Key result
Pulmonary epithelioid hemangioendothelioma misdiagnosed as mesothelioma highlights the need for repeat biopsies and NGS.
Why the study?
Epithelioid hemangioendothelioma presents with nonspecific imaging and pathological overlap with other malignancies, making it difficult to suspect and diagnose.
Case Report (n=1)
Highlights the importance of repeat biopsies and next-generation sequencing in diagnosing rare vascular sarcomas like EHE that can mimic other malignancies.
Potential misdiagnosis of rare sarcomas warrants diagnostic caution; this case leaves open NGS utility in ambiguous pleural tumors.
Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma that can initially present with a myriad of symptoms anywhere in the body. Imaging findings are often nonspecific, and the pathology tends to have overlap with other malignancies. As a result, it can be quite difficult to suspect and diagnose EHE. We present a case of pulmonary EHE in a 41-year-old female with left pleural thickening and subclavian tumor thrombus who was initially misdiagnosed and treated as mesothelioma. This instance demonstrates the importance of maintaining a broad differential and the utilization of repeat biopsies and next-generation sequencing for questionable diagnoses of atypical malignancies.
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Grewal et al. (2025) conducted a case report in Epithelioid hemangioendothelioma (EHE) (n=1). Repeat biopsies and next-generation sequencing was evaluated. A 41-year-old female with pulmonary epithelioid hemangioendothelioma was initially misdiagnosed as mesothelioma, highlighting the need for repeat biopsies and next-generation sequencing.
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