J Korean Ophthalmol Soc.  2016 Aug;57(8):1299-1302. 10.3341/jkos.2016.57.8.1299.

A Case of Intravascular Papillary Endothelial Hyperplasia of Eyelid

• Kim JY
• Lee MK
• Kim HY

• KMID: 2349079
• DOI: http://doi.org/10.3341/jkos.2016.57.8.1299

Abstract

PURPOSE
To report a case of intravascular papillary endothelial hyperplasia of the eyelid.
CASE SUMMARY
A 30-year-old male presented with a right upper eyelid mass, which had been growing in size for three years. The mass was about 7 mm in diameter, purplish, spherical, and cystic. Incision and drainage were performed, but the cystic mass instantly refilled with blood. Excisional biopsy was performed. On microscopic examination, a myriad of small delicate papillae projections into the dilated vascular lumen with organizing thrombus were noted. Each papilla was lined with a single layer of endothelial cells, surrounding a collagenized core. The endothelial cells were reactive for CD31 on immunohistochemical staining. There were focal areas of frequent mitoses, but neither cytological atypia nor necrosis was found. Hence, the lesion was diagnosed as intravascular papillary endothelial hyperplasia.
CONCLUSIONS
Intravascular papillary endothelial hyperplasia in the periorbital area is rarely reported, and it is important to distinguish it from hemangioma or angiosarcoma. Complete surgical excision is necessary to prevent recurrence. The authors report a case of intravascular papillary endothelial hyperplasia of the upper eyelid, which should be considered in the differential diagnosis of eyelid or orbital tumor.

Keyword

Eyelid tumor; Intravascular papillary endothelial hyperplasia; Masson's tumor; Mitosis

MeSH Terms

Adult
Biopsy
Collagen
Diagnosis, Differential
Drainage
Endothelial Cells
Eyelids*
Hemangioma
Hemangiosarcoma
Humans
Hyperplasia*
Male
Mitosis
Necrosis
Orbit
Recurrence
Thrombosis
Collagen

Figure

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  Figure 1. External photograph of eyelid. Spherical bluish mass measured about 7mm in diameter on the right upper lid.

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  Figure 2. Contrast enhanced oribtal computed tomography. It shows 7 × 8 sized, contrast enhancing round mass in right upper eyelid (arrow).

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  Figure 3. Histopathologic findings. (A) Each papillae lined by a single layer of endothelial cells surrounding a collagenized core (H&E ×400). (B) Focal area of frequent mitoses (arrows) (H&E ×400).

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  Figure 4. Immunohistochemistry findings. (A) Positive immunoreactivity for CD31 in endothelial cells (×100). (B) Negative immunoreactivity for desmin in endothelial cells (×100).

Reference

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