Intravascular papillary endothelial hyperplasia mimicking sister Mary Joseph nodule in a patient with ovarian carcinoma

@#Intravascular Papillary Endothelial Hyperplasia (IPEH) is a rare benign vascular lesion of the skin and subcutaneous tissues that results from the proliferation of endothelial cells within a blood vessel. In this article, we present the case of an IPEH mimicking a Sister Mary Joseph Nodule on the umbilicus of a 53-year old female patient with ovarian cancer. A diagnostic workup was performed with a computerized tomography of abdominal cavity and pelvis showing an expansive cystic tumor formation with probable ovarian origin. Two separate histopathologic readings were done on the cutaneous lesion which revealed contradicting findings of benign versus malignant tumors. Immunohistochemical stains done showed that the lesion was positive for ERG and negative for epithelial differentiation markers. No surgical intervention was done at the time of consultation as a cutaneous metastasis was primarily considered initially. It is crucial to rule out a diagnosis of Sister Mary Joseph nodule, especially in a background of ovarian carcinoma as it may mimic vascular lesions occurring on the umbilicus. Immunohistochemical staining is a significant tool to precisely diagnose such lesions so that it is neither inadequately nor aggressively managed.

Intravascular papillary endothelial hyperplasia (Masson's hemangioma) of the face

Intravascular papillary endothelial hyperplasia or Masson's hemangioma is a rare vascular tumor. The reactive proliferation of endothelial cells in this disease mimics other benign or malignant vascular proliferation such as angiosarcoma or Kaposi's sarcoma. It is important to make an accurate distinction to avoid confusion with these malignant tumors. This would facilitate a proper diagnosis, which is essential so that the patient is not subjected to unnecessarily aggressive or inappropriate treatment.

Huge central intravascular papillary endothelial hyperplasia of the mandible: a case report and review of the literature

Masson's tumor or intravascular papillary endothelial hyperplasia is an inflammatory soft tissue lesion that rarely occurs in the maxillofacial region and skeletal system. Precise clinical and para-clinical investigation is necessary for the accurate diagnosis and correct treatment of this lesion. This paper presents a massive intravascular papillary endothelial hyperplasia lesion in the bony tissue of the mandible. Histopathology features, clinical appearance, and suitable management are discussed, with a complete review of the literature. The patient underwent composite resection of the lesion as well as reconstruction. No recurrence was observed during 6 years of follow-up. To the best of our knowledge, this is the fourth case of Masson's tumor in mandibular skeletal tissue, which has unique and distinctive features due to its size and location. A rare occurrence in skeletal tissue, complex clinical presentations, and complicated histopathologic findings present diagnostic challenges for treatment of this lesion.

Intravascular Papillary Endothelial Hyperplasia as an unusual diagnosis for peri-orbital tumour - A case report

Intravascular papillary endothelial hyperplasia (IPEH) is a rare cause of orbital mass which can affect healthy individuals of any age/sex/race/region. It usually requires a histopathological examination, characterized by the appearance of papillary proliferation of vascular endothelial cells within the lumen of the blood vessel, for the final diagnosis. One should be aware that this is a highly vascular lesion which can cause excessive intraoperative bleeding and incomplete removal can lead to recurrences. IPEH of the orbit/eyelid has been reported in few parts of the world as isolated case reports but none from India so far.

Hiperplasia endotelial papilar intravascular en la cavidad oral: reporte de un caso / Intravascular papillary endothelial hyperplasia: report of a case

La hiperplasia endotelial papilar intravascular (HEPI) es una lesiónbenigna muy poco común en la cavidad oral. Fue descrita por primera vez por Masson en 1923 como hemangioendotelioma vegetante intravascular; más adelante, se le dieron diferentes nombres como angiomatosis intravascular, seudoangiosarcoma de Masson y, por último, hiperplasia endotelial papilífera intravascular. Los hallazgos en bocason poco comunes, y cuando se presentan, generalmente es en labio.Se expone el caso clínico de un paciente de 78 años de edad con una lesión asintomática bilobular en encía, que refi ere una evolución lenta y progresiva de 10 años. Se emitió un diagnóstico clínico presuntivo degranuloma periférico de células gigantes y se procedió a realizar biopsiaescisional, así como su envío a estudio histopatológico para confirmar eldiagnóstico; se emitió el diagnóstico de HEPI y se confirmó por medio de inmunohistoquímica. Esta lesión puede ser fácilmente confundida con neoplasias malignas vasculares (angiosarcoma, sarcoma de Kaposi),tanto clínica como histopatológicamente. El objetivo de este trabajo es describir mediante un caso clínico la importancia de un correcto diagnóstico a través de una adecuada exploración clínica, así comouna observación microscópica a conciencia y la comunicación interdisciplinaria entre el cirujano maxilofacial y el patólogo bucal, para no confundir esta entidad benigna con otro tipo de patologías que requieren tratamientos más agresivos e invasivos, sin ser adecuados para la HEPI.

Intravascular papillary endothelial hyperplasia (IPEH) is a rarebenign lesion in the oral cavity. It was fi rst described by Massonin 1923 as intravascular vegetating hemangio endothelioma, andlater received diff erent names, like «intravascular angiomatosis¼,«Masson’s pseudoangiosarcoma¼ and «intravascular papillaryendothelial hyperplasia¼; fi ndings in the mouth are rare, and when present, they are generally in the lip. The clinical case presented is a78-year-old patient with a bilobular asymptomatic lesion in gingivawith a slow and progressive 10-year evolution. A presumptive clinicaldiagnosis of peripheral giant-cell granuloma was issued, followed byan excisional biopsy and histopathology study to confi rm the diagnosis;it had been correctly diagnosed as IPEH, which was confi rmed byimmuno histochemistry. This lesion can be easily confused with vascular malignancies (angiosarcoma, Kaposi sarcoma) both clinically andhistologically. The intention of this work is, through a clinical case,to describe the importance of a correct diagnosis by a proper clinical examination, detailed microscopic observation and interdisciplinary communication between the surgeon and the pathologist, in order toavoid a misdiagnosis of this benign entity with other pathologies tha trequire more aggressive and invasive treatments, inadequate for IPEH.

A Case of Intravascular Papillary Endothelial Hyperplasia on Finger / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular proliferative process characterized by proliferation of endothelial cells with papillary formation located within a vascular lumen. It could manifest as a primary or pure form that develops in a distended vessel or it could be associated with hemangiomas, pyogenic granulomas, and/or lymphangiomas. We report a case showing development of intravascular papillary endothelial hyperplasia on a patient's right fifth finger.

A Case of Intravascular Papillary Endothelial Hyperplasia on Finger / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular proliferative process characterized by proliferation of endothelial cells with papillary formation located within a vascular lumen. It could manifest as a primary or pure form that develops in a distended vessel or it could be associated with hemangiomas, pyogenic granulomas, and/or lymphangiomas. We report a case showing development of intravascular papillary endothelial hyperplasia on a patient's right fifth finger.

A Case of Intravascular Papillary Endothelial Hyperplasia of Eyelid

PURPOSE: To report a case of intravascular papillary endothelial hyperplasia of the eyelid. CASE SUMMARY: A 30-year-old male presented with a right upper eyelid mass, which had been growing in size for three years. The mass was about 7 mm in diameter, purplish, spherical, and cystic. Incision and drainage were performed, but the cystic mass instantly refilled with blood. Excisional biopsy was performed. On microscopic examination, a myriad of small delicate papillae projections into the dilated vascular lumen with organizing thrombus were noted. Each papilla was lined with a single layer of endothelial cells, surrounding a collagenized core. The endothelial cells were reactive for CD31 on immunohistochemical staining. There were focal areas of frequent mitoses, but neither cytological atypia nor necrosis was found. Hence, the lesion was diagnosed as intravascular papillary endothelial hyperplasia. CONCLUSIONS: Intravascular papillary endothelial hyperplasia in the periorbital area is rarely reported, and it is important to distinguish it from hemangioma or angiosarcoma. Complete surgical excision is necessary to prevent recurrence. The authors report a case of intravascular papillary endothelial hyperplasia of the upper eyelid, which should be considered in the differential diagnosis of eyelid or orbital tumor.

Extra‑vascular type of oral intravascular papillary endothelialhyperplasia (Masson’s tumor) of lower lip: A case report and review of the literature.

Intravascular papillary endothelial hyperplasia (IPEH) is an unusual reactive lesion of vascular origin, which rarely occurs in the oral cavity. Pathogenetically, is it divided into true, mixed and extra‑vascular types. We report a case of extra‑vascular IPEH of the lower lip in 54‑year‑old female patient. Patient gives history of trauma 4 months back with lesion developing at the site to trauma. The lesion was 3 cm × 4 cm in size with soft to firm in consistency. Histologically, it is characterized by an exuberant papillary endothelial cell proliferation toward the lumen of an enlarged blood vessel from the area of an organizing thrombus. The lesion was surgically excised under local anesthesia. The patient was followed for 1‑year with no evidence of recurrence. This paper discusses the various aspects of IPEH of the oral cavity such as pathogenesis, clinical features, histopathology treatment, and prognosis.

Intravascular Papillary Endothelial Hyperplasia of the Nasopharynx: A Case Report and Review of the Literature / 대한이비인후과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign proliferation of intravascular endothelial cells. However, IPEH can be easily mistaken for an angiosarcoma, thus differential diagnosis is very important to avoid over-treatment. We report the case of a 22-year-old man who presented with small lobulating mass in nasopharynx. Computed tomography showed about 4 cm homogenous mass in the nasopharynx without extension into soft tissues. Complete surgical excision was done and biopsy during operation showed distended vessels and numerous papillae consist of endothelial cells lining a hyaline core. At follow up, no other complications were observed. Thus we present the case and a review of the literature.

Cutaneous Intravascular Papillary Endothelial Hyperplasia of the Forearm : A Case Report.

Intravascular papillary endothelial hyperplasia (IPEH) or reactive vascular endothelial lesion is a rare benign condition and is also known as Masson’s haemangioma. Blood vessel injury or venous thrombosis may predispose to this condition. Distinction of reactive entities from neoplastic condition like angiosarcoma is important. A case of cutaneous IPEH in forearm of an adult male is being reported here.

Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review

A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a 1.5x1.2x1 cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

Intravascular Papillary Endothelial Hyperplasia in Foot (A Case Report) / 대한족부족관절학회지

Intravascular papillary endothelial hyperplasia (IPEH) known as Masson's hemangioma is a rare benign reactive vascular lesion caused by the abnormal proliferation of endothelial cells. The lesion occurs most commonly in the fingers, head and neck, but very rare in the foot. We report a case of IPEH in the foot treated with operative excision.

Clinical Report of Intravascular Papillary Endothelial Hyperplasia

PURPOSE: Intravascular papillary endothelial hyperplasia(IPEH), also known as Masson's pseudoangiosarcoma, is a rare disease which is now considered as a reactive process of the endothelium rather than a benign neoplasm. It can occur in any blood vessels in the body but more common in the head and neck region as a solitary, often tender, bluish or reddish nodule. IPEH is characterized by the development of endothelial-lined papillary projections in a vascular lumen, usually associated with thrombotic material, the endothelial cells in the papillary structures showing only slight atypia and occasional mitotic Figures, the absence of tissue necrosis. METHODS: 8 patients with IPEH were enrolled in the study from 2002 to 2007. All 8 lesions were surgically excised for histopathologic diagnosis. RESULTS: 4 patients were female. The duration of the lesions ranged from 3 months to 15 years. The tumors were first noted between the ages of 20 and 72 years. 4 patients had lesions on the head; 2 on the toe; 1 on the back; and 1 on the finger, respectively. All lesions were solitary, ranged in size from 2mm to 27 mm. There were no recurrences. CONCLUSION: The clinical appearance of IPEH is not specific, presented as a primary neoplasm, and the diagnosis can be established by microscopic examination. Complete surgical excision is the best choice of therapy for patients with IPEH, and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.

Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor) of the Chest Wall: A Case Report

Intravascular papillary endothelial hyperplasia is a rare tumor-like lesion caused by hyperplastic proliferation of endothlial cells that is usually an incidental findings within thrombosed dilated blood vessels or vascular tumor. We report the sonographic appearance and pathological correlation of intravascular papillary endothelial hyperplasia that presented as an intramuscular solitary mass in chest wall.

A Case of Intravascular Papillary Endothelial Hyperplasia after IPL Treatment / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular tumor characterized by the development of endothelial-lined papillary projections in the vascular lumen. Most authors believe that IPEH represents an unusual pattern of organizing thrombus, implying that a thrombus is the initial cause. A 13-year-old boy came to hospital because of a purpuric patch and violaceous plaque on his right forearm. Clinically, the lesions were thought to be a hemangioma or other vascular malformation. Therefore, we treated him with intense pulsed light (IPL) four times. After treatment, the initial skin lesions were erythematous and edematous and a new bluish mass and multiple scattered subcutaneous nodules appeared near the original skin lesions. Histologic examination of the new bluish mass showed an organic thrombus and endothelial-lined capillary projections in the dilated vascular lumen, compatible with IPEH. Here, we report an interesting case of IPEH after IPL treatment in a 13 year-old boy.

A Case of Intravascular Papillary Endothelial Hyperplasia on the Sole / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH), a benign, reactive vascular lesion, is characterized by the development of endothelial-lined papillary projections in a vascular lumen. Although there has been some controversy about the nature of IPEH, most investigators favor the idea that IPEH usually results from a peculiar organization of a thrombus. The lesions are frequently located in the subcutis of the fingers, hands, forearms, head and neck as a solitary, often tender, bluish or reddish nodule. We report a rare case of IPEH arising on the left sole, an unusual site. IPEH should be among the differential diagnosis of tender lesions on the soles.

A Case of Intravascular Papillary Endothelial Hyperplasia on the Finger / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular tumor. It represents a reactive proliferation of endothelial cells arising in an organized thrombus. And it is histologically characterized by the development of endothelial-lined papillary projections in a vascular lumen. It occurs most frequently in the head and neck region or on the extremities. We report a case of intravascular papillary endothelial hyperplasia developed on the finger.

Three Cases of Intravascular Papillary Endothelial Hyperplasia on the Perinasal Area / 대한피부과학회지

Intravascular papillary endothelial hyperplasia is a rare nonneoplastic reactive process characterized by the development of endothelial papillary projection into the vascular lumen. It is now believed to be an unusual pattern of organization of a thrombus within a vein, or within one or more component vessels of various vascular abnormalities. Clinically, the most commonly involved site is the finger, but can also occur on the head and neck as a solitary, reddish or bluish nodule. Herein, we report three cases of intravascular papillary endothelial hyperplasia which developed on the perinasal area.

A Case of Multiple Intravascular Papillary Endothelial Hyperplasia / 대한피부과학회지

Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's pseudoangiosarcoma, is an unusual pattern of organization of a thrombus within a vein, or within one or more of the component vessels of various vascular abnormalities, such as cavernous hemangioma, pyogenic granuloma and lymphangioma. It is characterized by the development of endothelial-lined papillary projections in a vascular lumen. Lesions of IPEH usually occur on the head, neck or upper extremities as a solitary reddish or bluish nodule. Herein we report a 34-year-old female who presented with multiple bluish nodules on the left hand, which upon histopathological examination showed intravascular papillary endothelial hyperplasia.