Epithelioid Hemangioma of Bone: A Potentially Metastasizing Tumor?

• Published in: International journal of surgical pathology Vol. 14; no. 1; pp. 9 - 15
• Main Authors: Floris, Giuseppe, Deraedt, Karen, Samson, Ignace, Brys, Peter, Sciot, Raf
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01-01-2006
• Subjects: Adolescent; Angiolymphoid Hyperplasia with Eosinophilia - diagnosis; Angiolymphoid Hyperplasia with Eosinophilia - pathology; Antigens, CD34 - analysis; Bone Diseases - diagnosis; Bone Diseases - pathology; Diagnosis, Differential; Groin; Hemangioendothelioma, Epithelioid - diagnosis; Hemangioendothelioma, Epithelioid - pathology; Hemangioendothelioma, Epithelioid - secondary; Humans; Immunohistochemistry; Keratins - analysis; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Platelet Endothelial Cell Adhesion Molecule-1 - analysis; Radiography; Toe Phalanges - diagnostic imaging; Toe Phalanges - pathology; epithelioid hemangioma; angiolymphoid hyperplasia with eosinophilia; histiocytoid hemangioma; metastasis
• ISSN: 1066-8969; 1940-2465
• DOI: 10.1177/106689690601400102

The case of a 15-year-old boy with a severe swelling of the 2nd toe in the left foot and a large swelling of the left inguinofemoral region is described. Histologic examination of the foot lesion showed a typical epithelioid hemangioma of bone that extended into the soft tissues, with a secondary location in the groin, suggestive of lymph node involvement. Subsequently, imaging also revealed swelling of iliac and para-aortic lymph nodes, which probably indicates further lymph node spread.. Besides the fact that epithelioid hemangioma of the toe has not been reported yet, our case showed a noncontinuous localization, most likely in draining lymph nodes. This finding suggests metastatic disease, an event that is extremely rare for epithelioid hemangioma. As such, epithelioid hemangioma might be comparable to another benign vascular tumor, the retiform hemangioendothelioma, which occasionally metastasizes to the lymph nodes without systemic spread.