Epithelioid hemangioendothelioma of spine: A case report with review of literatures

Chen, Ping-Kang; Lin, Qi-Ting; Feng, You‐Zhen; Weng, Zeping; Cai, Xiang‐Ran

doi:10.1016/j.radcr.2020.10.024

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…In our study, we found that all cases showed isointensity on T1WI, hyperintensity or slight hyperintensity on T2WI, obvious enhancement. These MRI manifestations have also been reported in previous case reports[ 7 , 9 ]. The low-grade malignancy biological behavior of EHE results in a propensity to present with an ill-defined border, surrounding soft-tissue mass, no sclerotic rim, pathological compression fracture, and other signs.…”

Section: Discussionsupporting

confidence: 86%

Epithelioid hemangioendothelioma of the spine: an analysis of imaging findings

et al. 2022

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Background Epithelioid hemangioendothelioma (EHE) is a low-grade malignant vascular neoplasm with the potential to metastasize. Primary EHE of the spine is very rare and an accurate diagnosis is crucial to treatment planning. We aim to investigate the imaging and clinical data of spinal EHE to improve the understanding of the disease. Methods We retrospectively analyzed the imaging manifestations and clinical data of 12 cases with pathologically confirmed spinal EHE. The imaging features analyzed included number, locations, size, border, density, signal, majority of the lesions, expansile osteolysis, residual bone trabeculae, sclerotic rim, vertebral compression, enhancement. Results Patients included 5 female and 7 male patients (mean age: 43.0 ± 19.6 years; range 15–73 years). Multiple lesions were noted in 1 case and single lesion was noted in 11 cases. The lesions were located in the thoracic, cervical, lumbar, and sacral vertebrae in 7, 3, 1, and 1 cases, respectively. They were centered in the vertebral body and posterior elements in 9 and 3 cases, respectively. Residual bone trabeculae, no sclerotic margin, and surrounding soft-tissue mass were noted in 11 cases, each, and mild expansile osteolysis and vertebral compression were noted in 10 and 6 cases, respectively. MRI was performed for 11 patients, all of whom showed isointensity on T1WI, hyperintensity or slight hyperintensity on T2WI, and hyperintensity on fat-suppressed T2WI. A marked enhancement pattern was noted in 10 cases. Conclusion Spinal EHE tend to develop in the thoracic vertebrae. EHE should be considered when residual bone trabeculae can be seen in the bone destruction area, accompanied by pathological compression fracture, no sclerotic rim, and high signal intensity for a vascular tumor on T2WI.

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Section: Discussionsupporting

confidence: 86%

Epithelioid hemangioendothelioma of the spine: an analysis of imaging findings

et al. 2022

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“…[4] e lesion shows restriction on diffusion-weighted imaging. [7] e lesions show increased uptake on 99 m Tc Sestamibi bone scintigraphy and 18 F-FDG Positron emission tomography-CT. [2,7] Nuclear scintigraphy is useful to detect the multifocal and multicentric nature of the disease. [1] However, the imaging features of EH are somewhat nonspecific and the radiological differential diagnoses depend on the age of the patient.…”

Section: Discussionmentioning

confidence: 98%

Multicentric epithelioid hemangioendothelioma of humerus and scapula

Dhanya

Narayanan

Kapoor

et al. 2021

IJMSR

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Epithelioid hemangioendothelioma (EH) is a rare malignant vascular tumor occurring mainly in the liver and lungs, with bones being a rare site and primarily seen in the adult population. We present a rare case of multicentric EH in the right humerus in an adolescent male, who presented with complaints of pain and swelling in the right shoulder. Radiographs and Computed tomography showed a large expansile lytic lesion in the proximal end of the right humerus with areas of cortical destruction and matrix calcification. On Magnetic resonance imaging, the lesion was predominantly isointense on T1-weighted image, hyperintense on T2-weighted, and Short Tau Inversion Recovery images with prominent flow voids within. On post-contrast sequences, the lesion showed intense heterogenous enhancement with a non-enhancing central necrotic area. Multiple smaller lytic lesions with similar imaging characteristics were also found in the mid and distal shaft of the right humerus and the right coracoid process. Differentials of Telangiectatic osteosarcoma, Giant cell tumor, brown tumors of hyperparathyroidism, and metastasis were considered. Core biopsy revealed that the lesion was an EH. Though the imaging features of EH are non-specific, it may be considered in the differential diagnosis of an expansile lytic bone lesion with no periosteal reaction, showing cortical break and soft tissue component, especially if it is multifocal and multicentric.

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“…The mainstay of treatment for patients with EHE of the spine seems to be multimodal with surgery, total resection where feasible, as the centrepiece. 2,3,5 Pre-operative embolization to reduce the vascularity of the tumour and radiation and chemotherapy are also described. Given the rarity of EHE, especially EHE of the spine, there currently exists no universally accepted treatment guidelines with clearly defined outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…8 EHE in general affects patients in the age range 16-74 years but EHE of the bone is more prevalent in the third and fourth decade of life. 2,3,5 EHE can develop in any part of the body but is reported to more frequently in the liver (34%), lungs (21%), bone (19%) and other sites (26%). 1.,2 It was first described and named in 1982 by Weiz and Enzinger and is classified in the 2020 WHO classification of bone tumours as a low-to-intermediate grade neoplasm.…”

Section: Introductionmentioning

confidence: 99%

Primary epithelioid hemangioendothelioma of the Spine: A first in Africa. A case report and literature review

Kgaodi,

Lazarus,

Price

et al. 2024

Preprint

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Epithelioid hemangioendothelioma of spine: A case report with review of literatures

Cited by 5 publications

References 27 publications

Epithelioid hemangioendothelioma of the spine: an analysis of imaging findings

Epithelioid hemangioendothelioma of the spine: an analysis of imaging findings

Multicentric epithelioid hemangioendothelioma of humerus and scapula

Primary epithelioid hemangioendothelioma of the Spine: A first in Africa. A case report and literature review

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