# Pediatric inguinal-perineal cavernous hemangioma: A rare presentation and surgical outcome

## TL;DR

A 7-year-old boy with a rare inguinal-perineal hemangioma required surgery after initial antibiotic treatment failed, highlighting the importance of imaging and timely intervention.

## Contribution

This case report presents a rare pediatric presentation of cavernous hemangioma and emphasizes the role of imaging and surgical management in atypical vascular lesions.

## Key findings

- Imaging confirmed a multilocular, hemorrhagic lesion with vascular involvement.
- Surgical excision resolved the progressive swelling and prevented complications.
- Multidisciplinary care was critical for accurate diagnosis and effective treatment planning.

## Abstract

•Infantile hemangiomas are common vascular tumors that often regress spontaneously. However, complications such as disfigurement, functional impairment, or ulceration may require intervention. Imaging modalities, including Doppler ultrasound and MRI, are crucial for identifying vascular involvement and guiding management decisions.

Infantile hemangiomas are common vascular tumors that often regress spontaneously. However, complications such as disfigurement, functional impairment, or ulceration may require intervention. Imaging modalities, including Doppler ultrasound and MRI, are crucial for identifying vascular involvement and guiding management decisions.

•A 7-year-old male presented with a painful, oval-shaped swelling in the right inguinal region, measuring approximately 4 × 2 cm and extending toward the perineal area. The lesion was firm, smooth, erythematous, and well-defined, with no inguinal lymphadenopathy or cough impulse. Despite initial treatment with oral antibiotics for presumed inguinal lymphadenitis, the mass progressively enlarged. Investigations, including routine blood tests, were normal. Imaging revealed a multilocular, cystic lesion with vascular involvement. Surgical excision of a 5 × 2 × 1.5 cm hemorrhagic, multilocular lesion was performed, and histopathology confirmed the diagnosis of hemangioma.

A 7-year-old male presented with a painful, oval-shaped swelling in the right inguinal region, measuring approximately 4 × 2 cm and extending toward the perineal area. The lesion was firm, smooth, erythematous, and well-defined, with no inguinal lymphadenopathy or cough impulse. Despite initial treatment with oral antibiotics for presumed inguinal lymphadenitis, the mass progressively enlarged. Investigations, including routine blood tests, were normal. Imaging revealed a multilocular, cystic lesion with vascular involvement. Surgical excision of a 5 × 2 × 1.5 cm hemorrhagic, multilocular lesion was performed, and histopathology confirmed the diagnosis of hemangioma.

•This case highlights the importance of imaging and multidisciplinary management in diagnosing and treating vascular lesions with atypical presentations. Although most infantile hemangiomas are self-limiting, surgical intervention is warranted for progressive lesions causing discomfort or posing a risk of complications. Prompt surgical excision alleviates symptoms and prevents functional and cosmetic consequences, emphasizing individualized patient care.

This case highlights the importance of imaging and multidisciplinary management in diagnosing and treating vascular lesions with atypical presentations. Although most infantile hemangiomas are self-limiting, surgical intervention is warranted for progressive lesions causing discomfort or posing a risk of complications. Prompt surgical excision alleviates symptoms and prevents functional and cosmetic consequences, emphasizing individualized patient care.

•This case underscores the need to consider hemangiomas in the differential diagnosis of atypical pediatric inguinal masses. Early imaging and multidisciplinary management are critical for accurate diagnosis and effective treatment. Surgical excision is a definitive option for symptomatic or progressive lesions, ensuring symptom relief and preventing complications.

This case underscores the need to consider hemangiomas in the differential diagnosis of atypical pediatric inguinal masses. Early imaging and multidisciplinary management are critical for accurate diagnosis and effective treatment. Surgical excision is a definitive option for symptomatic or progressive lesions, ensuring symptom relief and preventing complications.

•Imaging confirmed a multilocular lesion with vascular and hemorrhagic features.•Progressive swelling required surgical excision for definitive treatment.•Surgery revealed a hemorrhagic lesion causing discomfort and risk of complications.•Multidisciplinary care addressed diagnostic uncertainty and surgical planning.•Early surgical intervention prevents functional and cosmetic complications.

Imaging confirmed a multilocular lesion with vascular and hemorrhagic features.

Progressive swelling required surgical excision for definitive treatment.

Surgery revealed a hemorrhagic lesion causing discomfort and risk of complications.

Multidisciplinary care addressed diagnostic uncertainty and surgical planning.

Early surgical intervention prevents functional and cosmetic complications.