Pseudomyogenic hemangioendothelioma can present with intensely 18F-FDG avid lytic bone lesions mimicking multiple myeloma and may undergo spontaneous regression.
Consider pseudomyogenic hemangioendothelioma in FDG-avid bone lesions; single case leaves open spontaneous regression for further study.
Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare, recently described vascular neoplasm that occurs predominantly in the distal extremities of young to middle aged adult males. In this report, we describe a patient who presented with numerous lytic bone lesions which were intensely ¹⁸F-FDG avid on PET/CT and presumed to be metastatic. Pathology revealed pseudomyogenic hemangioendothelioma. Follow-up CT showed enlargement and increasing sclerosis of several lesions, believed to represent progression; however, follow-up PET/CT confirmed a spontaneous regression of the disease.
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Bryanton et al. (2015) studied this question.
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