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Singh Y, Gupta A, Mridha AR, Rangarajan K. Calvarial Epithelioid Hemangioendothelioma Mimicking Osteosarcoma. Radiol Imaging Cancer 2024; 6:e230198. [PMID: 38456786 PMCID: PMC10988330 DOI: 10.1148/rycan.230198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Yashaswi Singh
- From the Department of Radiodiagnosis and Interventional Radiology,
All India Institute of Medical Sciences, New Delhi, India (Y.S., A.G.);
Department of Pathology, All India Institute of Medical Sciences, New Delhi,
India (A.R.M.); and Department of Radiology, All India Institute of Medical
Sciences, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, Rm No. 160D,
Ansari Nagar, New Delhi 110029, India (K.R.)
| | - Amit Gupta
- From the Department of Radiodiagnosis and Interventional Radiology,
All India Institute of Medical Sciences, New Delhi, India (Y.S., A.G.);
Department of Pathology, All India Institute of Medical Sciences, New Delhi,
India (A.R.M.); and Department of Radiology, All India Institute of Medical
Sciences, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, Rm No. 160D,
Ansari Nagar, New Delhi 110029, India (K.R.)
| | - Asit Ranjan Mridha
- From the Department of Radiodiagnosis and Interventional Radiology,
All India Institute of Medical Sciences, New Delhi, India (Y.S., A.G.);
Department of Pathology, All India Institute of Medical Sciences, New Delhi,
India (A.R.M.); and Department of Radiology, All India Institute of Medical
Sciences, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, Rm No. 160D,
Ansari Nagar, New Delhi 110029, India (K.R.)
| | - Krithika Rangarajan
- From the Department of Radiodiagnosis and Interventional Radiology,
All India Institute of Medical Sciences, New Delhi, India (Y.S., A.G.);
Department of Pathology, All India Institute of Medical Sciences, New Delhi,
India (A.R.M.); and Department of Radiology, All India Institute of Medical
Sciences, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, Rm No. 160D,
Ansari Nagar, New Delhi 110029, India (K.R.)
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Ota Y, Lee E, Sella E, Agarwal P. Vascular Malformations and Tumors: A Review of Classification and Imaging Features for Cardiothoracic Radiologists. Radiol Cardiothorac Imaging 2023; 5:e220328. [PMID: 37693195 PMCID: PMC10483253 DOI: 10.1148/ryct.220328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 09/12/2023]
Abstract
The International Society for the Study of Vascular Anomalies (ISSVA) classification is a comprehensive histology-based scheme that was updated in 2018. It is important for cardiothoracic imagers to understand this classification to ensure that accurate terminology is used and that archaic terms are avoided when vascular lesions are described. Knowledge of the various malformations (including common conditions, such as venous malformation, arteriovenous fistula, and arteriovenous malformation) and vascular tumors allows for timely diagnosis and appropriate management. This review describes various vascular anomalies, in accordance with ISSVA classification and terminology; highlights key imaging features associated with each; and discusses the role of different imaging modalities. Keywords: Pulmonary, Soft Tissues/Skin, Vascular, Arteriovenous Malformation © RSNA, 2023.
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Affiliation(s)
- Yoshiaki Ota
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Elizabeth Lee
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Edith Sella
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
| | - Prachi Agarwal
- From the Division of Cardiothoracic Radiology, Department of
Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI
48109
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Carney BW, Larson MC, Corwin MT, Lamba R. Imaging of Hepatobiliary Cancer. Curr Probl Cancer 2023:100964. [PMID: 37321910 DOI: 10.1016/j.currproblcancer.2023.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/04/2023] [Accepted: 05/20/2023] [Indexed: 06/17/2023]
Abstract
The liver and biliary tree are common sites of primary and secondary malignancies. MRI followed by CT is the mainstay for the imaging characterization of these malignancies with the dynamically acquired contrast enhanced phases being the most important for diagnosis. The liver imaging reporting and data system classification provides a useful framework for reporting lesions in patents with underlying cirrhosis or who are at high risk for developing hepatocellular carcinoma. Detection of metastases is improved with the use of liver specific MRI contrast agents and diffusion weighted sequences. Aside from hepatocellular carcinoma, which is often diagnosed noninvasively, other primary hepatobiliary tumors may require biopsy for definite diagnosis, especially when presenting with nonclassic imaging findings. In this review, we examine the imaging findings of common and less common hepatobiliary tumors.
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Affiliation(s)
- Benjamin W Carney
- Department of Radiology, University of California, Davis Health System, Sacramento, California.
| | - Michael C Larson
- Department of Radiology, University of California, Davis Health System, Sacramento, California
| | - Michael T Corwin
- Department of Radiology, University of California, Davis Health System, Sacramento, California
| | - Ramit Lamba
- Department of Radiology, University of California, Davis Health System, Sacramento, California
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Luo L, Cai Z, Zeng S, Wang L, Kang Z, Yang N, Zhang Y. CT and MRI features of hepatic epithelioid haemangioendothelioma: a multi-institutional retrospective analysis of 15 cases and a literature review. Insights Imaging 2023; 14:2. [PMID: 36600110 DOI: 10.1186/s13244-022-01344-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To improve the current imaging understanding of MRI or CT for hepatic epithelioid haemangioendothelioma (HEHE) to aid in its successful preoperative diagnosis. METHODS The imaging features of 15 patients (median age 38.6, range 20-71; 7 M/8 F) from eight institutions with pathologically confirmed HEHE were retrospectively analysed. Additionally, the CT/MR imaging features of 180 patients in 15 literature publications were collected, analysed and compared with our case series. RESULTS Fifteen patients underwent CT and MRI (n = 2), CT (n = 9) or MR (n = 8) scans. A total of 92.9% (13/14) of the patients were initially diagnosed with other lesions on imaging. A total of 86.7% (13/15) were multifocal. Nodules (11/15, 73.3%) were predominantly peripheral in distribution (12/15, 80.0%). Some cases were associated with hepatic capsular retraction (13/15, 86.7%), "target signs" (8/15, 53.3%) and "lollipop signs" (5/15, 33.3%). Peripheral enhancement of various shapes in the early phase with a progressive centripetal filling was the most common pattern of enhancement (12/15, 80.0%). Abnormal vascularity was seen in 50.7% (6/15) of the patients. Suspicious tumour thromboses in the inferior vena cava were seen in 3 (20.0%) of the patients. Two of the 15 patients (13.3%) had a history of smoking. CONCLUSIONS HEHEs have common distinctive features, including multifocal lesions that are predominantly peripheral, "target signs", "lollipop signs", hepatic capsular retraction and peripheral enhancement of various shapes in the early phase with progressive centripetal filling. Additional aggressive imaging features that may be valuable clues to the diagnosis can be identified by CT or MRI.
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Affiliation(s)
- Lianmei Luo
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua Dong Road, Zhuhai, 519000, Guangdong, China
| | - Zeyu Cai
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua Dong Road, Zhuhai, 519000, Guangdong, China
| | - Sihui Zeng
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Lizhu Wang
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua Dong Road, Zhuhai, 519000, Guangdong, China
| | - Zhuang Kang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ning Yang
- Department of Radiology, Peking Union Medical College Hospital, Beijing, China
| | - Yaqin Zhang
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua Dong Road, Zhuhai, 519000, Guangdong, China.
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Spinelli C, Ghionzoli M, Strambi S. Primary peritoneal hemangioendothelioma simulating an ovarian cyst: A case report and review of literature. World J Obstet Gynecol 2022; 11:40-46. [DOI: 10.5317/wjog.v11.i4.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/05/2022] [Accepted: 11/23/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Epithelioid hemangioendothelioma (EHE) is an extremely rare tumor with a prevalence of one in a million and a very heterogenous spectrum of disease that varies from an indolent to a metastasizing aggressive disease, with the liver, lung and bone being the primarily involved organs. Peritoneal forms of EHE are even rare, and only 12 cases have been reported to date in the literature.
CASE SUMMARY A 66-year-old female came to our attention complaining low abdominal and perineal pain. Magnetic resonance imaging examination showed a 52 mm × 58 mm × 32 mm cystic mass with some smooth septa, simulating an ovarian cyst. Explorative laparoscopy demonstrated the presence of a peritoneal mass of augmented consistency connected with a sigmoid epiploic appendix in the right side of the Pouch of Douglas, that was surgically removed. Histological exa-mination revealed a primitive peritoneafl hemangioendothelioma. The patient easily recovered from surgery with no residual pain or discomfort. She is regularly attending a 3-years follow-up that is negative for local recurrence of disease or distant metastases.
CONCLUSION Peritoneal form of EHE often simulates masses of other nature, as in our case. Given its unspecific clinical and radiological presentation, patients are often forced to a large series of tests and examinations before reaching a definitive diagnosis, that can only histologically made. The possibility of EHE should always be considered in case of unexplained chronic abdominal pain associated to a non-specific mass.
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Affiliation(s)
- Claudio Spinelli
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
| | - Marco Ghionzoli
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
| | - Silvia Strambi
- Pediatric and Adolescent Surgery Division, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56126, Italy
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Hong P, Lee JS, Lee KS. [Epithelioid Hemangioendothelioma Presenting as a Right Paratracheal Mass: A Case Report]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:1373-1379. [PMID: 36545423 PMCID: PMC9748454 DOI: 10.3348/jksr.2022.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/13/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022]
Abstract
Epithelioid hemangioendothelioma (EHE) is a low-grade malignant vascular neoplasm that can occur anywhere in the body. EHE has a low annual incidence (0.38/106) and prevalence (< 1/106), and primary mediastinal EHE is exceedingly rare. We report a case of EHE in a 53-year-old female which manifested as an incidentally discovered mass in the right paratracheal region. In this report, authors describe the pathological and radiological findings of primary mediastinal EHE invading the superior vena cava in the right paratracheal area.
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Atherton K, Hinen H. Vascular Anomalies. Dermatol Clin 2022; 40:401-423. [DOI: 10.1016/j.det.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jung R, Janardhan HP, Dresser K, Cotton JL, Hutchinson L, Mao J, Trivedi CM. Response by Jung et al to Letter Regarding Article, "Sustained Activation of Endothelial YAP1 Causes Epithelioid Hemangioendothelioma". Arterioscler Thromb Vasc Biol 2021; 41:e493-e495. [PMID: 34550712 DOI: 10.1161/atvbaha.121.316810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Roy Jung
- Division of Cardiovascular Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Harish P Janardhan
- Division of Cardiovascular Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Karen Dresser
- Department of Pathology (K.D., L.H.), University of Massachusetts Medical School, Worcester
| | - Jennifer L Cotton
- Department of Molecular, Cell, and Cancer Biology (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester.,Li-Weibo Institute for Rare Diseases Research (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Lloyd Hutchinson
- Department of Pathology (K.D., L.H.), University of Massachusetts Medical School, Worcester
| | - Junhao Mao
- Department of Molecular, Cell, and Cancer Biology (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester.,Li-Weibo Institute for Rare Diseases Research (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester
| | - Chinmay M Trivedi
- Division of Cardiovascular Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Medicine (R.J., H.P.J., C.M.T.), University of Massachusetts Medical School, Worcester.,Department of Molecular, Cell, and Cancer Biology (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester.,Li-Weibo Institute for Rare Diseases Research (J.L.C., J.M., C.M.T.), University of Massachusetts Medical School, Worcester
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Patel Z, Meadows L, Kehinde T, White JK. A primary solitary vascular tumor of calcaneum: case report and review of literature. Radiol Case Rep 2021; 16:2680-2686. [PMID: 34345331 PMCID: PMC8319004 DOI: 10.1016/j.radcr.2021.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022] Open
Abstract
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with metastatic potential and estimated prevalence of less than one case per million. Among the musculoskeletal system, the long bones are commonly involved with approximately half patients experiencing multicentric involvement. Clinical course of EHE is often variable and nonspecific. Poorly demarcated osteolytic lesions are most commonly seen radiologically. Diagnostic confirmation is usually obtained by biopsy and histopathological exam, including immunostaining for endothelial markers. We present a rare case of unicentric EHE involving the calcaneum. Our patient had an indolent course of disease after surgical resection and no recurrence in seven years on clinical and radiological surveillance.
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Affiliation(s)
- Zalak Patel
- Department of Radiology, West Virginia University, Morgantown, WV
| | - Lukas Meadows
- Department of Radiology, West Virginia University, Morgantown, WV
| | - Temitope Kehinde
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV
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