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Bladder
Bladder tumors - benign
Hemangioma
Reviewer: Tom Tong, M.D., Montefiore Medical Center North Division, Bronx, New York
Revised: 30 May 2010, last major update May 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Benign vascular tumor similar to its counterparts elsewhere
Epidemiology
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● Mean age 58 years; 75% men (Cancer 1999;86:498)
Sites
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● Predilection for dome, posterior wall and trigone
Clinical features
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● Generally considered a congenital anomaly, although 50% are detected in adults
● Associated with cutaneous hemangiomas, Klippel-Trenaunay syndrome (port-wine hemangiomas, varicose veins, soft tissue and bone hemihypertrophy)
● Painless hematuria, dysuria and abdominal pain
Case reports
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● 2 year old girl presenting with hemorrhagic shock (J Pediatr Surg 2008;43:e1)
● 14 year old boy with gross painless hematuria (Urology 2010 Feb 15 [Epub ahead of print])
Treatment
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● Biopsy with or without fulguration; very good outcome; rarely partial cystectomy
Clinical images
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Endoscopy of cavernous
hemangioma
Gross description (Macroscopy)
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● Sessile; median 0.7 cm
Gross images
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In Klippel-Trenaunay-Weber syndrome
Micro description (Histopathology)
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● Classified as cavernous, capillary, or arteriovenous based on conventional criteria from other sites
● Usually cavernous type
Micro images
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Cavernous hemangiomas Patient with Klippel-Trenaunay
syndrome
Capillary hemangioma of skin
Differential Diagnosis
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● Angiosarcoma: anastomosing channels lined by plump hyperchromatic cells
● Arteriovenous malformation: abrupt changes in thickness of medial and elastic layers of vessels, abnormal vascular dilation
● Telangiectasia: chronically dilated capillaries, no actually increase in number of vessels
End of Bladder > Benign tumors > Hemangioma
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