Epithelioid hemangioendothelioma as a rare cause of blue toe syndrome

• Published in: Journal of vascular surgery Vol. 54; no. 3; pp. 854 - 856
• Main Authors: Heldenberg, Eitan, Rabin, Igor, Cheyn, David, Lorber, Jonathan, Elkabetz, Erez, Sandbank, Judith, Bass, Arie
• Format: Journal Article
• Language: English
• Published: United States 01-09-2011
• Subjects: Adult; Blue Toe Syndrome - diagnosis; Blue Toe Syndrome - etiology; Blue Toe Syndrome - surgery; Female; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - surgery; Hemangioendothelioma, Epithelioid - complications; Hemangioendothelioma, Epithelioid - pathology; Hemangioendothelioma, Epithelioid - surgery; Humans; Popliteal Artery - pathology; Popliteal Artery - surgery; Reoperation; Saphenous Vein - transplantation; Thrombosis - diagnosis; Thrombosis - etiology; Thrombosis - surgery; Tomography, X-Ray Computed; Treatment Outcome; Vascular Grafting - adverse effects; Vascular Neoplasms - complications; Vascular Neoplasms - pathology; Vascular Neoplasms - surgery
• ISSN: 1097-6809
• DOI: 10.1016/j.jvs.2011.02.034

Blue toe syndrome (BTS), is a well-known entity of toe gangrene and rest pain secondary to micro emboli lodged within the digital arteries. BTS among young patients should alert physicians to look for causes such as trauma, connective tissue disease, hypercoagulability state, and others. We hereby describe a 32-year-old female with right BTS. A mass obstructing 80% of the right popliteal artery lumen was the source of emboli. The histologic results of the replaced arterial segment revealed a thrombus on top of epithelioid hemangioendothelioma. This is the first description of the association between primary vascular tumor and BTS.