Key result
A young woman with a painful subcutaneous mass was diagnosed with pseudomyogenic hemangioendothelioma after being misdiagnosed with herpes zoster and low-grade malignant fibrous histiocytoma.
Why the study?
Pseudomyogenic hemangioendothelioma is a rare angiogenic tumor with non-obvious neoplastic vessel features and endothelial differentiation that is easily misdiagnosed as other sarcomas or tumors.
Case Report (n=1)
Pseudomyogenic hemangioendothelioma is a rare angiogenic tumor that can be easily misdiagnosed due to its non-obvious morphological characteristics.
Clinicians should consider pseudomyogenic hemangioendothelioma in young adults with painful subcutaneous masses; this case extends the differential but leaves optimal management open.
Pseudomyogenic hemangioendothelioma (PHE) is a rare angiogenic tumor. Histologically, the morphological characteristics of neoplastic vessels and endothelial differentiation are not obvious, and it is easy to be confused with epithelioid sarcoma, epithelioid hemangioendothelioma and myogenic tumor. PHE usually occurs in arms and legs in young people and has a significant male predominance. The tumor has a predilection for the distal extremities and its typical manifestation is multiple center invasion of a single limb, which can involve all layers of skin and subcutaneous tissues,and is often accompanied by abvious pain. Histologically, PHE is characterized by infiltrative growth of tumor. Most tumor lesions are composed of sheets and loose fascicles of plump spindle or epithelioid cells within a background of variably prominent inflammatory infiltration, which was commonly composed of neutrophils. Some cells may resemble rhabdomyoblasts, and nuclear atypia and mitosis were rare. The tumor cells generally expressed positive cytokeratin (CK), ETS-related gene (ERG), Friend leukemia virus integration 1 (FLI1) and integrase interactor 1(INI1). In some cases, the tumor cells expressed CD31. A case of a young woman was reported in this paper, who presented with a subcutaneous mass with severe pain and was chronologically misdiagnosed with herpes zoster, low-grade malignant fibrous histiocytoma and epithelioid hemangioendothelioma. In this study, the clinical and pathological features, differential diagnosis and the latest progress in therapy of PHE were analyzed based on relevant literature.
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Huang et al. (2022) conducted a case report in Pseudomyogenic hemangioendothelioma (n=1). A young woman with a painful subcutaneous mass was diagnosed with pseudomyogenic hemangioendothelioma after being misdiagnosed with herpes zoster and low-grade malignant fibrous histiocytoma.
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