Skip to main content

Advertisement

SpringerLink
Log in

A novel treatment for bone lesions of multifocal epithelioid sarcoma-like hemangioendothelioma

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Epithelioid sarcoma-like hemangioendothelioma (ES-H) is a rare, indolent vascular neoplasm with characteristics similar to epithelioid sarcoma. It typically affects young males who present with skin and subcutaneous lesions in the extremities. Bone lesions, occurring in approximately 20 % of patients, are often multifocal, seen in conjunction with soft tissue lesions, and usually found in bones of the lower extremities. This report details the case of a 20-year-old male who presented with a 1-year history of painful skin lesions on his left lower extremity. Staging studies revealed bone lesions in the cuboid and calcaneus. Bone and soft tissue pathology was consistent with ES-H. The soft tissue lesions were treated with wide excision and the bony lesions with radiofrequency ablation (RFA). The patient had no evidence of recurrence at the 2-year follow-up. Treatment of ES-H typically consists of wide excision of all soft tissue lesions and possible adjuvant radiation therapy. Management of bony lesions has included marginal excision, wide excision, amputation, chemotherapy, observation, or a combination of these modalities. ES-H has the potential for distant metastases. There is no consensus regarding the appropriate treatment of multifocal epithelioid sarcoma-like hemangioendothelioma involving bone. A potential treatment strategy of wide excision of soft tissue lesions and RFA of bone lesions is proposed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

References

  1. Billings SD, Folpe AL, Weiss SW. Epithelioid sarcoma-like hemangioendothelioma. Am J Surg Pathol. 2003;27:48–57.

    Article  PubMed  Google Scholar 

  2. Amary MF, O’Donnell P, Berisha F, et al. Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma: characterization of five cases. Skeletal Radiol. 2013;42:947–57.

    Article  PubMed  Google Scholar 

  3. Billings SD, Folpe AL, Weiss SW. Epithelioid sarcoma-like hemangioendothelioma (pseudomyogenic hemangioendothelioma). Letter to the Editor. Am J Surg Pathol. 2011;35:1088.

    Article  PubMed  Google Scholar 

  4. Requena L, Santonja C, Martinez-Amo JL, Saus C, Kutzner H. Cutaneous epithelioid sarcomalike (pseudomyogenic) hemangioendothelioma. A little-known low-grade cutaneous vascular neoplasm. JAMA Dermatol. 2013;149:459–65.

    Article  PubMed  Google Scholar 

  5. Sheng W, Pan Y, Wang J. Pseudomyogenic hemangioendothelioma: report of an additional case with aggressive clinical course. Am J Dermatopathol. 2013;35:597–600.

    Article  PubMed  Google Scholar 

  6. Hornick JL, Fletcher CD. Pseudomyogenic hemangioendothelioma: a distinctive, often multicentric tumor with indolent behavior. Am J Surg Pathol. 2011;35:190–201.

    Article  PubMed  Google Scholar 

  7. Mirra JM, Kessler S, Bhuta S, et al. The fibroma-like variant of epithelioid sarcoma: a fibrohistiocytic/myoid cell lesion often confused with benign and malignant spindle cell tumors. Cancer. 1992;9:1382–95.

    Article  Google Scholar 

  8. Watabe A, Okuyama R, Hashimoto A, et al. Epithelioid sarcoma-like hemangioendothelioma: a case report. Acta Derm Venereol. 2009;89:208–9.

    PubMed  Google Scholar 

  9. Cai J, Peng F, Li L, Cheng Y, Wang J. Epithelioid sarcoma-like hemangioendothelioma: a clinicopathologic and immunohistochemical study of 3 cases. Zhonghua Bing Li Xue Za Zhi. 2011;40:27–31.

    PubMed  Google Scholar 

  10. Clarencon F, Jean B, Hang-Phuong P, et al. Value of percutaneous radiofrequency ablation with or without percutaneous vertebroplasty for pain relief and functional recovery in painful bone metastases. Skeletal Radiol. 2013;42:25–36.

    Article  PubMed  Google Scholar 

  11. McGinity M, Bartanusz V, Dengler B, et al. Pseudomyogenic hemangioendothelioma (epithelioid sarcoma-like hemangioendothelioma, fibroma-like variant of epithelioid sarcoma) of the thoracic spine. Eur Spine J. 2013;22:S506–7.

    Article  PubMed  Google Scholar 

  12. Sheng WQ, Wang J. Primary pseudomyogenic haemangioendothelioma of bone. Histopathology. 2012;61:1219–24.

    Article  CAS  PubMed  Google Scholar 

  13. Tokyol C, Uzum N, Kuru I, Uluoglu O. Epithelioid sarcoma-like hemangioendothelioma: a case report. Tumori. 2005;91:436–9.

    PubMed  Google Scholar 

  14. Trombetta D, Magnusson L, von Steyern FV, Hornick JL, Fletcher CD, Mertens F. Translocation t(7;19)(q22;q13)- a recurrent chromosome aberration in pseudomyogenic hemangioendothelioma? Cancer Genet. 2011;204:211–5.

    Article  CAS  PubMed  Google Scholar 

  15. Miettinen M, Sarlomo-Rikala M, Wang Z. Claudin-5 as an immunohistochemical marker for angiosarcoma and hemangioendotheliomas. Am J Surg Pathol. 2011;35:1848–56.

    Article  PubMed  Google Scholar 

  16. Simon CJ, Dupuy DE. Percutaneous minimally invasive therapies in the treatment of bone tumors: thermal ablation. Semin Musculoskelet Radiol. 2006;10:137–44.

    Article  PubMed  Google Scholar 

  17. Goetz MP, Callstrom MR, Charboneau JW, et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol. 2004;22:300–6.

    Article  PubMed  Google Scholar 

  18. Palussiere J, Pellerin-Guignard A, Descat E, Cornelis F, Dixmerias F. Radiofrequency ablation of bone tumours. Diagnost Intervent Imaging. 2012;93:680–4.

    Article  Google Scholar 

  19. Rimondi E, Mavrogenis AF, Rossi G, et al. Radiofrequency ablation for non-spinal osteoid osteomas in 557 patients. Eur Radiol. 2012;22:181–8.

    Article  PubMed  Google Scholar 

  20. Rosenthal D, Treat M, Mankin H, Rosenberg A, Jennings C. Treatment of epithelioid hemangioendothelioma of bone using a novel combined approach. Skeletal Radiol. 2001;30:219–22.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all the physicians and support staff at Saint Louis University School of Medicine involved in the care of this patient. We also thank Dr. Steven Billings, MD, for his consultation and review of the patient’s pathology slides.

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Saint Louis University, 3635 Vista Avenue, 7th floor, St. Louis, MO, 63110, USA

    Adrian T. Davis & David D. Greenberg

  2. Department of Dermatology, Saint Louis University, 1402 South Grand Boulevard, St. Louis, MO, 63104, USA

    A. Mary Guo

  3. Department of Pathology, Saint Louis University, 3635 Vista Avenue, 4th floor, St. Louis, MO, 63110, USA

    Nancy J. Phillips

Authors
  1. Adrian T. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Mary Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nancy J. Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David D. Greenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David D. Greenberg.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Davis, A.T., Guo, A.M., Phillips, N.J. et al. A novel treatment for bone lesions of multifocal epithelioid sarcoma-like hemangioendothelioma. Skeletal Radiol 44, 1013–1019 (2015). https://doi.org/10.1007/s00256-014-2089-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-014-2089-x

Keywords

Search

Navigation