Case Number : Case 2271 - 26 February 2019 Posted By: Uma Sundram

Hobnail Hemangioma.

Targetoid hemasiderotic hemangioma.

can we have HHV8 status , before we call it hobnail hemangioma

Hobnail hemangioma was my first thought, but i dont like the deeper compound so i would perform HHV8 to rule out Kaposi Sarcoma

Let me justify my diagnosis of hobnail hemangioma. The deep areas hold an interstitial spindle cell proliferation between the bundles of collagen, that surround preexisting vascular spaces in a Kaposi-like promontory sign manner. But this should be a plaque stage of Kaposi, so we should find a more fascicular infiltrative pattern; and, mostly, in Kaposi there isn't(usually) any zonation. However I agree with above. Without HHV8 I wouldn't do a diagnosis of hobnail hemangioma, in real life, of course.

Worried about KS

Hobnail hemangioma.

Thank you all for your insightful comments, especially those who i know look at this site daily. We are so appreciate of your support!

Yes, hobnail hemangioma. HHV8 is negative.

My interest in posting this case is its overlap with angiosarcoma in terms of architecture. A smaller biopsy would have made it difficult to completely exclude a well differentiated angiosarcoma. You may remember my prior post about the clinical scenarios for angiosarcoma (old person head and neck, post radiation (breast especially), stewart treves, arteriovenous fistula).

appreciative :)