposi sarcoma variants.
  • Infantile hemangioma: Also known as strawberry angioma, it commonly occurs in the head and neck area, is not associated with coagulopathy, and has strong expression of GLUT-1 on immunochemistry.
  • Infantile hemangiopericytoma: This is a rare soft-tissue tumor presenting in the first year of life as a multilobulated mass in the subcutaneous tissue. [34] Bleeding and coagulopathy may mimic Kasabach-Merritt syndrome.
  • Infantile sarcoma: This rare malignant tumor can present at birth or within the first few years of life as a firm, fixed tumor in deep tissue. [35]
  • Kaposiform hemangioendothelioma: This tumor shares many clinical and histological features with tufted angiomas, but it is locally aggressive involving the soft tissues and even internal organs. Additionally, over 70% of patients with kaposiform hemangioendothelioma go on to develop Kasabach-Merritt syndrome.

 

Differential Diagnoses