ABSTRACT
Spindle cell hemangioendothelioma was first described in 1986 to characterize a particular angiomatous lesion which shows different clinical features, however, it has recently been designated as spindle cell hemangioma (SCH) due to its benign nature. Microscopically, this peculiar vascular tumor consists of cavernous blood vessels intermixed with solid areas predominantly composed of spindle cells, resembling Kaposi sarcoma. A 39-year-old woman presented with a bean-sized, tender, bluish nodule on the pulp of her right thumb. The 1 year old lesion had increased slowly in size over this time. Histologic examination of the lesion showed that it was composed of large irregularly-dilated, thin-walled cavernous blood spaces containing organizing thrombi, numerous red blood cells, and a spindle cell mass which was partially connected with the vessel wall and invaded the stroma. A diagnosis of SCH was made based on histologic and immunohistochemical findings. After the lesion was totally excised, there has been neither recurrence nor occurence of new lesions to date.
Subject(s)
Adult , Female , Humans , Blood Vessels , Diagnosis , Erythrocytes , Hemangioendothelioma , Hemangioma , Recurrence , Sarcoma, Kaposi , ThumbABSTRACT
A case of a 21-year old female with Maffucci's syndrome is presented where the patient developed multiple cutaneous spindle-cell hemangioendotheliomas. She had multiple pea to walnut sized, non-tender, normal skin colored or slight bluish nodules and bony mass-like lesions on the left upper extremity and hand. A histological examination of the lesions showed that they were composed of irregularly dilated, thin walled cavernous blood spaces containing phleboliths and collapsed vascular spaces separated by spindled fibroblastic cells. Radiologically, the bony lesions showed radiolucent densities with calcified spots within the second proximal phalanx and metacarpal bone of the left hand, which were consistent with enchondromas.
Subject(s)
Female , Humans , Chondroma , Fibroblasts , Hand , Hemangioendothelioma , Juglans , Pisum sativum , Skin Pigmentation , Upper ExtremityABSTRACT
Spindle cell hemangioendothelioma is a rare vascular tumor which is presented with subcutaneous nodules and follows a benign indolent course but has a recurrent tendency, and is histologically resembling a cavernous hemangioma and Kaposi's sarcoma. We present a case of spindle cell hemangioendothelioma possessing clinical aggressiveness with painful bony erosion, histologic pleomorphism and mitoses. A 20-year-old man presented with a recurrent painful mass on the left ankle. The mass was dark brown and firm with irregular margins and measured 1.5 cm in diameter, which affected and eroded the underlying medial malleolus of the left tibia. Microscopically, the tumor was composed of cavernous endothelial-lined blood spaces and spindle cellular areas mimicking Kaposi's sarcoma. The spindle cells intermingled with plump epithelioid cells and showed a moderate degree of pleomorphism with occasional mitoses. Immunohistochemically, the spindle cells were focally positive for factor VIII-associated antigen and vimentin, and negative for S-100 protein, desmin, and epithelial membrane antigen.