Abstract
The classification of certain vascular bone tumors that show an epithelioid cytologic appearance remains confusing, with overlap in features of epithelioid hemangioma, hemangioendothelioma and epithelioid hemangioendothelioma. Radiographs of a 27-year-old woman who presented with ankle pain showed an expanded lytic-sclerotic lesion in the distal left fibula. Magnetic resonance imaging showed an intramedullary lesion with a small lateral intracortical component. The lesion was hypo- to isointense to muscle on T1-weighted images and heterogeneously hyperintense on T2-weighted images. Initial incisional biopsy was inconclusive. Open biopsy showed hemangioendothelioma with epithelioid morphology, and the lesion was completely resected with reconstruction using a peroneal fibular rotation graft. Examination of the resected specimen showed focal hemangioendothelioma with an epithelioid phenotype arising in a hemangioma. This case illustrates the difficulty and pitfalls of making the correct diagnosis on the basis of a small biopsy specimen.
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Presented (case no. 17) at the 26th Closed Meeting of the International Skeletal Society, Seattle, Washington, USA, August 1999
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Shah, Z.K., Peh, W.C.G., Shek, T.W.H. et al. Hemangioendothelioma with an epithelioid phenotype arising in hemangioma of the fibula. Skeletal Radiol 34, 750–754 (2005). https://doi.org/10.1007/s00256-005-0912-0
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DOI: https://doi.org/10.1007/s00256-005-0912-0