Elsevier

Journal of Orthopaedics

Volume 11, Issue 4, December 2014, Pages 197-199
Journal of Orthopaedics

Case Report
Pseudomyogenic (Epithelioid sarcoma-like) hemangioendothelioma with bone invasion

https://doi.org/10.1016/j.jor.2014.06.019Get rights and content

Abstract

Aim

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare local aggressive vascular tumor. Herein we present a 54-year-old male patient with a tumor on his index finger.

Case

The patient presented with a 1-year history of pain and swelling that progressively exacerbated. Bone invasion was observed on the middle phalanx via direct radiography. Histopathological examination findings were compatible with epithelioid sarcoma-like hemangioendothelioma.

Conclusion

To the best of our knowledge is the first case report of epithelioid sarcoma-like hemangioendothelioma with bone invasion.

Introduction

Epithelioid sarcoma-like hemangioendothelioma (ES-H) is a rare vascular tumor with a low degree of aggressiveness.1 It often originates in the peripheric vessels.2 Clinically, it imitates epithelioid sarcoma,3 and can be differentiated from epithelioid sarcoma on the basis of immunohistological and histochemical differences.4 ES-H can exhibit local aggressive behavior, but has never been observed to metastasize.1 ES-H is not specific to any particular location and can develop in any soft tissue of the body5; however, bone invasion is an extraordinary situation that might necessitate aggressive surgical treatment.

Section snippets

Case report

A 54-year-old male presented to Izmir Dokuz Eylul University, Orthopedics and Traumatology Department with a 1-year history of a painful mass on the right index finger that progressively increased in size. On physical examination an immobile lesion with irregular borders was observed on the volar surface of the proximal and middle phalanges of the right index finger. The lesion was painful upon palpation and hypoesthesia was noted on the ulnar side. Direct radiography showed the soft tissue

Discussion

ES-H is a low degree vascular tumor similar to epithelioid sarcoma in terms of clinical and histopathological characteristics6; however, it is not associated with distant metastasis and can be differentiated from epithelioid sarcoma based on some immunohistochemical indicators.6, 7, 8 The differential diagnosis has, together with epithelioid sarcoma, hemangioendothelioma, as well.7, 8 Although CD31 positivity is focal, due to positivity of other determinants the tumor is thought to be

Conflicts of interest

All authors have none to declare.

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