Intravascular epithelioid hemangioendothelioma of the femoral vein diagnosed by contrast-enhanced ultrasonography

This is the authors' abstract. We don't add key points for this paper.

RATIONALE: Intravascular epithelioid hemangioendothelioma (EHE) is a rare endothelial tumor with an intermediate grade of malignancy. We present a case of one woman affected by EHE of the femoral vein. Contrast-enhanced ultrasonography played a role in diagnosing EHE and helped differentiate it from thrombosis. To our knowledge, this is the first reported contrast-enhanced ultrasonography of intravascular EHE in the imaging literature. PATIENT CONCERNS: A 46-year-old woman presented to our hospital due to pain and swelling in her right lower limb since 5 years prior to her presentation. DIAGNOSES: The patient was misdiagnosed as having thrombosis by ultrasound. Contrast-enhanced ultrasonography showed solid lesions with visible blood supply, suggesting angiogenic tumors. INTERVENTIONS: The patient was treated by complete surgical removal of the mass and postoperative radiotherapy. Pathological examination confirmed the diagnosis of EHE. OUTCOMES: During follow-up, there were no signs of local or distant relapse. LESSONS: Intravenous EHE may be misdiagnosed as thrombosis by ultrasound and contrast-enhanced ultrasonography can help make the differential diagnosis.

CEUS may differentiate rare femoral vein EHE from thrombosis; leaves open its diagnostic role beyond this single case.