Intravascular papillary endothelial hyperplasia of the finger: a case of Masson’s tumor

Abstract

Intravascular papillary endothelial hyperplasia is an uncommon benign vascular lesion characterized by a reactive proliferation of endothelial cells. The lesion of the finger often presents diagnostic challenges to surgeons because of its rarity. We report a case of intravascular papillary endothelial hyperplasia to facilitate the recognition of this uncommon lesion.

Intravascular Papillary Endothelial Hyperplasia (Masson Tumor) of the Right Thumb: A Case Report and Literature Review

“…15 Trauma causes hematoma, with thrombosis and subsequent organization of the thrombus and the circulating macrophages producing growth factors that stimulate the proliferation of the endothelial layer of the blood vessels. 13,14 Other possible precipitating factors include vascular tumors, malformation, or pyogenic granuloma. 14 IPEH has three subtypes histologically: primary intravascular subtype, which is the most common; secondary subtype, arising in a preexisting vascular lesion; and an extravascular type, which is the least common.…”

“…7,10 Owing to a lack of consistent and specific radiological findings, microscopic histological diagnosis remains the standard method for diagnosing IPEH. 2,13,18 However, it can be challenging, as IPEH closely resembles angiosarcoma. On a histological level, IPEH can be distinguished from angiosarcoma by its intravascular location, papillary proliferation of the endothelium with organized thrombosis, absence of tumor necrosis and cellular pleomorphism, and lack of mitotic activity.…”

“…The CD105 marker is positive only in true primary vascular tumors, distinguishing IPEH from other similar vascular lesions, such as angiosarcoma. 7,9,10,13,16,20 IPEH is managed by simple excision, which is the gold standard treatment described in the literature. 2,4,7,9,10,16 However, there is no consensus regarding whether margin resection is indicated.…”

“…2 , 12 The exact cause of Masson tumor is still not well understood. 13 , 14 Several factors can play a role, but the most proposed cause is a preceding trauma, although around 70% of reported cases are idiopathic in nature. 15 …”

Masson’s Hemangioma of Knee: A Rare Case Report

“…There is a temporal association between basic fibroblastic growth factor and the development of IPEH/MH lesion [ 17 , 20 ]. The molecular pathogenesis in IPEH/MH formation is by the release of endothelial b-FGF by macrophages in the surrounding environment producing a positive feedback loop mechanism of the proliferation of endothelial cells [ 6 , 21 ].…”