Multifocal intravascular papillary endothelial hyperplasia in the retroperitoneum and spine: A case report and review of the literature

Petry, Max; Brown, Michèle A.; Hesselink, John R.; Imbesi, Steven G.

doi:10.1002/jmri.21724

Cited by 18 publications

(19 citation statements)

References 9 publications

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“…The positive staining with WT1 in our case of Masson tumor may reflect the proliferative endothelial reaction in this lesion. 14 We only had 3 cases of vascular malformations with positive WT1 immunostaining in our study: two targetoid hemosiderotic hemangiomas and one verrucous hemangioma (Table II). There is still a debate about the origin of targetoid hemosiderotic hemangioma.…”

Section: Wt1 Was First Identified As a Tumor Suppressor Involved In Tmentioning

confidence: 97%

Differentiation of vascular tumors from vascular malformations by expression of Wilms tumor 1 gene: Evaluation of 126 cases

Dhaybi¹,

Powell²,

McCuaig³

et al. 2010

Journal of the American Academy of Dermatology

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Section: Wt1 Was First Identified As a Tumor Suppressor Involved In Tmentioning

confidence: 97%

Differentiation of vascular tumors from vascular malformations by expression of Wilms tumor 1 gene: Evaluation of 126 cases

Dhaybi¹,

Powell²,

McCuaig³

et al. 2010

Journal of the American Academy of Dermatology

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“…5,7,9,13,14 Often, the papillae fuse to form an anastomotic vascular pattern that may mimic the appearance of angiosarcoma. 3,4,7,9,11,14,[17][18][19] However, in this case, the differential diagnosis can be established on the basis of two important points: (1) angiosarcomas usually occur in different clinical settings and are extravascular with an infi ltrative growth pattern that dissects collagen bundles; (2) in malignant lesions such as angiosarcomas, the endothelial cells display moderate to marked cytologic atypia with prominent mitotic activity, which is not observed in benign lesions such as IPEH. 5,7,20 In this study in particular, one case included a previous report of recurrence, leading us to review the histological features to exclude angiosarcoma and to perform complementary immunohistochemical analyses to verify the proliferative potential of the lesion.…”

Section: Discussionmentioning

confidence: 97%

“…5 Clinically, the differential diagnosis includes pyogenic granuloma, hemangioma, hematoma, traumatic fi broma, salivary gland tumor, thrombosed vein, mucocele, and nevus, while histologically it can resemble an angiosarcoma. [2][3][4][5]7,8,11,13,14 The best treatment is total excision-biopsy into healthy margins, and the prognosis is usually excellent. 4,5,8,9,13 Few cases of recurrence, which is most often associated with an underlying vascular tumor, have been reported.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic implications of oral intravascular papillary endothelial hyperplasia

et al. 2011

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This study examined the clinical, histological, and immunohistochemical features as well as the differential diagnoses of oral intravascular papillary endothelial hyperplasia (IPEH) to aid clinicians and pathologists in its diagnosis. Clinical features of five oral IPEH cases were obtained from medical records, and all histopathological diagnoses were reviewed. Immunohistochemical reactions, including anti-CD-34, laminin, vimentin, estrogen receptor alpha, and Ki-67, were assessed. Microscopically, a reactive proliferation of vascular cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus was seen. CD-34, vimentin, and laminin staining were strongly positive, while estrogen receptor alpha was negative in all cases. A low percentage of cells were positive for Ki-67 in four of five lesions, but one case was strongly positive. A diagnosis of angiosarcoma was investigated and rejected. IPEH presents specific microscopic characteristics that along with clinical data lead to an accurate diagnosis. The general dentist, the first to participate in the diagnostic process, must share the responsibility for diagnosis with the pathologist, and they must work together to determine the correct diagnosis and management. Oral lesions of IPEH are uncommon. Their main significance is that they show a microscopic resemblance to angiosarcoma. Thus, clinicians should have more information regarding this benign entity. Finally, we suggest that in recurrent cases exhibiting strong immunolabeling of proliferative markers the possibility of angiosarcoma should be investigated.

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“…Six cases (40.0%) were located in the renal vein [4,5,6,7,8], five (33.3%) were reported in the gastrointestinal tract [13,14,15,16], two (13.3%) in the adrenal gland [10,11], and one (6.7%) in the liver [12]. An additional case (6.7%) involved multiple lesions located in the renal hilum and the retroperitoneum [9]. Among these patients, 10 (66.7%) were female and 5 (33.3%) male, with a mean age of 38.9 years (range 7-69).…”

Section: Discussionmentioning

confidence: 99%

“…Less frequently, IPEH has been documented in the upper respiratory tract, skeletal muscle, urogenital systems, renal and hepatic systems, and rarely in the gastrointestinal tract. To date, 14 cases of IPEH arising within the abdominal cavity have been reported [4,5,6,7,8,9,10,11,12,13,14,15,16], and only 4 cases involved the gastrointestinal tract [13,14,15,16]. In each of the 4 cases in which IPEH involved the gastrointestinal tract, a primary pathologic etiology was elucidated.…”

Section: Introductionmentioning

confidence: 99%

Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding

Meadows¹,

Sun

Dardik

et al. 2010

Case Rep Gastroenterol

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Intravascular papillary endothelial hyperplasia (IPEH), or Masson’s tumor, a rare benign vascular lesion, occurs mainly in the head, neck, and hands in the human population. Aberrant tumor locations have been rarely reported. We present a case of a patient with chronic abdominal pain and melena of variable severity due to a Masson’s tumor, with no apparent Masson’s tumor-associated comorbidities, along with a comprehensive review of the literature. Using PubMed, a search engine provided by the U.S. National Library of Medicine and the National Institutes of Health, we searched for all reports of Masson’s tumor limited within the abdominal cavity. Furthermore, keywords such as ‘intravascular papillary endothelial hyperplasia’, ‘renal’, ‘gastrointestinal’, ‘hepatic’ and ‘intraabdominal’ were used to facilitate the search. We thus found fourteen cases of intraabdominal Masson’s tumors published. Six (42.9%) of these were located in the renal vein, 4 (28.6%) were reported in the gastrointestinal tract, 1 (7.1%) in the adrenal gland, 1 (7.1%) in the liver, and 1 (7.1%) instance with multiple lesion sites including the renal hilum and retroperitoneum. Among these patients, 9 (64.3%) were female and 5 (35.7%) male, with a mean age of 38.9 years (7–69). IPEH is a reactive process, having three subtypes, all involving the proliferation of epithelial cells around a thrombus in the setting of venous stasis. In its pure form, the organized thrombus is solely localized within the vascular lumen. Mixed-form IPEH is formed in preexisting vascular lesions (such as arteriovenous malformation, hemangioma, pyogenic granuloma, etc.). The rarest form is the extravascular variety, which arises in hematomas often from recent trauma to the area. In its pure form, IPEH has a zero recurrence rate when an R0 resection is performed; all mixed and extravascular forms show the highest recurrence rates. The exact histogenesis of these epithelial cells remains a mystery and multiple theories have been offered. Although difficult to distinguish from malignant angiosarcomas solely on presentation and radiologic work-up, Masson’s tumors occur more frequently in women, demonstrate no local invasion, do not metastasize, are commonly located intravascularly, and are associated with a significantly more favorable prognosis than angiosarcomas. Only four Masson’s tumors have been reported in the gastrointestinal tract, two of these cases were related to microvascular thrombosis secondary to paroxysmal nocturnal hemoglobinuria and two were formed secondary to arteriovenous malformations. Our case lacked solitary evidence of either of these comorbidities. An incidental finding of an enlarged ovary, which was removed during our exploratory laparoscopy, plus strong demographic statistics that suggest women have an increased prevalence of this lesion may help support a hormonal theory of pathogenesis.

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Multifocal intravascular papillary endothelial hyperplasia in the retroperitoneum and spine: A case report and review of the literature

Cited by 18 publications

References 9 publications

Differentiation of vascular tumors from vascular malformations by expression of Wilms tumor 1 gene: Evaluation of 126 cases

Differentiation of vascular tumors from vascular malformations by expression of Wilms tumor 1 gene: Evaluation of 126 cases

Diagnostic implications of oral intravascular papillary endothelial hyperplasia

Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding

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