Rapidly involuting congenital hemangioma (RICH) - leg

Case contributed by Francis Fortin

Presentation

Newborn with soft, partially compressible, asymptomatic mass noted on left leg at birth.

Patient Data

Age: Newborn
Gender: Male

First day of life

Photo

On the left leg, a 3.5 cm mass is noted with superficial violaceous discoloration and a peripheral pale halo. On palpation, the mass in

Likely unrelated macules are seen on the anterior surface of both shins (right leg not shown).

First day of life

ultrasound

A heterogeneous soft tissue mass is seen in the subcutaneous fat of the left lateral mid-leg. It is well-circumscribed, mostly hypoechoic with large internal venous lakes and numerous punctate microcalcifications. Moderately elevated arterial Doppler flow. The mass is partially compressible (not shown).

After 1 month, the mass has already begun to shrink both clinically and on ultrasound.

Case Discussion

Characteristic clinical and ultrasound appearance of a rapidly involuting congenital hemangioma.

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