Multiple cutaneous epithelioid hemangioendothelioma: a case with spindle cells

Epithelioid hemangioendothelioma in a child

Epithelioid hemangioendothelioma (EHE) is a rare tumour arising from the vascular endothelium of soft-tissue, bone and viscera. Skin involvement is rare. The disease has an indolent course, with the potential for recurrence and often associated with multi-systemic localisations. We present a rare case of cutaneous EHE without systemic involvement in 9-year-old boy. The tumour was completely excised and histopathologic diagnosis was consistent with EHE. Complete systemic assessment showed no internal localisation. Wide excision is the mainstay of therapy and regular follow-up is suggested due to the potential for recurrence. The majority of documented cases of EHE is in adults and has developed in association with an underlying systemic involvement. To the best of our knowledge, this is the second reported case of isolated cutaneous EHE in paediatric age group.

Cutaneous vascular tumours: an update

This review evaluates changes in vascular nomenclature particularly in the category of vascular tumours of intermediate malignancy that includes the various haemangioendotheliomas, Kaposi's sarcoma and giant cell angioblastoma. Recently described entities in this category, including the latter tumour and composite haemangioendothelioma, are described. Several newly characterized vascular tumours not included in recent classifications of vascular tumours are also summarized. These include acquired elastotic haemangioma, symplastic haemangioma, cutaneous epithelioid angiomatous nodule and cutaneovisceral angiomatosis with thrombocytopenia. The newly introduced clinical classification of congenital haemangiomas into non-involuting and rapidly involuting variants and radiation-induced atypical vascular lesions are also reviewed.

Cutaneous epithelioid hemangioendothelioma

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor of endothelial cell origin. We describe an EHE arising on the plantar surface of the foot that was treated as verruca vulgaris for several years before a biopsy showed EHE. We discuss the clinical and histopathologic differential diagnoses for these tumors and review additional cases in which EHE has been mistaken for benign entities clinically.