Vascular tumors in children and adolescents: a clinicopathologic study of 228 tumors in 222 patients.

Vascular tumors in 222 children and adolescents accounted for 25 percent of all soft tissue tumors in our series of over 900 pediatric cases. Based upon standard histopathologic criteria, 203 (89 percent) were benign, 21 (9 percent) were borderline or indeterminant, and 4 (2 percent) were malignant. The mean age at diagnosis was 12 years; 26 percent (58) of cases were diagnosed in the first year of life and 57 percent (127) in the first decade. The male:female ratio was 1:2. The head and neck (80 cases, 35 percent), extremities (79 cases, 35 percent), and trunk (65 cases, 28 percent) were respectively the regional sites. Seven patients with localized angiomas had more than one lesion; 22 required re-excision for recurrent tumors. Hemangiomas of one type or another accounted for 64 percent and lymphangiomas for 29 percent of the benign group. Capillary hemangioma (73 cases, 32 percent of entire group) was the most common type, followed by lymphangioma (59 cases, 26 percent). Nine patients had diffuse angiomatosis. Borderline tumors comprised 9 percent (21 cases) of cases including ten histiocytoid hemangiomas and 7 hemangiopericytomas. Angiosarcoma (three cases) and Kaposi's sarcoma (one case) constituted the malignant tumors.