Aggressive epithelioid hemangioendothelioma of the lower extremity: A case report and review of the literature

Bradley W. Bakotic, Morton Robinson, Marie Williams, Teresa Van Woy, Jean Nutter, Piotr Borkowski

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A case of epithelioid hemangioendothelioma (EHE) of the left lower extremity in a 50-year-old male is discussed. The neoplasm presented as a tan-purple, painful mass involving the fourth digit of the left foot. Following an excisional biopsy and partial amputation of the fourth digit, the lesion recurred with a multifocal distribution. A physical exam following the recurrence demonstrated multiple palpable lymph nodes in the left inguinal region. A complete amputation of the fourth digit was performed in conjunction with local excisions of the remaining lesions. Additionally, an inguinal lymphadenectomy was performed for staging purposes. Histologically, the tumor was predominantly composed of epithelioid endothelial cells forming nests, cords, and sheets and occasionally forming irregular, primitive vascular structures. Less commonly, nests of tumor cells assumed a spindled morphology. Patches of necrosis and hemorrhage were apparent throughout the neoplasm. There was minimal atypia and mitoses were not identified. Immunohistochemical stains for CD34, CD31, and Ulex europaeus antigens were positive in tumor cells. This case illustrates the potential aggressive behavior of this rare neoplasm and argues against the designation 'tumor of low-grade malignancy' with which it is commonly attributed.

Original languageEnglish
Pages (from-to)352-358
Number of pages7
JournalJournal of Foot and Ankle Surgery
Volume38
Issue number5
StatePublished - Sep 1 1999
Externally publishedYes

Fingerprint

Epithelioid Hemangioendothelioma
Lower Extremity
Neoplasms
Groin
Amputation
Ulex
Epithelioid Cells
Lymph Node Excision
Mitosis
Blood Vessels
Foot
Necrosis
Coloring Agents
Endothelial Cells
Lymph Nodes
Hemorrhage
Biopsy
Antigens
Recurrence

Keywords

  • Epithelioid angiosarcoma
  • Epithelioid hemangioendothelioma
  • Histiocytoid hemangioma
  • Vascular tumors of low-grade malignancy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Bakotic, B. W., Robinson, M., Williams, M., Van Woy, T., Nutter, J., & Borkowski, P. (1999). Aggressive epithelioid hemangioendothelioma of the lower extremity: A case report and review of the literature. Journal of Foot and Ankle Surgery, 38(5), 352-358.

Aggressive epithelioid hemangioendothelioma of the lower extremity : A case report and review of the literature. / Bakotic, Bradley W.; Robinson, Morton; Williams, Marie; Van Woy, Teresa; Nutter, Jean; Borkowski, Piotr.

In: Journal of Foot and Ankle Surgery, Vol. 38, No. 5, 01.09.1999, p. 352-358.

Research output: Contribution to journalArticle

Bakotic, BW, Robinson, M, Williams, M, Van Woy, T, Nutter, J & Borkowski, P 1999, 'Aggressive epithelioid hemangioendothelioma of the lower extremity: A case report and review of the literature', Journal of Foot and Ankle Surgery, vol. 38, no. 5, pp. 352-358.
Bakotic BW, Robinson M, Williams M, Van Woy T, Nutter J, Borkowski P. Aggressive epithelioid hemangioendothelioma of the lower extremity: A case report and review of the literature. Journal of Foot and Ankle Surgery. 1999 Sep 1;38(5):352-358.
Bakotic, Bradley W. ; Robinson, Morton ; Williams, Marie ; Van Woy, Teresa ; Nutter, Jean ; Borkowski, Piotr. / Aggressive epithelioid hemangioendothelioma of the lower extremity : A case report and review of the literature. In: Journal of Foot and Ankle Surgery. 1999 ; Vol. 38, No. 5. pp. 352-358.
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