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This article discusses a case of pseudomyogenic hemangioendothelioma (PHE), a type of vascular tumor, with a specific gene fusion called EGFL7:FOSB. The first case of PHE with this fusion showed widespread metastasis, while the second case presented with a more typical clinical presentation without evidence of distant tumors or metastasis. The article explores the variations in PHE, including tumor size, location, and involvement of different tissues. The authors also discuss the potential role of the EGFL7:FOSB fusion and other genomic alterations in the clinical outcome of PHE, including distant metastasis. [Extracted from the article]