Head and Neck Pathol (2009) 3:54–58 DOI 10.1007/s12105-009-0105-6 C A S E R E P O R T Angiomatosis in the Head and Neck—3 Case Reports Smitha R. Shetty Æ Sudeendra Prabhu Received: 26 December 2008 / Accepted: 26 January 2009 / Published online: 15 February 2009 Humana 2009 Abstract Angiomatosis is a diffuse vascular lesion which involves a large segment of the body in a contiguous fashion involving multiple tissues (e.g. subcutis, muscle, bone, adipose tissue etc.) in different planes. Such lesions usually present in the ﬁrst two decades of life with female predilection and are commonly seen in lower extremities. It clinically mimics hemangioma or vascular malformation and its surgical removal is difﬁcult because of its inﬁltra- tive nature and thus has high recurrence rate (90%). Therefore a precise histopathological diagnosis of angio- matosis is important to achieve a curative resection. Histopathologically it consists of proliferating blood ves- sels of varying caliber, inﬁltrating into the soft tissues. Proliferating capillaries are seen within or adjacent to major vessels. Few cases are reported in head and neck region. This article highlights three unusual cases of angiomatosis reported as benign lesions, in rare sites such as the malar region (predominantly inﬁltrating the adipose tissue), within the masseter (predominantly inﬁltrating the muscle) and in the mandible (inﬁltrating the bone). His- topathological differential diagnosis is also discussed. Keywords Angiomatosis Inﬁltrative hemangioma Hemangioma lymphatics and nerves which may involve skin, subcuta- neous tissue, skeletal muscle and occasionally bone [1]. It is extremely rare and benign but a clinically extensive vascular lesion of soft tissue which usually becomes symptomatic during childhood or adolescence [2]. According to Rao and Weiss [2], angiomatosis has been deﬁned as a histologically benign vascular lesion that affects a large segment of the body in a contiguous fashion, either by vertically involving multiple tissue types (e.g. subcutis, muscle, bone) or by involving similar types of tissues (e.g. multiple muscle). It has a highly characteristic but not totally speciﬁc histologic pattern. It has no malig- nant potential, but because of its inﬁltrative nature, it could be misdiagnosed as a malignancy using imaging tech- niques. For these reasons diagnosis based on clinical and radiographic ﬁndings in correlation with histologic features would be desirable [3]. Its diffuse inﬁltrative nature makes surgical resection difﬁcult; hence, recurrence is a common feature in angiomatosis [2, 3]. The aim of this paper is to present three cases of angi- omatosis which were clinically mimicking hemangioma, lipoma and arteriovenous (AV) malformation at rare sites such as within the masseter, malar region and in the mandible, respectively. The histopathological differential diagnosis and prognostic importance of angiomatosis is also discussed. Introduction Angiomatosis is a complex vascular malformation of infancy and childhood consisting of proliferating blood vessels with accompanying mature fat, ﬁbrous tissue, Case Reports Case 1 S. R. Shetty S. Prabhu (&) SDM College of Dental Sciences, Dharwad, India e-mail: drsudi78@yahoo.co.in A 13-year-old female presented with the complaint of swelling in the right side of face since 2 years. The swelling had slowly progressed in size during the period.