A fifteen-day-old-neonate was brought by the parents with a soft swelling over the left hand since birth. There was a gradual increase in the size associated with serous discharge.
The photograph of the lesion shows a reddish dome shaped lesion with a few vascular channels traversing it. Frontal and lateral radiographs show a soft tissue opacity over the ulnar aspect of the hand and wrist. The underlying bones are normal. Ultrasonography of the swelling shows a well-defined iso to hypoechoic soft-tissue lesion. On color Doppler examination, there is significant internal vascularity with both arterial and venous flow. The spectral Doppler shows a high peak systolic velocity of 65cm/sec.