2016 Volume 62 Issue 4 Pages 336-339
A 38-year-old woman had hit the right front of her head in a traffic accident six years earlier, suffered a scalp hematoma, and an induration had remained at the point of contact. Six years later, the induration suddenly started to swell and pulsate, so she came to the hospital. When she visited the hospital, the mass was 3 cm×3.5 cm, pink on the surface, hard, and the ulsation disappeared when we pressed the superficial temporal artery(STA) anterior to the right external auditorymeatus. Three-dimensional (3D) computed tomography(CT) angiographydid not clearlyshow ontinuitybetween the mass and the STA, but we suspected a traumatic STA aneurysm and operated on her. Intraoperative findings showed that the mass was not an aneurysm and that, although it did not have direct continuity with the main trunk of the STA, the mass was accompanied by numerous blood vessels seeminglybranching from STA branches. Pathological findings ndicated the proliferation of small vessels with endothelial cells called epithelioid endothelial cells and the infiltration of eosinocytes and lymphocytes around the vessels, and led us to a diagnosis of angiolymphoid hyperplasia with eosinophilia (ALHE). Although the athogenesis of this disease remains unknown, past studies suggested that one cause might be damage to blood vessels bya trauma. We suggest that ALHE, rare as it is, should be onsidered in the differential diagnosis of a pulsatile scalp mass occurring after a head injury.
