Congenital soft tissue hemangioma
- Etiology: vascular, capillaries intermixed with dilated vessels
- US: variable, can be more heterogeneous, calcification, necrosis, shunting, variable margins and vascularity
- DDX:
- Complications:
- Treatment: none, excision, embolization, ?steroids
- Clinical: prenatal detection, proliferation ceases by birth, rapidly involuting (RICH) with involution over 3-12 months and non-involuting (NICH) with lesion staying stable and partially involuting (PICH) with partial involution of lesion, consumptive coagulopathy which is mild and transient, GLUT-1 negative
Infantile soft tissue hemangioma
- Etiology: vascular, capillaries lined by plump endothelial cells
- US: in cutaneous / subcutaneous tissue, solid with patchy increased echogenicity, variable margins, high vessel density on color Doppler, low resistance waveforms on spectral doppler
- DDX:
- Complications: tend to be multiple, consider liver sonogram if >= 2 soft tissue lesions
- Treatment: propranolol, steroids
- Clinical: proliferation in first weeks-months of life, involution over years, no coagulopathy, GLUT1 positive, cherry red (superficial) or blue (deep) depending on depth of lesion
- Note: if lesion is:
— Beard distribution – possible airway compromise due to association with subglottic hemangiomas
— Periorbital – growth may compress optic nerve and cause blindness
— Midline sacrum – do MRI to rule out spinal dysraphism
— Unilateral facial distribution – consider PHACES syndrome
Radiology Cases of Soft Tissue Hemangioma

Clinical Cases of Soft Tissue Hemangioma
