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Perineural vascular proliferations are extremely rare, and only a few cases have been reported in the literature, usually under the designation of “intraneural hemangioma.” We report a case of a 28-year-old man with a nodule in the right palm of his hand that developed over an 8- to- 12-month period. Microscopic examination revealed a vascular proliferation growing within connective tissue and entrapping small nerve bundles. The features of the lesion are consistent with an unusual hamartomatous growth of small vessels and nerves rather than a hemangioma arising within a nerve. Clinical and histological details, and a discussion of the relevant literature on this unusual lesion, are provided.