Primary Cutaneous Epithelioid Hemangioendothelioma on the Back

Kim, Won Jeong; Park, Hyun Je; Kim, Hoon Soo; Chin, Hyun Woo; Kim, Su Han; Ko, Hyun Chang; Kim, Byung Soo; Kim, Moon Bum

Abstract

Epithelioid hemangioendothelioma (EHE) is an uncommon vascular neoplasm that is considered to be a low-grade malignancy with a severity between an angiolymphoid hyperplasia with eosinophilia and an epithelioid hemangiosarcoma. The appearance of cutaneous EHE is extremely rare and only about 20 cases have been reported in the Korean and English literatures. A 70-year-old man presented with an approximately 1-year history of an isolated painful subcutaneous nodule of the back. A histopathologic examination revealed nests and cords of epithelioid eosinophilic cells in hyalinized stroma with intracytoplasmic vacuoles. Tumor cells were strongly positive for the endothelial cell markers CD31 and CD34, and we didn't find any metastatic lesions under radiologic examination. On the basis of these findings, the diagnosis of primary cutaneous EHE was made. To our knowledge, cutaneous EHEs were reported in only 2 cases in the Korean literature, and that of the trunk has not been published previously. Moreover, there is no meta-analytic study about cutaneous EHE. So, we report here a rare case of EHE of the back and review the relevant literature.