Benign Lymphangioendothelioma: A Report of a Rare Vascular Hamartoma in a Young Indian Child

Sir, An 8-year-old boy presented to us with a raised asymptomatic cutaneous lesion over his left leg for the past one and half years. It started as a bluish, slightly elevated spot which gradually increased to attain its present size and shape. There was no preceding history of trauma or use of any medication. There was no overt history of external bleeding or oozing. Cutaneous examination revealed an ill-defined, oblong-shaped plaque (4 cm × 3 cm size) with a bluish hue situated over the anterior aspect of the left thigh. It was studded with a few dark-blue and reddish papules. Focal crusting over the surface was also noted [Figure 1]. The lesion was non-tender and soft in consistency, and there was no lesional thrill or bruit. No other cutaneous lesion was present elsewhere in his body. Hair, nail, and mucosae were normal. General and systemic examinations were noncontributory. Routine blood investigations were within normal limits. Assuming the case to be a vascular malformation, the lesion was completely excised a year back, and regular follow-up showed no recurrence until date. Histopathological examination (hematoxylin and eosin stain) [Figures 2-4] of the excised specimen revealed compact hyperkeratosis with irregular acanthosis. Dilated thin-walled spaces lined by intermittent flat endothelial cells resembling lymphatic channels were seen in the upper and mid-dermis. Similar, but more slit-like, structures were seen in the deeper dermis along with dilated blood vessels containing red blood cells.