Key result
A 65-year-old female with a complex oncologic history presented with a rare mediastinal epithelioid hemangioendothelioma metastatic to hilar lymph nodes and pleural fluid.
Case Report (n=1)
This case highlights the diagnostic challenges of metastatic epithelioid hemangioendothelioma in a patient with a complex history of multiple other malignancies.
Raises suspicion for rare vascular tumors in complex oncology patients with mediastinal involvement; extends sparse case reports but leaves management questions open.
Epithelioid hemangioendothelioma is a rare mesenchymal tumor of vascular origin, classified as a sarcoma of intermediate malignant potential. Involvement of numerous sites of the body, including visceral organs, soft tissue, testis, skeleton, brain, meninges, and skin have been described. We report an unusual case of a mediastinal epithelioid hemangioendothelioma in a 65-year-old female initially presenting as a metastasis to lymph nodes of the hilar region and subsequently as a malignant pleural effusion. The patient had a complex history of papillary renal cell carcinoma, papillary thyroid carcinoma, and Waldenstrom's hyperglobulinemia making the diagnosis of metastatic epithelioid hemangioendothelioma difficult. Clinical, cytological and immunohistochemical features of this tumor are described with an emphasis on diagnostic pitfalls.
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Antic et al. (2009) conducted a case report in Mediastinal epithelioid hemangioendothelioma (n=1). A 65-year-old female with a complex oncologic history presented with a rare mediastinal epithelioid hemangioendothelioma metastatic to hilar lymph nodes and pleural fluid.
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