CASE REPORT ‘Mini’ free groin flap for treatment of a tufted angioma of the finger D. Collins a, *, N.J. Sebire b , A. Barnacle b , V. Ramakrishnan a , L. Kangesu a,b a St Andrews’ Centre for Burns and Plastic Surgery, Chelmsford CM1 7ET, UK b Great Ormond Street Hospital for Children, London, UK Received 2 December 2010; accepted 5 January 2011 KEYWORDS Tufted angioma; Kaposiform hemangioendothelioma; Groin flap; Microsurgery Summary Tumours in children can be alarming and diagnosis difficult when the pathology is rare. Furthermore tumours on the finger and subsequent treatment may lead to loss of func- tion. The often-difficult decisions regarding treatment of vascular anomalies are often best managed in the multidisciplinary team meeting. Kaposiform hemangioendothelioma (KHE) and tufted angioma (TA) are rare forms of vascular tumours. There is evidence that they may represent variants of the same tumour group. We present a unique case of TA/KHE involving the finger in a three-year-old child. ª 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. Introduction Tufted angioma (TA) is a rare, histologically benign, vascular tumour characterised by cellular tufts of capillary sized vessels protruding into larger thin-walled vessels, scattered in a ‘cannonball’ fashion throughout the dermis. The term ‘tufted angioma’ was first introduced by Wilson Jones 1 in 1976. The lesion itself however, was first described by Nakajawa in 1949 under the name angioblastoma. 2 A similar vascular lesion was described in 1971 as a progressive capil- lary haemangioma. 3 It is generally now thought that all these descriptions represent the same lesion. Kaposiform heman- gioendothelioma (KHE) is a similar endothelium derived spindle cell tumour that usually presents in the paediatric population and can be locally aggressive, characterised by a proliferation of spindled endothelial cells. KHE can be locally destructive and often causes systemic effects as a result of the KasabacheMerritt phenomenon (KMP). Recently, expression of the marker D2-40 has been demon- strated in both of these lesions, but not in other hae- mangiomas, suggesting that these tumours may be part of the same disease spectrum. Case report A three-year old, Caucasian male presented with an enlarging legion on the dorsal aspect of the left middle finger. The lesion had initially presented at the age of sixteen months as a slow growing erythematous patch. It was subsequently excised at the age of twenty-two months * Corresponding author. E-mail address: dpcollins@doctors.org.uk (D. Collins). Journal of Plastic, Reconstructive & Aesthetic Surgery (2011) 64, e128ee131 1748-6815/$ - see front matter ª 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2011.01.003