Pseudomyogenic Hemangioendothelioma of Bone Initially Managed as Slipped Capital Femoral Epiphysis: A Case Report

Abstract

Pseudomyogenic hemangioendothelioma is a rare, recently described neoplasm that usually presents as multifocal lesions in a single extremity. The disease has demonstrated a high propensity for infiltrative growth and local recurrence but limited metastatic potential. Variations of histological appearance and immunohistochemical signatures have been described, but typically involve spindle or polygonal cells with nuclear atypia and neutrophilic infiltration. Here we present a case report of an 8-year-old female who presented with hip pain that was initially diagnosed and managed as a slipped capital femoral epiphysis (SCFE). Subsequent evaluation led to the diagnosis of pseudomyogenic hemangioendothelioma of bone. Due to the degree of osseous destruction, described patterns of local recurrence, and metastatic potential of this neoplasm, a wide resection with endoprosthetic reconstruction of the proximal femur was performed. This case highlights the importance of due diligence in the diagnoses of SCFE and bone tumors in young patients with abnormalities of the proximal femur, including consideration of the need for biopsy.

Share and Cite:

Friel, N. , Rothenberg, A. and Weiss, K. (2014) Pseudomyogenic Hemangioendothelioma of Bone Initially Managed as Slipped Capital Femoral Epiphysis: A Case Report. Journal of Cancer Therapy, 5, 363-368. doi: 10.4236/jct.2014.54043.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Billings, S.D., Folpe, A.L. and Weiss, S.W. (2003) Epithelioid Sarcoma-Like Hemangioendothelioma. The American Journal of Surgical Pathology, 27, 48-57. http://dx.doi.org/10.1097/00000478-2003 01000-00006
[2] Hornick, J.L. and Fletcher, C.D. (2011) Pseudomyogenic Hemangioendothelioma: A Distinctive, Often Multicentric Tumor with Indolent Behavior. The American Journal of Surgical Pathology, 35, 190-201. http://dx.doi.org/10.1097/PAS.0b013e3181ff0901
[3] Mirra, J.M., Kessler, S., Bhuta, S. and Eckardt, J. (1992) The Fibroma-Like Variant of Epithelioid Sarcoma. A Fibrohistiocytic/Myoid Cell Lesion Often Confused with Benign and Malignant Spindle Cell Tumors. Cancer, 69, 1382-1395. http://dx.doi.org/10.1002/1097-0142(19920315)69:6<1382::AID-CNCR2820690614>3.0.CO;2-Y
[4] Jo, V.Y. and Fletcher, C.D. (2014) WHO Classification of Soft Tissue Tumours: An Update Based on the 2013 (4th) Edition. Pathology, 46, 95-104. http://dx.doi.org/10.1097/PAT.0000000000000050
[5] Cacciatore, M. and Dei Tos, A.P. (2014) Challenging Epithelioid Mesenchymal Neoplasms: Mimics and Traps. Pathology, 46, 126-134. http://dx.doi.org/10.1097/PAT.0000000000000063
[6] Mangham, D.C. and Kindblom, L.G. (2014) Rarely Metastasizing Soft Tissue Tumours. Histopathology, 64, 88-100. http://dx.doi.org/10.1111/his.12310
[7] Sheng, W., Pan, Y. and Wang, J. (2013) Pseudomyogenic Hemangioendothelioma: Report of an Additional Case with Aggressive Clinical Course. The American Journal of Dermatopathology, 35, 597-600. http://dx.doi.org/10.1097/DAD.0b013e31827c8051
[8] Sheng, W.Q. and Wang, J. (2012) Primary Pseudomyogenic Haemangioendothelioma of Bone. Histopathology, 61, 1219-1224. http://dx.doi.org/10.1111/j.1365-2559.2012.04347.x
[9] Trombetta, D., Magnusson, L., von Steyern, F.V., Hornick, J.L., Fletcher, C.D. and Mertens, F. (2011) Translocation t(7;19) (q22;q13)-A Recurrent Chromosome Aberration in Pseudomyogenic Hemangioendothelioma? Cancer Genetics, 204, 211-215. http://dx.doi.org/10.1016/j.cancergen. 2011.01.002

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.