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Epithelioid hemangioma of bone is a rare benign vascular tumor. Because of the locally destructive clinical presentation and the presence of atypical histologic features with increased mitotic activity and necrosis, it is often misdiagnosed as low-grade malignant epithelioid hemangioendothelioma or high-grade malignant epithelioid angiosarcoma. Correct diagnosis through imaging studies and histopathological examination is mandatory to determine the appropriate course of treatment, as the prognosis differs from that of other malignant hemangioma tumors. A 69-year-old male who presented with intractable shoulder pain caused by epithelioid hemangioma in the acromion of the scapula was treated with tumor curettage. This paper reports a good result with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH.

Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH. [ABSTRACT FROM AUTHOR]

Simple Summary: Epithelioid vascular tumors are rare bone vascular lesions with a spectrum of overlapping cancer entities with varying degrees of malignant potential that remain controversial because of their rarity, unusual morphologic features, and unpredictable biologic behavior. The classification of vascular tumors of bone proposed by the World Health Organization in 2020 incorporated morphologic findings with available genetic evidence, including mainly angiosarcoma, epithelioid hemangioma, pseudomyogenic hemangioendothelioma, and epithelioid hemangioendothelioma. Here, we report our experience with eleven patients suffering from epithelioid hemangioma (EH) of the spine. As very few cases of EH of the spine have been reported in the literature, the evidence-based decision-making process for these patients can be very difficult. Thus, we propose a treatment flowchart based on our single center's experience. Epithelioid hemangioma is recognized by the World Health Organization as a distinct benign neoplasm; however, it is characterized by locally aggressive and rarely metastasizing behavior. Epithelioid vascular tumors are rare bony vascular lesions with varying degrees of malignant potential that remain controversial because of their rarity, unusual morphological features, and unpredictable biological behavior. The application of new molecular tools, such as massive parallel sequencing technologies, have provided new diagnostic markers and an opportunity to further refine the classification of bone vascular neoplasms. Very few cases of EH of the spine have been reported in the literature; therefore, it is difficult to make evidence-based therapeutic decisions for these patients. We report herein our experience with eleven patients suffering from EH of the spine. The study population included three males and eight females treated in our center from 2016 to the present; the average age was 44.8 years (range 14–75 years). The surgical, clinical, and radiographic data were retrospectively analyzed. The mean follow-up was 34.8 months. All patients presented lytic vertebral body lesions, six of them with pathological fracture. The majority of patients (80%) presented myelo-radicular compression. All patients were surgically treated, and preoperative embolization was performed in all cases. In light of the literature review and the clinical experience of our center, we can consider EH a locally aggressive tumor that requires surgical treatment in case of symptoms. Here, we propose a treatment algorithm that could be useful in the management of patients with this rare disease. [ABSTRACT FROM AUTHOR]

Introduction: Epithelioid hemangioma (EH) is an intermediate locally aggressive tumor that consists of epithelioid cells and endothelial cell differentiation, which can occur at any age, but is most common between the ages of 30 and 40 years. EH in the thoracic spine is rare, and accurate diagnosis is critical to treatment planning. Our aim was to explore the imaging and clinical data of thoracic spine EH to improve the understanding of this rare disease. Methods: From January 1, 2018 to June 30, 2023, a database of thoracic spine masses was retrospectively reviewed. Five patients with histologically proven thoracic spine EH and complete imaging available were identified and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) findings were evaluated separately by two radiologists with more than 10 years of experience. Positron emission tomography (PET)/CT was conducted by two nuclear medicine diagnostic technologists with at least 5 years of experience. Results: The patients included three male and two female patients aged 23 to 56 years (mean age was 38.4 ± 14.3 years). All patients underwent CT, MRI, and 18FFDG PET/CT examination before treatment. Four patients were limited to one vertebral involvement, only one patient had multiple vertebral involvement, and all tumors involved the accessories, including one involving the posterior ribs. The maximum diameter of the tumor ranged from 2.7 to 4.3. Conclusions: CT, MRI, and 18F-FDG PET/CT findings of thoracic spine EH have certain characteristics, and understanding these imaging findings will help to obtain accurate diagnosis before surgery. [ABSTRACT FROM AUTHOR]

This article, published in the journal Pediatric Dermatology, presents a case study of an 8-year-old boy with a raised lesion on his scalp. The lesion rapidly grew in size over three months and was characterized by an erythematous to yellowish-white, dome-shaped exophytic nodule. The diagnosis was determined to be angiolymphoid hyperplasia with eosinophilia (ALHE) based on histopathological examination. ALHE is a rare vasoproliferative disorder with an unclear etiology, and treatment options include corticosteroids, surgery, cryotherapy, and lasers. The patient in this case study did not experience recurrence after surgical excision. [Extracted from the article]

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign, reactive vaso-proliferative condition in the dermal and subcutaneous tissues of the head and neck. A 28-year-old female presented with slow-growing painless swelling behind her left ear. FNAC revealed benign soft tissue neoplasm and histopathological examination after surgical excision revealed angiolymphoid hyperplasia with eosinophilia. ALHE origin has been variously attributed to prior trauma, hyperestrogenemia, infectious agents, atopy, reactive hyperplasia, and benign neoplasia. Retroauricular ALHE has been rarely reported. However, on the basis of our case report, it should be a viable differential diagnosis when large subcutaneous tumors of the head and neck are encountered. When big subcutaneous tumors of the head and neck are present, especially in females, a valid differential diagnosis for angiolymphoid hyperplasia with eosinophilia, a rare condition marked by dermal or subcutaneous endothelial cell proliferation, should also be considered. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma is an uncommon benign vascular lesion which most commonly appears as a nodular lesion in the head and neck area. Here, we present a rare case of nodular swelling in the dorsal aspect of the tongue in a 30 year old male for the past 3 months. Excision of growth was done and histopathological examination revealed epithelioid hemangioma of the tongue. Patient is on regular follow up and there is no evidence of recurrence. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma of bone is a rare benign, locally aggressive vascular tumor that can be particularly challenging to diagnose given its frequent multifocality, non-specific imaging findings, and wide range of morphologic appearances. Additionally, some epithelioid hemangiomas demonstrate atypical histologic features including increased cellularity, necrosis, and moderate cytologic atypia – characteristics that may raise concern for malignancy. Molecular studies can serve as a powerful, objective tool in the differential diagnosis of diagnostically challenging epithelioid vascular tumors. Importantly, FOS and FOSB gene rearrangements have been identified as the genetic hallmarks of osseous epithelioid hemangioma, present in greater than 70% of cases. FOSB -fusion-positive epithelioid hemangioma, in particular, may display atypical histologic features. While ZFP36 is the typical FOSB fusion partner in epithelioid hemangioma, we herein present a case of epithelioid hemangioma of bone with a rare WWTR1::FOSB fusion. This case demonstrates the diagnostic challenges associated with epithelioid hemangioma, especially in the setting of FOSB gene rearrangements, and the importance of genomic studies in the work up of these vascular tumors. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vascular lesion presenting as multiple nodules on the head and neck. Surgery had been considered to be the best treatment modality for ALHE. We report the case of a 6-month-old boy with ALHE on his tongue that was treated successfully with oral prednisolone.

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Introduction. Epithelioid hemangioma is a benign vascular neoplasm associated with FOS and/or FOSB protein overexpression detected by immunohistochemistry (IHC). Methods. The aim of our study was to determine the co-expression or independent IHC expression of FOS and FOSB in a cohort of epithelioid hemangiomas. We also included two cohorts of other vascular lesions: papillary endothelial hyperplasia and lobular capillary hemangioma / pyogenic granuloma. Results. We identified 50 cases of epithelioid hemangioma, 84% of which were cutaneous and the remaining involved other anatomic locations. Over two thirds of all cases expressed FOSB (68%; 34/50) while FOS immunoreactivity was identified in 46% of all cases. Co-expression of FOSB and FOS occurred in 37% of cases while 76% of all cases stained for at least one of the antibodies. Fifty-eight percent (n = 14/24) and 33% (8/24) of all cases of papillary endothelial hyperplasia expressed FOS and FOSB, respectively. Thirty-two per cent of lobular capillary hemangiomas (n = 8/25) were positive for either FOS or FOSB. Conclusion. In summary, we present the largest cohort of epithelioid hemangiomas assessed with both FOS and FOSB and demonstrated that the use of both antibodies increases the detection rate of these proliferations by 10%. Nonetheless, the use of thresholds may not be appropriate, as only a subset of lesional endothelial cells label with FOS/FOSB. Over half of all cases of papillary endothelial hyperplasia and a third of lobular capillary hemangiomas also displayed immunoreactivity with FOS and/or FOSB. [ABSTRACT FROM AUTHOR]

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign proliferation of blood vessels of uncertain etiology. It primarily affects the head-and-neck region. Histologically, it is characterized by the prominent proliferation of plump endothelial cells, and accompanying eosinophilic and lymphocytic infiltration. Herein, we report the case of ALHE in a 65-year-old male.

Keywords: epithelioid angiomatous nodule; epithelioid angiosarcoma; epithelioid hemangioendothelioma; epithelioid hemangioma; FOSB; vascular neoplasm EN epithelioid angiomatous nodule epithelioid angiosarcoma epithelioid hemangioendothelioma epithelioid hemangioma FOSB vascular neoplasm 97 100 4 01/23/23 20230201 NES 230201 CASE A 67-year-old white male presented with a subcutaneous mass at the base of the penis (Figures 1-3). A lobular growth pattern, vascular channel formation, and minimal cellular atypia or mitotic activity support EH over its malignant counterparts including EHE or epithelioid angiosarcoma. Epithelioid angiosarcoma, epithelioid angiomatous nodule, epithelioid hemangioma, epithelioid hemangioendothelioma, vascular neoplasm, FOSB Tumor cells were negative for CAMTA1 and human herpesvirus-8. [Extracted from the article]

A 60-year-old healthy man presented with several enlarging, tender, spontaneously bleeding, and episodically pruritic nodules on his ear. Five agminated pink-red papulonodules of the superior postauricular sulcus were noted on examination. Pathological examination revealed a lobular dermal vascular proliferation with plump endothelial cells protruding into the lumen in a hobnail pattern, along with a dense perivascular inflammatory infiltrate composed of plasma cells, lymphocytes, and numerous eosinophils. The diagnosis of angiolymphoid hyperplasia with eosinophilia was confirmed. After discussing treatment modalities, the patient opted for Mohs micrographic surgery (MMS). Three stages of MMS were able to remove all large vessel involvement and clear the peripheral margins, but the tumor had a complex branching pattern of growth in the deep bed of the wound with numerous tiny foci remaining. Owing to risk of disfigurement, no further excision was undertaken. The area was reconstructed with a temporalis fascia flap and a full-thickness skin graft. Despite remaining microscopic disease, the patient remained without recurrence or symptoms at one year of follow up.

Epithelioid haemangioendothelioma (EHE) is a rare vascular soft tissue malignant tumour with unknown etiology; the estimated prevalence of EHE is less than one in 1 million. A 56-year-old man was admitted in our department due to pain in the right side of the abdomen lasting for two years and weight loss up to 10 kg. Since 2012, the patient underwent lung and abdominal CT scanning as well as biopsy, however the diagnosis was challenging. In 2015, repeated abdominal CT scanning and a liver core biopsy was performed. The epithelioid haemangioendothelioma was diagnosed based by histopathological examination with subsequent radiological and clinical correlation. Therefore, accurate histopathological examination with radiological and clinical correlation is essential in the diagnosis of epithelioid haemangioendothelioma. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma (EH) is a rare angioproliferative disorder for which histopathology is the main approach to diagnosis. The tendency to recur is of concern to clinicians and patients. The factors associated with recurrence have been sporadically reported and a large-scale cohort study has been lacking. This study aims to investigate the clinicopathological characteristics and long-term clinical outcomes of EH patients from two tertiary care hospitals. A two-center retrospective cohort study of 43 patients with a diagnosis of EH between 2013 and 2023 was evaluated at follow-up. A comprehensive and detailed review of clinical and pathological data with long-term follow-up was performed. Information on prognosis was available for 43, and 8 (8/43, 18.6%) experienced local recurrence. Facial (Cramer's V = 0.405, P = 0.029) and multiple (relative risk [RR] 4.306, 95% confidence interval [CI] 1.213, 15.282, Phi = 0.369, P = 0.016) lesions, subcutaneous involvement (RR 5.063, 95% CI 1.157, 22.151, Phi = 0.374, P = 0.014), and the presence of lymphoid follicles (RR 9.750, 95% CI 3.853, 24.671, Phi = 0.670, P < 0.001) were associated with higher recurrence rates. According to the presence or absence of well-differentiated angiogenesis, EH can be pathologically classified into vascular, cellular, and intermediate types, while the depth, degree, and pattern of inflammation, tissue eosinophilia, eosinophilic microabscesses, and hobnail endothelial cells differed significantly between cellular and vascular types. The characteristics of EH are distinguished by different pathological subtypes. This study provides insight into the clinicopathological features and outcome of EH to assist clinicians in the diagnosis and management of this rare condition., (© 2024 Japanese Dermatological Association.)

Introduction: Epithelioid hemangiomas (EHs) are rare vascular lesions which generally affect the skin and subcutaneous tissue but rarely seen in bones. It is a benign entity but intermediate grade, i.e., locally aggressive in nature. It has very confusing clinicoradiological and histopathological features which make diagnosis difficult and help us to avoid inappropriate treatment., Case Report: We present with a 32-year-old male with multifocal EH involving the distal radius, a few carpal bones (trapezium, trapezoid, and capitate), and the base of 2nd and 3rd metacarpals with extensive surrounding soft-tissue involvement. He was managed with intralesional extended curettage + bone grafting and is disease free till follow-up., Conclusion: As EH is a rare entity, this comes as a differential diagnostic in locally aggressive-looking lytic lesions in the bone which helps the treating orthopedic surgeons or orthopedic oncosurgeons to have this differential in their mind for a better diagnosis and further management., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Background: The status of cutaneous epithelioid angiomatous nodule (CEAN) as a distinct entity remains controversial. This study investigated the relationship between CEAN and epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia (ALHE). Methods: Data of seven lesions with CEAN features from four cases (Cases 1–4: 61‐year‐old, 76‐year‐old, 53‐year‐old, and 21‐year‐old men, respectively) were investigated. Results: Cases 1 and 2 showed multiple lesions in the head and neck region, but Cases 3 and 4 showed solitary lesions on the back and scalp, respectively. Moreover, the histopathologic findings of the lesions of Cases 1 and 2 were consistent with those of conventional epithelioid hemangioma or classic cutaneous ALHE. Diffuse immunoexpression of FOSB was observed in Cases 1 and 2, but FOSB split signals were absent in break‐apart fluorescence in situ hybridization (FISH). In contrast, the histopathologic findings of the lesions of Cases 3 and 4 were consistent with those of cellular‐type epithelioid hemangiomas. Diffuse immunoreactivity for c‐FOS was observed in Cases 3 and 4, and split signals of FOS were present in break‐apart FISH in Case 3. Conclusions: This study showed that the seven tumors with CEAN features could be reclassified under the epithelioid hemangioma/ALHE group, although the small sample size is a limitation. [ABSTRACT FROM AUTHOR]

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare reactive angio-proliferative lesion. ALHE was initially classified as the late stage of Kimura’s disease (KD), although studies later showed that they were two separate clinical entities. Diagnosing ALHE remains a clinical challenge. Here, we report a case of ALHE in a young man and review current literature with an emphasis on how to distinguish ALHE particularly from KD. A 26-year-old man presented with a subcutaneous nodule in right infra-auricular area. Recurrence had occurred after three surgical excisions. Neither enlargement of salivary glands nor lymph nodes were found. Hematological examinations and renal function were normal. The mass was removed surgically. Microscopic examination showed proliferation of vascular channels with accompanying mixed inflammatory infiltrate consisting of lymphocytes, plasma cells, and eosinophils. Based on clinical data and histopathological examination, the patient was diagnosed with ALHE. Several clinical features differ between ALHE and KD, such as gender predilection, hypereosinophilia, IgE levels, and renal involvement. However, clinical features can overlap, so definitive diagnosis relies on histopathological examination. The most important hallmark of ALHE is vascular proliferation with epithelioid endothelial cells. Distinguishing ALHE from KD is important due to the lack of systemic manifestations in ALHE. However, ALHE can be easily mistaken for other diseases due to its rarity. Careful microscopic examination is very important to distinguish ALHE from KD and other mimicking lesions.

Epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vascular lesion presenting as multiple nodules on the head and neck. Surgery had been considered to be the best treatment modality for ALHE. We report the case of a 6-month-old boy with ALHE on his tongue that was treated successfully with oral prednisolone. [ABSTRACT FROM AUTHOR]

Cardiac epithelioid hemangioma is extremely rare. Currently, there are only a few described cases of intraluminal hemangiomas of the aorta and the aortic valve and no described cases with extraluminal epithelioid hemangiomas of the ascending aorta. We now present a case of epithelioid hemangioma of the ascending aorta that was an incidental finding during the coronary artery bypass and successfully resected.

Epithelioid hemangioma is a rare, histologically benign but locally aggressive primary vascular neoplasm that can rarely arise in bone. Mainstay treatment is surgical resection or curettage with bone grafting. We report a novel multidisciplinary, joint-sparing treatment approach for an epithelioid hemangioma of bone arising in the acetabulum causing severe thinning of the subchondral bone plate. After 4 sessions of transarterial bland particle and ethanol embolization, the resultant increased ossification of the tumor allowed preservation of the articular surface during surgical resection. Imaging follow-up 14 months after surgical resection showed no evidence of recurrence and continued ossification of the portions of the lesion treated only with embolization. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma (EH) is a benign vascular lesion, typically consisting of small vascular channels lined by epithelioid endothelial cells and associated with a dense lymphocytic infiltrate with eosinophils. Here, we report a rare case of EH involving large arteries. The patient presented with a 9‐month history of an asymptomatic nodule on the forehead, which was thought to be an epidermal inclusion cyst. Skin biopsy revealed large arteries with clusters of epithelioid cells in the vascular walls and lumen. Scattered eosinophils were noted in the walls. Adjacent areas showed groups of small‐caliber vessels lined by prominent endothelial cells and associated with a dense lymphoid infiltrate with eosinophils. No significant cytologic atypia was noted. Given the presence of the classic small‐vessel involvement, along with CD31 reactivity for the epithelioid cells in the large vessels, the findings are classified as EH involving large arteries, which is an uncommon subtype. There have only been a handful of such cases reported in the literature. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma is a rare reactive vasoproliferative disease presenting with painless vascular nodules in the dermal and subcutaneous tissues of the head and neck. Clinical diagnosis can be difficult as, in most cases, the only symptom is a progressively tender swelling next to a vessel course. Thus far, few cases of epithelioid hemangioma localized to the nose have been described in the literature. Herein, we present a case of a 47-year-old woman with just such a lesion of the nose, focusing on its diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Epithelioid hemangioma is a rare, benign vascular lesion classically presenting with painless nodules in the head and neck region. Hemangioma lesions are typically small, located within the dermis and subcutaneous tissue, and rarely exceed 10 cm in size. Complete surgical excision, with negative margins, is the recommended treatment as local recurrence is common. We describe an unusual presentation of epithelioid hemangioma that, to our knowledge, has not been previously described in the literature, epithelioid. Case presentation We report an atypical case of a large epithelioid hemangioma lesion with deep intramuscular involvement in a 16-year-old male. Ultrasound and MRI showed a hypervascular mass on the patient’s left upper back, and biopsy confirmed the diagnosis. Treatment consisted of preoperative embolization followed by excision and local tissue rearrangement. Conclusions Epithelioid hemangiomas are considered uncommon in the pediatric population. Moreover, it is challenging to diagnose these lesions due to their similarities to other vascular anomalies. We aim to increase awareness of this condition and obtain more precision in diagnosis, thus standardizing the approach for those treating individuals with vascular anomalies.

Objective: To investigate the clinical and pathological features of epithelioid hemangioma (EH). Methods: Retrospective analyses were performed on the clinical and pathological data of sixteen patients with EH, and related literatures were reviewed. Results: Sixteen patients, including 8 females and 8 males, were aged 45.44±12.52 years, with 3-month to 12-year history of EH. All subjects showed typical clinical and histopathological features.The main manifestations of the skin were red to dark red papules and nodules, some of which were accompanied with pruritus and erosion. Involvements of the head, ears, and vulva were 10, 5 and 1 cases, respectively. Five cases showed single skin lesion, and 11 cases with multiple skin lesions. Histopathological features included typical vascular proliferation, thickened vessel walls, epithelioid-like endothelial cells protruding into the lumen, and perivascular infiltration of large amounts of lymphocytes and eosinophils. Conclusions: Epithelioid hemangioma is rare. The diagnosis should be based on both clinical and pathological features. Enhancing awareness of this disease would be helpful to avoid misdiagnosis and improper treatment.

Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2024 The Korean Society of Radiology.)

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign proliferation of blood vessels of uncertain etiology. It primarily affects the head-and-neck region. Histologically, it is characterized by the prominent proliferation of plump endothelial cells, and accompanying eosinophilic and lymphocytic infiltration. Herein, we report the case of ALHE in a 65-year-old male. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma, otherwise known as angiolymphoid hyperplasia with eosinophilia, is a rare benign vasoproliferative disease with an unknown etiology. We report the case of a 42-year-old man with routine bloods test showing mildly elevated serum bilirubin level. CT scan revealed a lesion in the left liver lobe not typical of FNH. PET/CT scan and a dynamic liver MRI were consistent with a malignant mass. Surgical resection was performed. Histopathology of the 45 mm mass reported well-defined, slightly lobular proliferations of capillary-sized vessels around several central muscular vessels. Although the endothelial cells revealed a “hobnail” appearance, none of them showed pleomorphism or mitotic activity. Endothelial cells showed reactivity for the endothelial markers (CD34, CD31) and smooth muscle was detected in the blood vessel walls via immunohistochemistry. Despite its benign nature, epithelioid hemangioma of the liver can lead to a diagnostic and therapeutic dilemma due to the malignant looking features on imaging modalities.

Epithelioid hemangioma is a rare benign vascular tumor that consists of capillary-sized vessels lined by epithelioid endothelial cells. Diffuse cavernous hemangioma is a congenital benign vascular neoplasm consisting of increased dilated vessels. We report a case of epithelioid hemangioma and diffuse cavernous hemangioma that co-occurred in the rectum. To our knowledge, this is the first report in which two rare vascular lesions coexisted. Because both epithelioid hemangioma and diffuse cavernous hemangioma are often clinically confounded by malignant tumors, differentiating these benign lesions from other possible malignant tumors is significant. [ABSTRACT FROM AUTHOR]

Abstract Background Although epithelioid hemangiomas involving bone have been described in previous case reports and case series, the effects of radiation therapy on vertebral epithelioid hemangioma has not been fully reported. Here we provide a case report of tumor response to radiation therapy in a young adult with a large epithelioid hemangioma involving the fourth lumbar vertebrae. Case presentation A 27-year-old Latino man with a past medical history of type 1 diabetes and a 3-year history of low back pain presented to a hospital emergency department following acute worsening of back pain. On transfer to our tertiary medical center, he described the pain as “shock-like” which originated at the lateral aspect of his right hip and radiated down to his right knee. Paresthesia was also reported along the medial aspect of his lower right leg. Imaging included a computed tomography scan and magnetic resonance imaging which revealed fourth lumbar and right iliac lytic bone lesions. Image-guided biopsies of the lytic lesions were consistent with a diagnosis of epithelioid hemangioma and radiation therapy was recommended as the primary treatment. Our patient’s low back and leg pain were initially managed with acetaminophen, oxycodone, pregabalin, and lidocaine patch 5%. He noted improvement in pain after his third fraction of radiation. Pain intensity continued to decline and oxycodone was discontinued. Conclusions This case report demonstrates an unusual etiology of back and leg pain in a young man and elucidates the palliative effects of radiation therapy for epithelioid hemangioma involving the lumbar spine.

Epithelioid hemangioma is an uncommon benign vascular neoplasm which can arise in bone. Resection is generally curative, but occasionally lesions recur and recurrence after surgery can be morbid and destructive. Recent case reports have described the effective use of oral propranolol to control recurrent epithelioid hemangioma of the orbit. We report the case of a 26 year old man with recurrent aggressive osseous epithelioid hemangioma in the pelvis of which has been controlled for over a year with outpatient propranolol monotherapy.

Epithelioid hemangioma of the bone is a rare kind of vascular neoplasm posing a diagnostic challenge because of its ability to mimic malignant tumors. We report a case of a fast-growing, talofibular joint–involving epithelioid hemangioma, which was suspectedly initiated by vascular damage due to trauma and arthroscopy. The ankle mass appeared as a lytic lesion on the CT images and as a T1 hypo-, T2 mildly hyperintense, lobulated structure on the MRI scans. The contrast enhancement pattern was typical to vascular neoplasms. Histologically the lesion consisted of well-formed vessels lined with epithelioid cells with a slightly atypical nuclear morphology, inflammation with a significant number of eosinophils, and low mitotic rate. Immunohistochemistry analysis showed the presence of vascular markers but no rearrangements characteristic of soft tissue sarcomas were registered by the next-generation sequencing. The surgical treatment was curative. The report presents current imaging methods and summarizes the imaging findings of transarticular spreading tumors. The paper also highlights that for the differential diagnosis of vascular tumors showing signs of aggressivity, the pathological analysis is inevitable. Correct diagnosis of the epithelioid hemangioma is essential, as the treatment of more malignant entities is substantially different. An added value of the report is that to the best of our knowledge, a transarticular spreading epithelioid hemangioma of the ankle has never been described before. [ABSTRACT FROM AUTHOR]

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, benign inflammatory vasoproliferation. The literature is divided regarding whether it embodies a vascular neoplasm or a reactive process secondary to various stimuli. ALHE presents as solitary or clustered papules or nodules primarily on the head and neck, especially on or around the auricle. Histologically, ALHE is characterized by a proliferation of blood vessels lined by plump epithelioid endothelial cells and a prominent perivascular infiltrate rich in lymphocytes and eosinophils. ALHE follows a benign clinical course, yet treatment is challenging because of its high recurrence rate. We present the case of a 37-year-old Filipino man with lesions located on the central face. Kimura disease was considered due to his age, sex, and ethnicity; however, his clinical features-specifically, the presence of discrete papules and lack of lymphadenopathy-and his histological findings were consistent with ALHE. He reported trauma prior to the onset of the lesions, suggesting a reactive etiology. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma (EH), a rare benign tumor, is documented in only a few cases in the medical literature. The complications of epithelioid hemangioma depend on the site of their presentation. If located in the eye, epithelioid hemangiomas may lead to amblyopia; in the larynx, they can cause respiratory issues; and if affecting bone, they can result in osteolytic lesions. Here, we present a case of a 40-year-old male who presented with swelling in the medial end of the right clavicle. Following clinical evaluation and a computed tomography scan, an excision biopsy was performed. The excised lesion measured 3 x 2.5 cm, and histopathological examination confirmed the finding as an epithelioid hemangioma., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Duddu et al.)

Introduction: Epithelioid hemangioma (EH) is an intermediate locally aggressive tumor that consists of epithelioid cells and endothelial cell differentiation, which can occur at any age, but is most common between the ages of 30 and 40 years. EH in the thoracic spine is rare, and accurate diagnosis is critical to treatment planning. Our aim was to explore the imaging and clinical data of thoracic spine EH to improve the understanding of this rare disease., Methods: From January 1, 2018 to June 30, 2023, a database of thoracic spine masses was retrospectively reviewed. Five patients with histologically proven thoracic spine EH and complete imaging available were identified and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) findings were evaluated separately by two radiologists with more than 10 years of experience. Positron emission tomography (PET)/CT was conducted by two nuclear medicine diagnostic technologists with at least 5 years of experience., Results: The patients included three male and two female patients aged 23 to 56 years (mean age was 38.4 ± 14.3 years). All patients underwent CT, MRI, and 18 F-FDG PET/CT examination before treatment. Four patients were limited to one vertebral involvement, only one patient had multiple vertebral involvement, and all tumors involved the accessories, including one involving the posterior ribs. The maximum diameter of the tumor ranged from 2.7 to 4.3., Conclusions: CT, MRI, and 18 F-FDG PET/CT findings of thoracic spine EH have certain characteristics, and understanding these imaging findings will help to obtain accurate diagnosis before surgery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hu, Li, Xiong, Li, Cai and Wang.)

Primary vascular tumors of bone are a heterogeneous group of neoplasms, ranging from benign hemangiomas to frankly malignant epithelioid hemangioendotheliomas and angiosarcomas. Over the years, their classification has been a matter of discussion, due to morphologic similarities and uncertainty regarding biologic behavior. Over the past decade, with the development of next-generation sequencing, there has been a significant improvement in the molecular characterization of these lesions. The integration of their morphologic, immunohistochemical and molecular features has led to a better stratification, with important prognostic and therapeutic implications. Nevertheless, primary vascular bone tumors still represent a challenge for medical oncologists. Given their rarity and heterogeneity, in the last few years, there has been no significant progress in medical treatment options, so further research is needed. Here we present a review of the current knowledge regarding primary vascular tumors of the bone, correlating clinicopathologic features with tumor behavior and therapeutic approaches. • Vascular bone tumors are a heterogeneous group of rare entities. • Molecular characterization of these entities has led to a better stratification. • An accurate diagnostic approach is absolutely necessary for therapeutic planning. • Management of these rare tumors should be carried out in sarcoma Reference Centers. • Further research is needed to improve treatment for patients with inoperable tumors. [ABSTRACT FROM AUTHOR]

Introduction: Angiolymphoid hyperplasia with eosinophilia (ALHE) or epithelioid hyperplasia is an uncommon condition due to benign proliferation of dermal and subdermal vessels. It is most commonly seen in young to middle-age females. Skin lesions include single or multiple red papules, plaques and nodules. It most commonly involves head and neck. Its etiology has not been determined. The ALHE lesions are usually resistant to commonly suggested treatment methods including surgery. Recurrence of treated lesions is also common. Case Presentation: Herein, we report a 39-year-old woman who presented with multiple red papules and nodules on her forearm, hand and nail bed. Conclusion: Condition and extension of lesions in this case is very significant. Her lesions were confirmed to be ALHE after histopathological assessment.

Osseous vascular anomalies can be characterized as vascular tumors or malformations. Classification is vital for prognosis and treatment. Much remains unknown about conditions such as Gorham-Stout disease. Treatments target the proposed genetic pathways such as PI3KCA/AKT/mTOR pathway., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Epithelioid hemangioma is a rare, benign vascular lesion classically presenting with painless nodules in the head and neck region. Hemangioma lesions are typically small, located within the dermis and subcutaneous tissue, and rarely exceed 10 cm in size. Complete surgical excision, with negative margins, is the recommended treatment as local recurrence is common. We describe an unusual presentation of epithelioid hemangioma that, to our knowledge, has not been previously described in the literature, epithelioid. Case presentation: We report an atypical case of a large epithelioid hemangioma lesion with deep intramuscular involvement in a 16-year-old male. Ultrasound and MRI showed a hypervascular mass on the patient’s left upper back, and biopsy confirmed the diagnosis. Treatment consisted of preoperative embolization followed by excision and local tissue rearrangement. Conclusions: Epithelioid hemangiomas are considered uncommon in the pediatric population. Moreover, it is challenging to diagnose these lesions due to their similarities to other vascular anomalies. We aim to increase awareness of this condition and obtain more precision in diagnosis, thus standardizing the approach for those treating individuals with vascular anomalies. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma of bone is a rare vascular neoplasm with a ubiquitous distribution. To date, up to 25% epithelioid hemangioma of bone presents synchronous bone lesions. We report a unique case of epithelioid hemangioma with multifocal metachronous bone lesions without any fatal outcome observed after a long period. Importantly, a strong nuclear expression of FOSB antibody was detected by immunohistochemical analysis. In this case, the pathologic and radiologic findings are also described. We suggest that epithelioid hemangioma can present multifocal metachronous bone lesions without producing a fatal outcome. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma is an uncommon benign vascular neoplasm which can arise in bone. Resection is generally curative, but occasionally lesions recur and recurrence after surgery can be morbid and destructive. Recent case reports have described the effective use of oral propranolol to control recurrent epithelioid hemangioma of the orbit. We report the case of a 26 year old man with recurrent aggressive osseous epithelioid hemangioma in the pelvis of which has been controlled for over a year with outpatient propranolol monotherapy. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma (EH) or angiolymphoid hyperplasia is an uncommon benign vasculoproliferative neoplasm. We are reporting a case of EH involving the gingiva in a 12-year-old male patient who reported to the outpatient Department of Oral Medicine and Radiology with the chief complaint of gingival growth in the lower mandibular gingiva involving both buccal and lingual gingiva and facial asymmetry due to enlarged left submandibular lymph nodes. Histopathological features diagnosed the case definitive of EH.