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Bladder

Nonurothelial benign tumors

Hemangioma

Reviewer: Tom Tong, M.D. (see Reviewers page)
Revised: 9 February 2013, last major update May 2010
Copyright: (c) 2003-2013, 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;76:463)

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
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● Sessile
● Median 0.7 cm

Gross images
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In Klippel-Trenaunay-Weber syndrome

Micro description
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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 > Nonurothelial benign tumors > Hemangioma

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