TY - JOUR
T1 - Aggressive epithelioid hemangioendothelioma of the lower extremity
T2 - A case report and review of the literature
AU - Bakotic, Bradley W.
AU - Robinson, Morton
AU - Williams, Marie
AU - Van Woy, Teresa
AU - Nutter, Jean
AU - Borkowski, Piotr
PY - 1999/1/1
Y1 - 1999/1/1
N2 - 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.
AB - 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.
KW - Epithelioid angiosarcoma
KW - Epithelioid hemangioendothelioma
KW - Histiocytoid hemangioma
KW - Vascular tumors of low-grade malignancy
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U2 - 10.1016/S1067-2516(99)80007-6
DO - 10.1016/S1067-2516(99)80007-6
M3 - Article
C2 - 10553549
AN - SCOPUS:0032695221
VL - 38
SP - 352
EP - 358
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
SN - 1067-2516
IS - 5
ER -