Multifocal epithelioid hemangioendothelioma of the phalanges of the hand

Soft tissue epithelioid hemangioendothelioma on the palm of the hand. Case report

Hemangioendothelioma is a malignant vascular tumor, according to ISSVA classification of vascular tumors. This patient presented an epithelioid hemangioendothelioma; this type of tumor can exhibit significant local destruction, sometimes requiring limb amputation. With deferred Mohs micrographic surgery and reconstructive surgery with multiple conventional and microsurgical techniques, partial or total amputation of the hand was avoided.

Bone and Soft Tissue Tumors About the Foot and Ankle

The foot and ankle delicately balance the need for support of the weight of the human body, with the need for flexibility. Palpable masses about the foot and ankle, therefore, are most commonly related to trauma or mechanical instability. Non-neoplastic causes, such as ganglion cysts and callus, therefore, predominate. However, the radiologist must be aware of the imaging appearance of less common benign and malignant neoplasms that can involve the foot and ankle.

Primary angiosarcoma of bone: a retrospective analysis of 60 patients from 2 institutions

BACKGROUND

Angiosarcoma of bone is a rare high-grade malignant vascular tumor. The literature regarding treatment and outcome of patients with this tumor is limited.We performed a 2 institutional retrospective study to analyze treatment and survival of patients with angiosarcoma of bone.

PATIENTS AND METHODS

We reviewed patients with the histologic diagnosis of primary angiosarcoma of bone treated from 1980 to 2009. Demographic details, histology, treatment, and survival were reviewed.

RESULTS

A total of 38 men and 22 women (median age, 54 y) were recruited. Most lesions occurred in the femur and the pelvis. Metastatic disease at presentation was diagnosed in 24 patients (40%). Forty-three patients underwent surgery, with 30 of them achieving surgical complete remission (SCR). Radiotherapy was applied to 17 patients, and chemotherapy to 13/35 and 15/22 patients with localized and metastatic disease, respectively.The 5-year overall survival (OS) was 20%: 33% for patients with localized disease and 0% for metastatic patients. Higher 5-year OS was reported for patients who achieved SCR (46%) than for those who did not (0%). In nonmetastatic patients, a trend toward improved survival was observed after SCR and adjuvant chemotherapy based on cisplatin, doxorubicin, and ifosfamide.Fifteen patients received chemotherapy for metastases. Two RECIST partial responses of 13 evaluable patients were documented (paclitaxel [n=1] and doxorubicin [n=1]). Stable disease was observed in 2 patients.

CONCLUSIONS

Complete surgical resection is essential for outcome. Survival of patients with metastatic or unresectable disease is very poor. Activity of taxanes and anthracycline was observed in the metastatic setting and merits further evaluation.

Epitheloid hemangioendothelioma of the subcutaneous tissues of a finger

Epithelioid hemangioendotheliomas (EHEs) are known to have a variable malignant potential. EHEs are rarely seen in the hand and there is no consensus about their management. The options include excision, excision followed by adjuvant radiotherapy and amputation. In this paper, we report a case of EHE of a finger that was treated by excision. Although the tumor had ill-defined borders and there was histological evidence of tumor extension to all resection margins, no local recurrence or metastasis were noted during the 3 years of followup. The literature is reviewed and an argument is made that EHEs of the hand may have a more benign behavior compared with EHEs of the lower limbs and viscera.

Cutaneous epithelioid hemangioendothelioma

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor of endothelial cell origin. We describe an EHE arising on the plantar surface of the foot that was treated as verruca vulgaris for several years before a biopsy showed EHE. We discuss the clinical and histopathologic differential diagnoses for these tumors and review additional cases in which EHE has been mistaken for benign entities clinically.