Acta Dermato-Venereologica 99-6CompleteContent | Page 29

627 Vascular Mass of the Scalp in a Newborn: A Quiz Afi-Emiliène EDEE 1 , Matthias TALLEGAS 2 , Anne JOURDAIN 3 , Antoine LISTRAT 4 , Baptiste MOREL 5 and Annabel MARUANI 1 1 Department of Dermatology, Unit of Paediatric Dermatology, Reference Center for Vascular Anomalies – MAGEC, 2 Department of Pathology, 3 Department of Pediatric Oncology, 4 Department of Pediatric neurosurgery, and 5 Department of Pediatric Radiology, University Hospital Center of Tours, FR-37044 Tours Cedex 9, France. E-mail: [email protected] A female infant, 5 weeks old, was referred to our hospital for a congenital mass, located in the left parietal area of the skull. She had no family history and was born at term with the use of forceps for delivery. After birth, the mass, that had been considered a hematoma, progressively increased in volume but did not seem to cause any pain. At age 5 weeks (Fig. 1a), the infant underwent Doppler ultrasonography that showed a highly vascularized solid tumor. MRI (magnetic resonance imaging) revealed a left parietal subcutaneous mass, heterogeneous with hemorrhagic ranges (hyper T1 signal). There were also liquid ranges (hyper T2 and hypo T1 signals). There were no intracerebral anomalies or ce- rebral effusion (Fig. 1c). CT (computer tomography) scan was performed for a better view of the bone. We observed a thinning of the parietal bone and focal interruption of the cortex over a few millimeters on the opposite side of the lower part of the lesion. Also, focal bone interruptions were observed, with no intracranial anomalies. Conclusions from imaging favored an atypical infantile hemangioma. A beta-blocker test, 2 mg/kg/day, was not ef- ficacious after 15 days (Fig. 1b). The decision was made to surgically remove the entire lesion, when the infant turned 2 months (Fig. 1d). What is your diagnosis? See next page for answer. Fig. 1. Clinical features and imaging of the tumor. a) Congenital mass of the skull in a 5 week-old girl; b) At the age of 2 months, the mass had increased in size; c) MRI revealed a heterogeneous mass with hemorrhagic ranges (hyper T1 signal); d) The tumor was removed (macroscopy). QUIZ SECTION This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3131 Acta Derm Venereol 2019; 99: 627–628