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Xu B, Tan H, Bian P. Endoscopic Management of Recurrent Epistaxis Caused by Retiform Hemangioendothelioma in a Child: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613241253372. [PMID: 38757668 DOI: 10.1177/01455613241253372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Retiform hemangioendothelioma (RH) is a rare intermediate (locally aggressive) vascular tumor that mostly affects the dermis of the trunk and limbs, but has never been reported in the inferior turbinate. A 10-year-old Chinese boy presented with recurrent epistaxis in his left nasal cavity and anemia for more than 2 years. Radiographic and electronic video laryngoscopic images showed an expansile mass in the left inferior turbinate. Endoscopic surgery and electrocautery were performed to resect the tumor beyond the macroscopic border. Histopathologically, the tissues were infiltrated by hyperplastic blood vessels arranged in a retiform pattern, and endothelial cells proliferate significantly in some areas. Immunohistochemistry showed a positive result for CD31, CD34, Fli-1, and ERG. No epistaxis, tumor recurrence, or metastasis was found on reexamination over 18 months after surgery.
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Affiliation(s)
- Baicheng Xu
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Huan Tan
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Panpan Bian
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Qin TT, Cao LT, Lu LX, Wang XL, Zhang JC, Li B, Yu XH, Ren XL. Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation. Open Life Sci 2023; 18:20220592. [PMID: 37333485 PMCID: PMC10276542 DOI: 10.1515/biol-2022-0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/14/2023] [Accepted: 03/12/2023] [Indexed: 06/20/2023] Open
Abstract
Retiform hemangioendothelioma (RH) is a type of low-grade malignant angiosarcoma. It commonly involves the skin and subcutaneous tissue of the lower extremities, but a few cases have been reported in the gut. However, hepatic RH has not been previously reported. This report presents the case of RH of the liver in a 61-year-old woman who was admitted to the hospital having presented with liver space-occupying lesions of 2 months evolution. The patient underwent an abdominal ultrasound examination, which indicated a hemangioma, but abdominal computed tomography diagnosed a liver abscess. In order to determine the nature of the lesion, an ultrasound-guided liver biopsy was performed, after which a pathological diagnosis confirmed the presence of RH in the liver. The patient underwent ultrasound-guided microwave ablation three times and has been followed up for 8 years with no tumor recurrence or metastasis. Surgical excision is still the first choice for the treatment of hepatic RH. As shown in this case, however, for patients who refuse to undergo surgery or have surgical contraindications, ultrasound-guided microwave ablation is an alternative treatment option. The report of this case expands the scope of liver tumors to a certain extent and provides a reference for clinical diagnosis and treatment.
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Affiliation(s)
- Tian-Tian Qin
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
- Department of Infectious Diseases, The Second Affiliated Hospital of Air Force Medical University, Xi’an710038, China
| | - Li-Ting Cao
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Li-Xia Lu
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Xiu-Li Wang
- Department of Ultrasonography, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Jiu-Cong Zhang
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Bin Li
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Xiao-Hui Yu
- Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
| | - Xiao-Long Ren
- Department of Ultrasonography, The 940 Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 333 of Binhenan Road, Qilihe District, Lanzhou, 730050, China
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McCollum KJ, Al-Rohil RN. Cutaneous Vascular Neoplasms of Uncertain Biological Behavior. BIOLOGY 2021; 10:biology10111160. [PMID: 34827153 PMCID: PMC8614966 DOI: 10.3390/biology10111160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Abstract
Neoplasms of uncertain biological behavior present physicians with a genuine conundrum in practice. Cutaneous vascular neoplasms within this category are exceedingly rare, possessing significant gaps and uncertainty in many facets of clinical practice. Firstly, lesions were selected for review based on their categorization as indeterminate behavior, indicating the potential for local recurrence and rarely metastasize. After identification of the target lesions, a comprehensive review of the literature using national databases produced several landmark studies and case series regarding these neoplasms. Limiting the review to only cutaneous limited tumors narrowed the pool of studies; however, quite a large sum of papers remained. Examination of each paper yielded beneficial results on diagnosing, effective treatments, follow-up findings, and prognosis for each indeterminate lesion discussed. Overall, the literature search combined the molecular, histologic, immunohistochemical, surgical strategies to develop an up-to-date and comprehensive framework to guide physicians when encountering such lesions. The tumors reviewed include: kaposiform hemangioendothelioma, endovascular papillary angioendothelioma, pseudomyogenic hemangioendothelioma, retiform hemangioendothelioma, epithelioid hemangioendothelioma, and composite hemangioendothelioma.
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Affiliation(s)
- Kasey J. McCollum
- Department of Pathology, Duke University Medical Center, Durham, NC 27710-0001, USA;
| | - Rami N. Al-Rohil
- Department of Pathology, Duke University Medical Center, Durham, NC 27710-0001, USA;
- Department of Dermatology, Duke University Medical Center, Durham, NC 27710-1000, USA
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Zhang M, Yin X, Yao W, Liu N, Yue Y. Retiform hemangioendothelioma: a rare lesion of the vulva. J Int Med Res 2021; 49:3000605211027783. [PMID: 34340581 PMCID: PMC8358529 DOI: 10.1177/03000605211027783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
Retiform hemangioendothelioma (RH) is a rare borderline-malignant vascular tumor with specific histological characteristics, usually occurring in the limbs and trunk. We report the case of a 63-year-old woman who presented with a painless, oval nodule that had been growing slowly on her left vulva for 3 years. Magnetic resonance imaging of the pelvic cavity revealed a 4.4- × 2.7- × 1.8-cm cystic lesion in the subcutaneous fat of the left vulva. Resection beyond the macroscopic border was performed. Pathology revealed vascular structures with elongated and narrow arborizing vascular channels that were arranged in a retiform pattern resembling rete testis tissue. Immunohistochemical endothelial staining was positive for CD31, CD34, and Friend leukemia integration-1 (FLI-1). The above features confirmed a diagnosis of RH. There was no local recurrence or metastasis during the 26-month follow-up. RH of the vulva is rare, and its diagnosis is supported by specific histological characteristics and immunohistochemical staining for CD31, CD34, and FLI-1. Wide surgical resection with tumor-free margins is important for a favorable prognosis.
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Affiliation(s)
- Mingyue Zhang
- Department of Gynecological Oncology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaojiao Yin
- Department of Gynecological Oncology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Weikai Yao
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ning Liu
- Department of Gynecological Oncology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ying Yue
- Department of Gynecological Oncology, The First Hospital of Jilin University, Changchun, Jilin, China
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Kim IK, Cho HY, Jung BS, Pae SP, Cho HW, Seo JH, Park SH. Retiform hemangioendothelioma in the infratemporal fossa and buccal area: a case report and literature review. J Korean Assoc Oral Maxillofac Surg 2016; 42:307-314. [PMID: 27847741 PMCID: PMC5104875 DOI: 10.5125/jkaoms.2016.42.5.307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/20/2016] [Accepted: 09/09/2016] [Indexed: 11/21/2022] Open
Abstract
We report a case of retiform hemangioendothelioma (RH) located in the infratemporal fossa and buccal area in a 13-year-old Korean boy. The tumor originated from the sphenoid bone of the infratemporal fossa area and spread into the cavernous sinus, orbital apex, and retro-nasal area with bone destruction of the pterygoid process. Tumor resection was conducted via Le Fort I osteotomy and partial maxillectomy to approach the infratemporal fossa and retro-nasal area. The diagnosis of RH was confirmed after surgery. In the presented patient, surgical excision was incomplete, and close follow-up was performed. There was no evidence of expansion or metastasis of the residual tumor in the 8 years after surgery. In cases of residual RH with low likelihood of expansion and metastasis, even though RH is an intermediate malignancy, close follow-up can be the appropriate treatment choice over additional aggressive therapy. To date, 29 papers and 48 RH cases have been reported, including this case. This case is the second reported RH case presenting as primary bone tumor and the first case originating in the oromaxillofacial area.
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Affiliation(s)
- Il-Kyu Kim
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Hyun-Young Cho
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Bum-Sang Jung
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Sang-Pill Pae
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Hyun-Woo Cho
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Ji-Hoon Seo
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
| | - Seung-Hoon Park
- Department of Oral and Maxillofacial Surgery, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea
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Wick MR. Contributions of Dr. Juan Rosai to the pathology of cutaneous vascular proliferations: A review of selected lesions. Semin Diagn Pathol 2016; 33:284-93. [PMID: 27318413 DOI: 10.1053/j.semdp.2016.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Vascular proliferations in the skin have been thoroughly studied over the past 35 years, and a great deal of knowledge has been accrued regarding their pathobiological features. Dr. Juan Rosai has been a consistent contributor to the literature on this topic throughout most of his career, and this article reviews selected cutaneous endothelial lesions that he helped to characterize. They include histiocytoid-epithelioid hemangioma, targetoid-hobnail hemangioma, acquired tufted hemangioma, glomeruloid hemangioma, spindle cell hemangioma, retiform hemangioendothelioma, and angiosarcoma. Two potential simulants of angiosarcoma-papillary intravascular endothelial hyperplasia and cutaneous rudimentary meningocele-meningothelial hamartoma-are also considered.
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Affiliation(s)
- Mark R Wick
- Division of Surgical Pathology, University of Virginia Medical Center, Charlottesville, Virginia; Division of Cytopathology, University of Virginia Medical Center, Charlottesville, Virginia; Division of Autopsy Pathology, University of Virginia Medical Center, Charlottesville, Virginia.
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Fernandez-Flores A. Aportaciones de la anatomía patológica en el diagnóstico de las infecciones cutáneas: una perspectiva histórica. PIEL 2016. [PMCID: PMC7148901 DOI: 10.1016/j.piel.2015.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Histopathology and Pathogenesis of Vascular Tumors and Malformations. VASCULAR TUMORS AND DEVELOPMENTAL MALFORMATIONS 2016. [DOI: 10.1007/978-1-4939-3240-5_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Liu Q, Ouyang R, Chen P, Zhou R. A case report of retiform hemangioendothelioma as pleural nodules with literature review. Diagn Pathol 2015; 10:194. [PMID: 26503428 PMCID: PMC4624164 DOI: 10.1186/s13000-015-0433-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/17/2015] [Indexed: 11/10/2022] Open
Abstract
Retiform hemangioendothelioma (RH) is a rare low-grade variant of angiosarcoma mostly reported on dermis or subcutaneously. A 30-year-old woman suffering from dry cough, dyspnea and pleural effusion has been described. Distinctive symptoms and lesions on high resolution computed tomography (HRCT) scan and common histological, immunological feature are discussed. Diagnosis was made by thoracoscopy as RH.
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Affiliation(s)
- Qingqing Liu
- Department of Internal Medicine, Second Xiangya Hospital of Central South University, 139 Renming Rd, Changsha, Hunan, 410011, PR China.
| | - Ruoyun Ouyang
- Department of Internal Medicine, Second Xiangya Hospital of Central South University, 139 Renming Rd, Changsha, Hunan, 410011, PR China.
| | - Ping Chen
- Department of Internal Medicine, Second Xiangya Hospital of Central South University, 139 Renming Rd, Changsha, Hunan, 410011, PR China.
| | - Rui Zhou
- Department of Internal Medicine, Second Xiangya Hospital of Central South University, 139 Renming Rd, Changsha, Hunan, 410011, PR China.
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Nobeyama Y, Ishiuji Y, Nakagawa H. Retiform hemangioendothelioma treated with conservative therapy: report of a case and review of the literature. Int J Dermatol 2015; 55:238-43. [PMID: 26267121 DOI: 10.1111/ijd.12908] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/09/2014] [Accepted: 11/22/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Retiform hemangioendothelioma (RH) is a locally aggressive vascular tumor. Wide surgical excision with tumor-free margins is the standard treatment strategy. However, surgical excision is not an option for lesions near critical anatomical structures, such as those on the face. We report the case of a patient with retiform hemangioendothelioma that responded to non-surgical treatments. METHODS We describe the case of a 72-year-old male patient with a retiform hemangioendothelioma on the face that responded to a combination of pulsed dye laser, local corticosteroid injection, and application of imiquimod cream. In addition, we reviewed past case reports of patients with retiform hemangioendothelioma. RESULTS Thirty-five cases that describe the management of RH, including the present case, have been reported. Review of the cases indicate a relatively low disease-free survival rate in cases that underwent surgical excision as the initial therapy for retiform hemangioendothelioma. CONCLUSION Surgical excision might not be the best therapeutic option. Local control with conservative therapy is an acceptable strategy for lesions in anatomical regions including the face.
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Affiliation(s)
- Yoshimasa Nobeyama
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yozo Ishiuji
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidemi Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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Abstract
Hemangioendothelioma is the term used to name those vascular neoplasms that show a borderline biological behavior, intermediate between entirely benign hemangiomas and highly malignant angiosarcomas. Although originally spindle cell hemangioendothelioma was proposed as a specific clinicopathologic variant of hemangioendothelioma, currently, it is considered as an entirely benign lesion, and thus, the name spindle cell hemangioma seems to be the most accurate for this lesion. Authentic hemangioendotheliomas involving the skin and soft tissues include papillary intralymphatic angioendothelioma (also known as Dabska tumor), retiform hemangioendothelioma, kaposiform hemangioendothelioma, epithelioid hemangioendothelioma, pseudomyogenic hemangioendothelioma (also known as epithelioid sarcoma-like hemangioendothelioma), and composite hemangioendothelioma. Each of these neoplasms exhibit characteristic histopathologic features. The most characteristic finding of papillary intralymphatic hemangioendothelioma consists of papillary tufts, with a central hyaline core lined by hobnail-like endothelial cells protruding into the lumina. Retiform hemangioendothelioma is an infiltrative neoplasm composed of elongated arborizing vessels, arranged in an anastomosing pattern that resembles that of the rete testis, and lined by a single layer of hobnail-like endothelial cells that protrude within the narrow lumina. Kaposiform hemangioendothelioma is composed of several solid poorly circumscribed nodules, and each nodule is composed of a mixture of small capillaries and solid lobules of endothelial cells arranged in a glomeruloid pattern. A frequent finding consists of the presence of areas of lymphangiomatosis adjacent to the solid nodules. Epithelioid hemangioendothelioma is composed of cords, strands, and solid aggregates of round, oval, and polygonal cells, with abundant pale eosinophilic cytoplasm, vesicular nuclei, and inconspicuous nucleoli, embedded in a fibromyxoid or sclerotic stroma. Many neoplastic cells exhibit prominent cytoplasmic vacuolization as an expression of primitive vascular differentiation. Pseudomyogenic hemangioendothelioma is a poorly circumscribed, fascicular lesion with infiltrative borders composed of round or oval neoplastic cells, with vesicular nuclei and inconspicuous nucleoli, and ample homogeneous eosinophilic cytoplasm, giving them a rhabdomyoblastic appearance. Finally, composite hemangioendothelioma is the term used to name locally aggressive vascular neoplasms of low-grade malignancy showing varying combinations of benign, low-grade malignant, and high-grade malignant vascular components. From the immunohistochemical point of view, proliferating cells of all hemangioendotheliomas express a lymphatic endothelial cell immunophenotype. Most hemangioendotheliomas are low-grade vascular neoplasms, with a tendency to recur locally and a low metastatic potential, mostly to regional lymph nodes. Epithelioid hemangioendothelioma, especially large lesions and those located in deep soft tissues, seems to have a more aggressive biological behavior.
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Affiliation(s)
- Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
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Lombardini E, Summers B. Two Canine Malignant Vascular Tumours with Features of Human Retiform Haemangioendothelioma. J Comp Pathol 2013; 148:225-9. [DOI: 10.1016/j.jcpa.2012.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 04/25/2012] [Accepted: 05/16/2012] [Indexed: 11/29/2022]
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Unresectable retiform hemangioendothelioma treated with external beam radiation therapy and chemotherapy: a case report and review of the literature. Sarcoma 2010; 2010. [PMID: 20936126 PMCID: PMC2948930 DOI: 10.1155/2010/756246] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 08/15/2010] [Accepted: 08/16/2010] [Indexed: 11/17/2022] Open
Abstract
Retiform hemangioendothelioma (RH) is an infrequently encountered vascular neoplasm of intermediate or borderline malignancy. Treatment of RH is controversial. We present a case of a 44-year-old Asian male presenting with an unresectable RH of the pelvis. The patient was treated with concurrent low-dose Cisplatin and External beam Radiation (4140cGy in 180cGy per fraction). This is the first report of a clinical complete response and a long-term local control of this rare tumor. This has significant clinical implication, since it gives the first evidence of treatment of this rare tumor using concurrent low-dose chemotherapy and radiation.
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Emberger M, Laimer M, Steiner H, Zelger B. Retiform hemangioendothelioma: presentation of a case expressing D2-40. J Cutan Pathol 2009; 36:987-90. [DOI: 10.1111/j.1600-0560.2009.01161.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Elston DM. Vascular tumors. Dermatopathology (Basel) 2009. [DOI: 10.1016/b978-0-7020-3023-9.10023-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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16
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Güvenç MG, Midilli K, Özdoğan A, İnci E, Tahamiler R, Enver Ö, Şirin G, Ergin S, Kuşkucu M, Divanoğlu EÖ, Yılmaz G, Altas K. Detection of HHV-8 and HPV in laryngeal carcinoma. Auris Nasus Larynx 2008; 35:357-62. [DOI: 10.1016/j.anl.2007.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 08/18/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
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17
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Ioannidou D, Panayiotides J, Krasagakis K, Stefanidou M, Manios A, Tosca A. Retiform hemangioendothelioma presenting as bruise-like plaque in an adult woman. Int J Dermatol 2006; 45:53-5. [PMID: 16426378 DOI: 10.1111/j.1365-4632.2004.02341.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Despina Ioannidou
- Department of Dermatology, Heraklion University General Hospital, Heraklion, Crete, Greece.
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18
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Tan D, Kraybill W, Cheney RT, Khoury T. Retiform hemangioendothelioma: a case report and review of the literature. J Cutan Pathol 2005; 32:634-7. [PMID: 16176302 DOI: 10.1111/j.0303-6987.2005.00379.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Retiform hemangioendothelioma (RH) is a rare, recently described vascular neoplasm of low malignant potential. METHODS We report a case of RH of the foot of a 19-year-old white female. Histologically, the tumor grew as numerous elongated vessels resembling the shape of rete testis with involvement of the skin adnexal structures and subcutaneous adipose tissue. No dissection of collagen by small groups of endothelial cells was seen. Wide local excision was performed and the patient was healthy with no metastasis at 14 months follow-up. RESULTS AND CONCLUSIONS Our case is discussed in the context of previously reported cases of RH; we also include a review of all cases of RH published to date.
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Affiliation(s)
- Dongfeng Tan
- Department of Pathology and Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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19
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Cohen A, Wolf DG, Guttman-Yassky E, Sarid R. Kaposi's sarcoma-associated herpesvirus: clinical, diagnostic, and epidemiological aspects. Crit Rev Clin Lab Sci 2005; 42:101-53. [PMID: 15941082 DOI: 10.1080/10408360590913524] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHI) is one of the few viruses proven to be associated with tumorigenesis in humans. Its causal association with all clinical and epidemiological variants of Kaposi's sarcoma (KS) is well established. KSHV is also involved in the pathogenesis of primary effusion lymphoma (PEL) and a subset of multicentric Castleman's disease (MCD). Possible associations of KSHV with other clinical settings have been extensively examined. The findings from several of these studies are contradictory and are yet to be resolved. Concentrated effort over the last decade, since the initial discovery of KSHV, led to the development of several experimental systems that resulted in a better comprehension of the biological characteristics of KSHV and set the stage for the understanding of mechainisms by which diseases are induced by the virus. The development of molecular, histological, and serological tools for KSHV diagnosis allowed researchers to track the transmission and to study the epidemiology of KSHV. These assays have been applied, in particular in ambiguous cases, in order to confirm clinically and pathologically based diagnoses. Here, we review the advances in the clinical, experimental, diagnostic, and epidemiological research of KSHV.
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Affiliation(s)
- Adina Cohen
- Faculty of Life Sciences, Bar-Ilan Universiy, Ramat-Gan, Israel
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Schmid H, Zietz C. Human herpesvirus 8 and angiosarcoma: analysis of 40 cases and review of the literature. Pathology 2005; 37:284-7. [PMID: 16194826 DOI: 10.1080/00313020500169495] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS To prove a possible involvement of the endotheliotropic human herpesvirus 8 (HHV-8) in the pathogenesis of angiosarcoma in samples from patients in a low HHV-8 seroprevalence area. METHODS A comprehensive series of angiosarcomas (n = 40) as well as positive and negative control tissues from patients with Kaposi's sarcoma, human immunodeficiency virus (HIV)-associated multicentric Castleman's disease or juvenile haemangioma, respectively, was analysed with two sensitive methods: immunohistochemical staining for the HHV-8 latency-associated nuclear antigen 1 (LANA-1); and polymerase chain reaction (PCR) for HHV-8 VP23 DNA sequences. RESULTS None of the angiosarcoma cases and none of the negative control samples (juvenile haemangiomas) revealed positive immunohistochemical staining with the LANA-1 antibody. In contrast, HHV-8 LANA-1 was clearly detected in all analysed cases of Kaposi's sarcoma and multicentric Castleman's disease. These results were confirmed by PCR assay at the DNA level. CONCLUSION In conclusion, the great majority of angiosarcomas investigated to date, including the series of 40 angiosarcomas analysed here, does not contain HHV-8 DNA sequences or protein. This argues against a relevant role of the endotheliotropic HHV-8 in the pathogenesis of angiosarcoma and, for vascular diseases, speaks in favour of a relatively restricted pathogenic role of HHV-8 to Kaposi's sarcoma and multicentric Castleman's disease.
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Affiliation(s)
- Holger Schmid
- Institute of Pathology, Ludwig Maximilians University of Munich, Germany
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21
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Abstract
Cutaneous vascular proliferations are a vast and complex spectrum. Many appear as hamartomas in infancy; others are acquired neoplasms. Some vascular proliferations are hyperplastic in nature, although they mimic hemangiomas, i.e., neoplasms. The vast majority of the vascular lesions are hemangiomas. Between the hemangiomas and frankly angiosarcomas, there is a group of neoplasms that are angiosarcomas, albeit ones of low grade histologically and, probably, biologically. The term "hemangioendothelioma" has been created to encompass these neoplasms. Vascular proliferations are, fundamentally, composed of endothelial cells. Some hemangiomas, however, contain also abundant pericytic, smooth muscle, or interstitial components, or a combination of them. These heterogeneous cellular components are present usually in hemangiomas. Some of the newly described vascular proliferations, however, are difficult to differentiate from some of the angiosarcomas. Others are markers, occasionally, of serious conditions such as Fabry's Disease (angiokeratoma) and POEM's syndrome (glomeruloid hemangioma). Kaposi's sarcoma continues to be an enigma. The demonstration of Herpes virus 8 in this condition raises doubt about its neoplastic nature. The demonstration of endothelial differentiation of its nodular lesions is tenuous and its true nature remains unresolved. While physicians have known about post-mastectomy angiosarcomas from the origin of the radical mastectomy, a new group of unusual vascular proliferations of the mammary skin are being defined. These lesions arise in the setting of breast-conserving surgical treatment with adjuvant radiation therapy. The incubation period is usually 3 to 5 years, in contrast with the 10, or more, in classical cases of post-mastectomy angiosarcoma. These lesions usually are subtle, both clinically and histologically, in contrast with the "classical," dramatic presentation of mammary angiosarcoma. The spectrum of findings ranges from "simple" lymphangiectasia-like vascular proliferations to unequivocal angiosarcomas. The pathogenesis of these lesions remains a mystery. There are very few clues that allow one to separate hemangiomas from angiosarcomas. The presence of heterologous cellular elements and, particularly, well-developed smooth muscle components tends to favor a hemangioma. Similarly, the presence of thrombosis usually supports hemangioma. Nevertheless, there are no unequivocal or reliable individual diagnostic criteria. A thorough knowledge of the different conditions and their differential diagnoses eventually leads to the proper diagnosis in most cases.
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Affiliation(s)
- Steven J Hunt
- Northern Pathology Laboratory, Iron Mountain, Michigan, USA
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García Escudero A, Segura Sánchez J, Navarro Bustos G, González Serrano T, Ríos Martín JJ, González Cámpora R. Hemangioendotelioma retiforme: descripción de dos casos y revisión de la literatura. ACTAS DERMO-SIFILIOGRAFICAS 2003. [DOI: 10.1016/s0001-7310(03)79234-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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O'Hara CD, Nascimento AG. Endothelial lesions of soft tissues: a review of reactive and neoplastic entities with emphasis on low-grade malignant ("borderline") vascular tumors. Adv Anat Pathol 2003; 10:69-87. [PMID: 12605089 DOI: 10.1097/00125480-200303000-00002] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Soft tissue proliferations composed of endothelial cells are a heterogeneous group of lesions that can cause diagnostic difficulty. Further complicating the issue is the constantly changing nomenclature of some entities, as well as reclassification of some vascular tumors from the high-grade malignant category to the low-grade malignant or borderline category. Modern ancillary techniques such as immunohistochemistry and cytogenetics have done little to advance our knowledge of these lesions. This review article outlines the most recent classification of endothelial lesions of the skin and soft tissues, with emphasis on the low-grade malignant (borderline) category. In addition, many tumor-like lesions containing an endothelial component are also discussed.
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Affiliation(s)
- Carolyn D O'Hara
- Department of Laboratory Medicine and Pathalogy, Mayo Clinic, Rochester, Minnesota 55905, USA
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McMenamin ME, Fletcher CDM. Reactive angioendotheliomatosis: a study of 15 cases demonstrating a wide clinicopathologic spectrum. Am J Surg Pathol 2002; 26:685-97. [PMID: 12023572 DOI: 10.1097/00000478-200206000-00001] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Reactive angioendotheliomatosis (RAE) is a rare condition characterized by cutaneous vascular proliferation that usually occurs in patients with diverse types of coexistent systemic disease. Although intravascular proliferation of endothelial cells has been considered to be the key histologic feature in RAE, other patterns of vascular proliferation have also been described. We reviewed the clinicopathologic features in 15 cases of RAE. The study group comprised eight males and seven females with an age range of 47-88 years (median 65 years). Eleven patients had coexistent systemic disease: renal disease (six patients, including three post renal transplantation); valvular cardiac disease (two patients); one patient each had alcoholic cirrhosis, glioblastoma multiforme (on chemotherapy), and rheumatoid arthritis/polymyalgia rheumatica. Six patients were iatrogenically immunosuppressed at the onset of the skin lesions. The clinical appearance included multiple erythematous macules, plaques, tumors, and ulcerated lesions, with a wide distribution but a propensity to involve limbs. Lesions had been present for 1 month to 4 years (median 4 months). Lesions resolved in four cases, improved in two cases, remained static in one case, and progressed in four cases. Two cases were recent and follow-up was not available in two other cases. Three patients died of their coexistent systemic disease with resolution, improvement, and progression of lesions, respectively. All lesions were characterized histologically by a proliferation of capillaries in the dermis, with variably diffuse (seven cases), lobular (six cases), or mixed lobular and diffuse patterns (two cases). There was marked intercase and intracase heterogeneity in histologic features. Common features included fibrin microthrombi (nine cases), reactive (fasciitis-like) dermal alterations (seven cases), and foci of epithelioid endothelium (four cases). Four of 10 cases tested showed positive immunohistochemical staining for HHV-8 latent nuclear antigen in lesional endothelial cell nuclei. This study suggests that RAE has a broader clinicopathologic spectrum than previously described. The pathogenesis of this rare disorder is unknown, but it is likely that immunologic factors play a role.
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Affiliation(s)
- Máirín E McMenamin
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA
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Kazakov DV, Prinz BM, Michaelis S, Schmid M, Müller B, Adams V, Burg G, Kempf W. Study of HHV-8 DNA sequences in archival biopsies from lesional skin of Kaposi's sarcoma, various mesenchymal tumors and related reactive conditions. J Cutan Pathol 2002; 29:279-81. [PMID: 12100627 DOI: 10.1034/j.1600-0560.2002.290503.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND HHV-8 has been identified as the causative agent of Kaposi's sarcoma (KS) and some lymphoproliferative disorders. In addition, there are anecdotal reports on the presence of HHV-8 in other tumors, especially cutaneous epithelial and mesenchymal neoplasms. The aim of the study was to ascertain the value of identification of HHV-8 viral DNA sequences in routinely processed, formalin-fixed, paraffin-embedded tissues for the diagnosis of Kaposi's sarcoma and other mesenchymal tumors. METHODS The presence of HHV-8 sequences in archival material was studied by nested PCR using specific primers for amplification of a 233-bp long fragment of HHV-8 (ORF 26). RESULTS Thirty-three patients with KS (18 classic/sporadic, six post-transplant and nine AIDS-related) and various mesenchymal tumors and related conditions (n = 76) were studied. HHV-8 DNA sequences were detected in 29 of the 33 cases of KS and in one case of multiple eruptive dermatofibroma (MEDF). CONCLUSIONS Identification of HHV-8 DNA sequences in routinely processed tissue is a useful diagnostic marker for KS. Although other mesenchymal tumors are usually not associated with HHV-8, its presence is not fully specific for KS since HHV-8 sequences were also found in one case of MEDF. Therefore, PCR analysis for the detection of HHV-8 should only be used as an additional diagnostic marker for KS and in the context of other tools such as routine histology.
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Affiliation(s)
- Dmitry V Kazakov
- Department of Dermatology, University Hospital, Zürich, Switzerland
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26
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Abstract
BACKGROUND Hobnail hemangioma (HH) is a rare subtype of hemangioma that shares the morphological feature of hobnail endothelia with retiform hemangioendothelioma (RHE) and has to be considered in the differential diagnosis of Kaposi sarcoma. Since DNA of the human herpesvirus type 8 (HHV-8) has been detected in more than 90% of Karposi sarcomas and could recently be demonstrated in RHE, we sought to detect HHV-8 DNA in HH. METHODS AND RESULTS DNA from 12 HH was extracted and subjected to polymerase chain reaction analysis for HHV-8 DNA using two independent protocols with a single set of primers and a nested PCR approach, respectively. PCR amplification was performed using the LightCycler as well as using a thermocycler. HHV-8 DNA could not be detected in HH, although each sample contained DNA adaequately preserved for PCR reactions, as determined by amplification of the beta actin gene. CONCLUSIONS HHV-8 appears to play no rule in the pathogenesis of HH. Absence of HHV-8 DNA in HH might be important in the differential diagnosis to other vascular tumours, in particular Kaposi sarcoma.
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MESH Headings
- DNA Primers/chemistry
- DNA, Neoplasm/analysis
- DNA, Viral/analysis
- Diagnosis, Differential
- Endothelium, Vascular/pathology
- Endothelium, Vascular/virology
- Hemangioendothelioma/genetics
- Hemangioendothelioma/pathology
- Hemangioendothelioma/virology
- Herpesviridae Infections/genetics
- Herpesviridae Infections/pathology
- Herpesviridae Infections/virology
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/isolation & purification
- Herpesvirus 8, Human/pathogenicity
- Humans
- Polymerase Chain Reaction
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
- Skin Neoplasms/virology
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Affiliation(s)
- Ralf Gutzmer
- Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
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Satta R, Cossu S, Massarelli G, Cottoni F. Anaplastic transformation of classic Kaposi's sarcoma: clinicopathological study of five cases. Br J Dermatol 2001; 145:847-9. [PMID: 11736920 DOI: 10.1046/j.1365-2133.2001.04437.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Joomaye Z, Lecam-Savin C, Tabardel-Maurizot M, Dambron P, Guichenez P, Ramdani M, Gislon J, Duhamel O. [Pulmonary epithelioid hemangioendothelioma: a tumor with an atypical course not to be unrecognized]. Rev Med Interne 2001; 22:889-90. [PMID: 11599193 DOI: 10.1016/s0248-8663(01)00442-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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