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Table 5 Characteristics of the main vascular and perivascular tumours of the hand according to the International Society for the Study of Vascular Anomalies (ISSVA) classification and the WHO classification of soft tissue tumours

From: CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings

Classification

Tumour

Clinical context

Imaging features

Associated lesions

Vascular tumour

Benign

Pyogenic granuloma (lobular capillary haemangioma)

Occurs at the site of trauma; occur in up to 5% of pregnancies

Small, exophytic, and hypervascular tumour; increased blood flow

 

Vascular tumour

Benign

Intramuscular haemangioma

Young adults

Lobulated intramuscular hypervascular mass with non-vascular tissue (fat)

 

Vascular tumour

Benign; can evolve to an angiosarcoma

Spindle cell haemangiomas in Maffucci syndrome

Non-hereditary mesodermal dysplasia

Cavernous vascular spaces that sometimes contain phleboliths

Enchondromatosis

Vascular tumour

Benign

Intravascular papillary endothelial hyperplasia (Masson’s tumour)

 

Mimics the imaging characteristics of the associated vascular lesions

 

Vascular tumour

Benign

Epithelioid haemangioma

Affects peripheral medium-sized muscular arteries

Hypervascularised tumour developed in the arterial wall

 

Vascular tumour

Borderline

Kaposi's sarcoma

HIV infection

Hypervascularised tumour of the skin

Bone lesions in 85% of the cases

Vascular tumour

Malignant

Angiosarcoma

Chronic lymphoedema; Maffucci syndrome

Highly aggressive tumour

Chronic lymphoedema; Maffucci syndrome

Perivascular tumour

Menign (malignant tumours are uncommon)

Glomus tumour

Mostly affects women

Painful lesion

In the nail bed (up to 90%)

Hypervascularised tumour; less than 1 cm wide; affecting the fingers, usually in the nail bed

 

Perivascular tumour

Benign

Angioleiomyoma

Painful in 50% of the cases

Homogeneous, hypervascularised tumour; less than 3 cm large; in the subcutaneous tissue; may be connected to a vessel

 

Perivascular tumour

Benign

Myopericytoma

 

Homogeneous and hypervascularised tumour, less than 2 cm large, in the subcutaneous tissue; may be connected to a vessel

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