Breast hemangiomas are extremely rare neoplasms in the male population. We report a case of a 77-year old man with a breast hemangioma which was detected in physical examination as a small nodule ten years after a chest injury. The final histological diagnosis was hemangioma of the breast, 6 cm in the largest diameter. To our knowledge, this is the largest benign vascular breast neoplasm in a male patient reported up to date. The mammographic and pathologic findings in this case are presented. The rarity of the lesion and its differential diagnosis from angiosarcoma are discussed while the problems encountered in the correct diagnosis and classification of this tumor are also presented. The need for extreme caution in the interpretation of the histological characteristics of all palpable vascular tumors of the breast is emphasized.