If cavernous hemangioma is suspected, what is the recommended management?

• A. Send them to a vascular surgeon
• B. Observe only
• C. Start antibiotics
• D. Excisional biopsy

Answer: (A)

Vascular lesions like cavernous hemangiomas require specialist evaluation rather than routine office procedures. They are highly vascular, so manipulating them—biopsy or excision—can trigger severe, difficult-to-control bleeding. Antibiotics don’t address the lesion’s problem, and simply observing can miss progressive growth or a bleeding risk. The safest and most appropriate first step is to refer to a vascular surgeon who can confirm the diagnosis with imaging (such as Doppler ultrasound or MRI) and plan definitive treatment, which may include embolization, sclerotherapy, or carefully coordinated surgical removal. Excisional biopsy is generally avoided outside a setting with vascular control due to the high risk of hemorrhage.