Hemangioma symplastic D18.01

Very rare, benign, solitary, less symptomatic tumor of the skin of different size. Because of its skin colour it is not clinically recognizable as a vascular tumour. It is a histological accidental finding.

Angioleiomyoma-like tumor with few unusually thick-walled vessels that are interspersed with large-nucleated polymorphic muscle cells with conspicuous lobed nuclear atypes. This conveys a pseudomalignant aspect. Mitoses are rare. The endothelia shown are without cell and nuclear polymorphism, a sure sign for the benignity of the process.

The diagnosis is a histological random diagnosis. Further measures are not necessary. No danger of recurrence.

The term "sym-plast" refers to a multinuclear cell (giant cell) created by fusion. Such phenomena are observed in the symplastic leiomyoma of the uterus and in cutaneous leiomyomas. In glomus tumors this phenomenon can also shape the histological picture.

1. Cooney EJ et al (2015) Case report: Atypical, 'symplastic' leiomyoma recurring as leiomyosarcoma in the vagina. Gynecol Oncol Rep 14:4-5.
2. Goh SG et al (2006) Symplastic hemangioma: report of two cases. J Cutan catheter 33:735-740.
3. Kutzner H et al (2000) Symplastic hemangioma. dermatologist 51:327-331
4. Mesbah Ardakani N et al (2016) Symplastic Pilar Leiomyoma: Description of a Rare Entity. At J Dermatopathol PubMed PMID: 26981742.