Congenital Large Cutaneous Hemangioma with Arteriovenous and Arterioarterial Malformations: A Novel Association

Background: Congenital cutaneous hemangioma is a benign vascular lesion that is a leading cause of severe hemodynamic compromise in a fetus when it is of significant size and especially in association with arteriovenous malformation. Case report: A large cutaneous hemangioma involving the right arm of a 32-week-old male fetus was complicated by fetal hypotrophy, hydrops fetalis and neonatal death. Axillary arteriovenous fistulas and bilateral arterial carotid-subclavian anastomosis were demonstrated at autopsy. Microscopically, the main tumor was a mixed capillary-cavernous hemangioma with vascular channels lined by CD31-positive and GLUT1/Ki-67-negative endothelial cells. Conclusion: Congenital hemangioma can be associated with vascular malformations, and that associations with other vascular malformations may increase the morbidity/mortality.