Giant Scalp Hemangioma in a Term Neonate: Diagnostic Challenges and Imaging Insights – A Case Report

Introduction: Benign newborn hemangiomatosis (BNH) is a rare, non-heritable, and typically self-resolving condition, characterized by multiple cutaneous neonatal hemangiomas (IH) with few or no visceral lesions. These lesions generally manifest between the second and eighth week of life and may be congenital (30%) or, more frequently, infantile (70%).Case Presentation: A male neonate, born at 38 weeks of gestation via spontaneous vaginal delivery to a 30-year-old gravida 8, para 6 woman with no prior medical history, presented with multiple cutaneous lesions. The pregnancy was uncomplicated, with normal prenatal laboratory findings and unremarkable fetal survey. Apgar scores were not documented due to the home birth setting.Discussion: This report contributes to the limited literature on prenatal detection of cranial hemangiomas by presenting a rare case of a rapidly involuting congenital hemangioma (RICH) identified in the third trimester. Although such prenatal diagnoses are uncommon, our findings align with prior reports indicating that in utero detectable hemangiomas generally appear after 26 weeks of gestation. Infantile hemangiomas, the most common benign vascular neoplasms in children, affect up to 4–5% of Caucasian infants and result from proliferation of endothelial-like cells. In this case, the lesions may reflect hemangiomatous disruption of developing hair follicles or represent a hamartomatous formation.Conclusion: Close monitoring and follow-up imaging during the first year of life are essential to assess lesion progression and involution. Recognizing the distinctive clinical and imaging features of cranial hemangiomas is critical to avoid unnecessary interventions and to implement appropriate management. This case underscores the importance of interdisciplinary collaboration in the care of neonates with vascular anomalies.