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Liu A, Bauer JS, Lin CC, Appelboom G, Zanazzi G. Dural composite hemangioendothelioma: The first intracranial case. Surg Neurol Int 2024; 15:55. [PMID: 38468685 PMCID: PMC10927221 DOI: 10.25259/sni_3_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 03/13/2024] Open
Abstract
Background Composite hemangioendothelioma (CHE) is a rare, locally aggressive neoplasm of intermediate malignant potential. It is composed of a mixture of vascular tumors with a predilection for the dermis and subcutis of the extremities. Case Description In this report, we describe a 41-year-old man who presented with a 2-month history of headache, dizziness, and intermittent seizures. Magnetic resonance imaging showed a hemorrhagic, multilobulated, and dural-based mass with extension into the calvarium. The mass measured 10.3 × 4.8 × 4 cm along the interhemispheric fissure and encased the superior sagittal sinus. Excision was performed, and histopathologic examination revealed a heterogeneous mixture of vascular components consisting of epithelioid hemangioendothelioma, retiform hemangioendothelioma, and hemangioma. This is the first report of a primary intracranial CHE. Conclusion The spectrum of mesenchymal neoplasms within the cranium expands to encompass CHE.
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Affiliation(s)
- Alice Liu
- Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, USA
| | - Joshua S. Bauer
- Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - Chun-Chieh Lin
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, USA
- Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, USA
| | - Geoff Appelboom
- Department of Neurosurgery, New York University Langone Health, New York, USA
| | - George Zanazzi
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, USA
- Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, USA
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Spinelli C, Ghionzoli M, Strambi S. Primary peritoneal hemangioendothelioma simulating an ovarian cyst: A case report and review of literature. World J Obstet Gynecol 2022; 11:40-46. [DOI: 10.5317/wjog.v11.i4.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/05/2022] [Accepted: 11/23/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Epithelioid hemangioendothelioma (EHE) is an extremely rare tumor with a prevalence of one in a million and a very heterogenous spectrum of disease that varies from an indolent to a metastasizing aggressive disease, with the liver, lung and bone being the primarily involved organs. Peritoneal forms of EHE are even rare, and only 12 cases have been reported to date in the literature.
CASE SUMMARY A 66-year-old female came to our attention complaining low abdominal and perineal pain. Magnetic resonance imaging examination showed a 52 mm × 58 mm × 32 mm cystic mass with some smooth septa, simulating an ovarian cyst. Explorative laparoscopy demonstrated the presence of a peritoneal mass of augmented consistency connected with a sigmoid epiploic appendix in the right side of the Pouch of Douglas, that was surgically removed. Histological exa-mination revealed a primitive peritoneafl hemangioendothelioma. The patient easily recovered from surgery with no residual pain or discomfort. She is regularly attending a 3-years follow-up that is negative for local recurrence of disease or distant metastases.
CONCLUSION Peritoneal form of EHE often simulates masses of other nature, as in our case. Given its unspecific clinical and radiological presentation, patients are often forced to a large series of tests and examinations before reaching a definitive diagnosis, that can only histologically made. The possibility of EHE should always be considered in case of unexplained chronic abdominal pain associated to a non-specific mass.
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Affiliation(s)
- Claudio Spinelli
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
| | - Marco Ghionzoli
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
| | - Silvia Strambi
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
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Muacevic A, Adler JR, Villanueva-Solórzano PL, Degollado-García J, Cano-Velázquez G, Tena-Suck ML, Ramos-Peek MA. Surgical Approach and Further Management of Intracranial Hemangioendothelioma With Double Location: A Case Report. Cureus 2022; 14:e32072. [PMID: 36600818 PMCID: PMC9803365 DOI: 10.7759/cureus.32072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Hemangioendotheliomas are highly vascularized lesions, and their intracranial presentation is extremely rare. We present the case of a 65-year-old female patient who was evaluated for cranial deformity, headache, and left hemiplegia. Two bone lesions that were destroying and expanding the bone diploe with intracranial extension were identified in the fronto-temporal and parietal regions. Both lesions were multilobed and showed heterogeneous behavior. Mixed hemangioendotheliomas were identified after the successful resection of both tumors in two separate surgical procedures. The prognosis of this type of tumor with an intracranial location is not well-defined because there are too few reported cases.
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A Review of the Spectrum of Imaging Manifestations of Epithelioid Hemangioendothelioma. AJR Am J Roentgenol 2020; 215:1290-1298. [PMID: 32841059 DOI: 10.2214/ajr.20.22876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE. The purpose of this article is to review the spectrum of imaging manifestations of epithelioid hemangioendothelioma across different organ systems and briefly describe its current treatment strategies. CONCLUSION. Epithelioid hemangioendothelioma is a rare, locally invasive neoplasm with metastatic potential. Although most commonly occurring in liver, lungs, and bones, it can also present at multiple other sites. Because of its nonspecific clinical and imaging manifestations, it is often misdiagnosed. The possibility of epithelioid hemangioendothelioma must be considered in the presence of a slowly growing mass that invades adjacent structures. Imaging can help plan percutaneous biopsy, detect sites of disease, and identify poor prognostic factors.
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Süß P, Volz F, Lang C, Staszewksi O, Palmedo G, Taschner CA, Scheiwe C, Kurz P, Mentzel T, Prinz M. A Case of Large Meningeal Epithelioid Hemangioendothelioma With WWTR1–CAMTA1 Gene Rearrangement and Slow Growth Over 15 Years. J Neuropathol Exp Neurol 2018; 77:871-876. [DOI: 10.1093/jnen/nly066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Patrick Süß
- Institute of Neuropathology, Faculty of Medicine
| | - Florian Volz
- Department of Neurosurgery, University Medical Center
| | - Christine Lang
- Department of Neuroradiology, University Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | - Christian A Taschner
- Department of Neuroradiology, University Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Philipp Kurz
- Comprehensive Cancer Center Freiburg, Freiburg, Germany
- Department of Pathology, Faculty of Medicine
| | - Thomas Mentzel
- Dermatopathologie Friedrichshafen, Friedrichshafen, Germany
| | - Marco Prinz
- Institute of Neuropathology, Faculty of Medicine
- BIOSS Center for Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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6
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Freiburg Neuropathology Case Conference : A Painless Mass Lesion of the Parietal and Occipital Bones. Clin Neuroradiol 2018; 28:301-306. [PMID: 29696306 DOI: 10.1007/s00062-018-0691-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Barger J, Tanweer O, Liechty B, Snuderl M, Jafar JJ. Suprasellar epithelioid hemangioendothelioma: Case report and review of the literature. Surg Neurol Int 2016; 7:S596-602. [PMID: 27656318 PMCID: PMC5025957 DOI: 10.4103/2152-7806.189729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Epithelioid hemangioendothelioma (EHE) is a rare sarcoma of vascular origin, which is clinically and histologically intermediate between benign hemangioma and angiosarcoma. It is most commonly found in the liver, lung, and bone, however, 46 intracranial cases have been reported in the literature, of which this is the fifth reported suprasellar tumor. CASE DESCRIPTION A 45-year-old woman developed progressive lethargy, somnolence, and memory decline over the course of 6 months. On computed tomography (CT), she was found to have a large hypothalamic mass and underwent subtotal resection via a bifrontal craniotomy. CONCLUSIONS While primary intracranial EHE is an uncommon presentation of a rare tumor, the suprasellar region does not seem to be an unusual location when it does occur. Prognosis is generally good, and may be better for primary intracranial disease than that for EHE originating elsewhere. Surgery is the first line of therapy, with variable benefit from adjuvant chemotherapy or radiation when total resection is not possible. Chemotherapeutic approaches in current use are directed at preventing endothelial proliferation.
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Affiliation(s)
- James Barger
- Department of Neurosurgery, New York University School of Medicine, New York, USA
| | - Omar Tanweer
- Department of Neurosurgery, New York University School of Medicine, New York, USA
| | - Benjamin Liechty
- Department of Pathology, New York University School of Medicine, New York, USA
| | - Matija Snuderl
- Department of Pathology, New York University School of Medicine, New York, USA
| | - Jafar J Jafar
- Department of Neurosurgery, New York University School of Medicine, New York, USA
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Tian WZ, Yu XR, Wang WW, Zhang BO, Xia JG, Liu HQ. Computed tomography and magnetic resonance features of intracranial hemangioendothelioma: A study of 7 cases. Oncol Lett 2016; 11:3105-3110. [PMID: 27123072 DOI: 10.3892/ol.2016.4356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/04/2016] [Indexed: 12/11/2022] Open
Abstract
The current study aimed to present the neuroradiological and histopathological features of intracranial hemangioendothelioma (HE). The computed tomography (CT; n=3) and magnetic resonance imaging (MRI; n=7) features, and the clinical presentations of 7 patients with pathologically documented HEs were retrospectively analyzed. Lesions were observed in the right side of the skull (the frontal bone in 1 patient and the parietal bone in 1 patient), the tentorium (2 patients), the cerebral falx (1 patient), the right cavernous sinus (1 patient) and the right temporal lobe (1 patient). The tumor was lobulated in 5 cases and round in 2 cases. The majority of tumors appeared isointense or hypointense with multiple scattered hyperintensities on T1-weighted MRI. Moreover, the lesions appeared as inhomogeneous hyperintense regions with multiple enlarged and tortuous blood flow voids on T2-weighted MRI. The lesions also showed marked gadolinium enhancement in a honeycomb pattern. CT scan results showed a isoattenuation region (32-47 HU), with numerous small, round, high-density foci. The 2 cases with skull lesions presented with local bone destruction and discontinuous bone lines of the tabula interna ossis cranii. In 1 case, MR angiography revealed abnormal vessels in the basilar region. A total of 4 cases were epithelial HE, 2 were retiform HE and 1 was kaposiform HE. Histological examination revealed endothelial cell proliferation with vascular lesions and a mucous matrix or dense fibrous mesenchyme. In conclusion, intracranial HE is rare, but should be considered in the differential diagnosis when evaluating intracranial neoplasms. A well-defined lobulated mass and imaging features that include internal heterogeneity, small scattered hemorrhages and thromboses, signal voids of vessels, and marked and delayed enhancement may confirm the diagnosis of HE.
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Affiliation(s)
- Wei-Zhong Tian
- Department of Radiology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Xiang-Rong Yu
- Department of Radiology, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong 519000, P.R. China
| | - Wei-Wei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - B O Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Jian-Guo Xia
- Department of Radiology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Han-Qiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China; Department of Radiology, Huashan Hospital Baoshan Branch, Fudan University, Shanghai 200431, P.R. China
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Tsuchiya T, Oya S, Mori H, Matsui T. Multiple hemorrhagic intraparenchymal tumors presenting with fatal intracranial hypertension: A rare manifestation of systemic epithelioid hemangioendothelioma. Surg Neurol Int 2015; 6:156. [PMID: 26539307 PMCID: PMC4604639 DOI: 10.4103/2152-7806.166799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epithelioid hemangioendotheliomas (EHE) is an extremely rare tumor that can arise not only intracranially but also systemically. Its radiological characteristics and the mechanism underlying the multiple organ involvement in EHE are poorly understood. CASE DESCRIPTION A 24-year-old woman with a 7-month history of coughing and blood-stained sputum complained of visual disturbance in the right eye that had persisted for 1-month. Magnetic resonance (MR) imaging revealed multiple intraparenchymal masses with low-intensity on MR susceptibility-weighted images with minimal enhancement with gadolinium. Systemic computed tomography revealed multiple nodules in both lungs and the liver. Because her neurological status rapidly deteriorated, brain biopsy of the right frontal mass was performed. The pathological diagnosis was EHE. Over the following 3 months, the patient gradually developed disturbance of consciousness. She died at 4 months after admission because of significant intracranial hypertension. CONCLUSION Although intracranial EHEs are extremely rare, they should be included in the differential diagnoses of multiple small-sized masses with low-intensity on MR susceptibility-weighted images. We also emphasize that the systemic involvement of this tumor was more compatible with multicentric development than metastasis.
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Affiliation(s)
- Tsukasa Tsuchiya
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Soichi Oya
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Toru Matsui
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Epithelioid hemangioendothelioma of the mastoid: resection for recurrence and adjuvant radiation with 8-year followup. Case Rep Surg 2013; 2013:469201. [PMID: 23424708 PMCID: PMC3568894 DOI: 10.1155/2013/469201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 12/05/2012] [Indexed: 12/11/2022] Open
Abstract
Epithelioid hemangioendothelioma (EH) is a rare, vascular neoplasm that can affect any age group and has been reported previously in sites including bone, liver, lung, breast, and brain. We describe a case of EH located in the mastoid, which appears to be the first report of EH in this site. The patient was 62 years old when they presented with dizziness and nausea. A suboccipital surgical approach was utilized to resect the tumor. After 18-month followup, the patient was symptom-free; however, imaging demonstrated a recurrence and the patient was taken back to the operating room for a resection. There is no evidence of recurrence after 8 years of followup. This paper aims to reinforce the need for a timely radical excision and aggressive clinical followup as the best hope for cure. Here, we describe an illustrative case and review the pertinent literature.
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Rocha Oliveira PC, Alcantara FP, Souza-Vianna PED, Brito APD. Cerebral epithelioid hemangioendothelioma with thoracic simultaneous involvement: advanced MRI features. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:637-8. [PMID: 22899038 DOI: 10.1590/s0004-282x2012000800015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zheng J, Liu L, Wang J, Wang S, Cao Y, Zhao J. Primary intracranial epithelioid hemangioendothelioma: a low-proliferation tumor exhibiting clinically malignant behavior. J Neurooncol 2012; 110:119-27. [PMID: 22886511 DOI: 10.1007/s11060-012-0945-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 07/16/2012] [Indexed: 12/21/2022]
Abstract
Epithelioid hemangioendothelioma is an extremely rare intracranial tumor and is regarded as a low-proliferation tumor. We present two cases of primary intracranial epithelioid hemangioendothelioma and give an overview of the English literature pertaining to this disease. We described two new cases of primary intracranial epithelioid hemangioendothelioma and performed a search of MEDLINE (PubMed) using the words "epithelioid hemangioendothelioma". Only cases in the English language that were intracranially located and contained clinical information pertinent to the analysis were included. The tumor in case 1 originated from the right temporal bone and invaded the surrounding cranium, dura and temple muscles. The tumor in case 2 was located in the petroclival bone and had also invaded the surrounding cranium. Both tumors were well vascularized. The tumors were totally (case 1) or subtotally (case 2) removed with moderate blood loss. A total of 36 cases of intracranial epithelioid hemangioendothelioma were found in the literature. The tumor was typically diagnosed in young adults and infants. There was no sex predominance in adult patients, while in children, males were more frequently affected (M/F ratio, 3.5:1). Surgical removal was the main therapeutic protocol, and adjuvant therapy included radiotherapy or chemotherapy. Including the 2 patients presented here, a total of 38 patients were analyzed: 32 % showed local invasion, 24 % suffered a recurrence, 15 % had metastases, and the mortality rate was 15 %. Intracranial epithelioid hemangioendothelioma is a rare, low-proliferation tumor, but it exhibits some clinically malignant behaviors, such as local invasion, recurrence and metastasis. Total resection is mandatory where possible, and radiotherapy and/or chemotherapy are otherwise required. Preoperative feeding-artery embolization is recommended.
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Affiliation(s)
- Jian Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Chongwen District, Beijing, 100050, China.
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El Demellawy D, Nasr A, Alowami S. Epithelioid hemangioendothelioma of the temporal artery presenting as temporal arteritis: case report and literature review. Rare Tumors 2009; 1:e20. [PMID: 21139892 PMCID: PMC2994445 DOI: 10.4081/rt.2009.e20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 07/14/2009] [Indexed: 11/22/2022] Open
Affiliation(s)
- Dina El Demellawy
- University of Northern Ontario School of Medicine, Thunder Bay, William Osler Health Care-Brampton Civic Hospital, Department of Pathology and Laboratory Medicine, Brampton, Ontario, Canada
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Parajón A, Vaquero J. Meningel intracranial epithelioid hemangioendothelioma: case report and literature review. J Neurooncol 2008; 88:169-73. [PMID: 18278439 DOI: 10.1007/s11060-008-9543-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Accepted: 02/04/2008] [Indexed: 11/30/2022]
Abstract
Intracranial epithelioid hemangioendothelioma (EH) is a very rare vascular neoplasm. We describe a case of meningeal intracranial tumor in a 58 year old man, located in the greater wing of the sphenoid bone. The tumor was completely excised via pterional approach and the pahological analysis showed a hemorrhagic lesion with capillary-sized vessels lined by atypical-appearing endothelial cells that expressed CD31, CD34 and Factor VIII antigens. A diagnosis of EH was established, and one year after surgery the patient is symptom-free, without tumor recurrence or residual tumor. A review of the literature disclosed other 34 cases of intracranial EH. In these tumors, total resection is mandatory if possible, otherwise radiotherapy is recommended. Outcome is favorable in the majority of cases.
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Affiliation(s)
- Avelino Parajón
- Department of Neurosurgery, Puerta de Hierro Hospital, Autonomous University, San Martín de Porres, Madrid, Spain
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Mohan S M, Symss NP, Pande A, Chakravarthy VM, Ramamurthi R. Intracranial epithelioid hemangioendothelioma. Childs Nerv Syst 2008; 24:863-8. [PMID: 18478237 DOI: 10.1007/s00381-008-0634-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2007] [Revised: 02/22/2008] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Epithelioid hemangioendothelioma (EHE) is an uncommon soft-tissue vascular neoplasm. Although a well-defined entity outside the neuraxis, its intracranial occurrence is rare. Literature review revealed 35 reported cases till date. CASE REPORT The authors report a case of intracranial EHE in a 15-year-old girl, who presented with a short history and unusual radiology. Following radical removal, the lesion recurred within 1 month and progressed to terminal stages. This tumor is thought to have an indolent intermediate malignancy potential and such rapid progression has not been reported so far.
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Affiliation(s)
- Murali Mohan S
- Post Graduate Institute of Neurological Surgery, ALNC, VHS Hospital, Taramani, Chennai, 600 113, India.
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Posligua L, Anatelli F, Dehner LP, Pfeifer JD. Primary peritoneal epithelioid hemangioendothelioma. Int J Surg Pathol 2006; 14:257-67. [PMID: 16959716 DOI: 10.1177/1066896906290682] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epithelioid hemangioendothelioma is an uncommon malignant vascular tumor of intermediate grade that occurs in a variety of organs and soft tissues. Diagnosis of epithelioid hemangioendothelioma is often complicated by the rarity of the tumor, and because the tumor shares many morphologic features with other peritoneal neoplasms. This report presents 3 cases of epithelioid hemangioendotheliomas arising as primary tumors of the peritoneum and reviews 7 previously reported cases to establish the demographic, clinical, morphologic, immunohistochemical, and ultrastructural features of this neoplasm. These cases demonstrate that the light microscopic features are very similar to epithelioid hemangioendothelioma arising at more conventional sites, such as the liver, that immunohistochemical analysis provides a reliable approach for confirming or establishing the diagnosis, and that at least one endothelial marker (either CD31, CD34, or factor VIII) should be positive for a definitive diagnosis. This series identifies the characteristics of peritoneal epithelioid hemangioendothelioma that can be reliably used for diagnosis.
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Affiliation(s)
- Lorena Posligua
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital, Washington University Medical Center, St. Louis, Missouri, USA
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Baehring JM, Dickey PS, Bannykh SI. Epithelioid hemangioendothelioma of the suprasellar area: a case report and review of the literature. Arch Pathol Lab Med 2005; 128:1289-93. [PMID: 15504067 DOI: 10.5858/2004-128-1289-ehotsa] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intra-axial involvement of the brain by an epithelioid hemangioendothelioma is rare, and biological properties of the tumor are uncertain. Most of the primary brain manifestations are confined to the cerebral hemispheres. We report magnetic resonance imaging and microscopic findings of a case of suprasellar involvement by an epithelioid hemangioendothelioma. The tumor was treated with a subtotal resection only, and no progression of the disease was noted during a 6-month follow-up. Review of the literature suggested that most epithelioid hemangioendotheliomas in the brain are unifocal tumors with a rather favorable clinical outcome.
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Affiliation(s)
- Joachim M Baehring
- Department of Neurology, Yale University School of Medicine, New Haven, Conn 06510, USA
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