Key result
Video-assisted thoracoscopic surgery with permanent biopsy successfully diagnosed and treated pulmonary epithelioid hemangioendothelioma that was initially misdiagnosed as benign, with no recurrence at 18 months.
Case Report (n=1)
Pulmonary epithelioid hemangioendothelioma can be misdiagnosed as a benign nodule on frozen biopsy, requiring careful pathological evaluation and immunohistochemistry for accurate diagnosis.
Caution advised on frozen biopsy for pulmonary nodules; leaves open VATS role in this rare tumor.
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of borderline malignancy that originates from endothelial cells. Chest computed tomography (CT) performed during a routine cancer screening revealed multiple small pulmonary nodules in a 50-year-old man who had previously undergone endoscopic submucosal dissection of early gastric cancer. To rule out metastatic nodules, a wedge resection of the left upper lobe was performed and the frozen biopsy reported a benign fibrotic nodule. Using immunohistochemistry, the final pathology was indicated to be PEH, and consecutive surgery for the right-side nodules was planned and performed.
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Kim et al. (2015) conducted a case report in Pulmonary epithelioid hemangioendothelioma (n=1). Video-assisted thoracoscopic surgery (VATS) wedge resection was evaluated. Video-assisted thoracoscopic surgery with permanent biopsy successfully diagnosed and treated pulmonary epithelioid hemangioendothelioma that was initially misdiagnosed as benign, with no recurrence at 18 months.
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