An unusual presentation of glomeruloid hemangioma in a patient with VHL syndrome: A case report and review of literature

Leomar Y. Ballester, Phyu P. Aung, Jin-Ping Lai, John J. DiGiovanna, Zied Abdullaev, Svetlana Pack, W. Marston Linehan, Jere B. Stern, Peter A. Pinto, Chyi-Chia R. Lee

Dermatology Branch, National Cancer Institute, National Institute of Health, Bethesda, USA.
Laboratory of Pathology, National Cancer Institute, National Institute of Health, Bethesda, USA.
Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, USA.

DOI: 10.4236/ojcd.2013.32012                

Abstract

Von Hippel-Lindau (VHL) is an inherited neoplasia syndrome caused by inactivation of the VHL tumor suppressor gene, characterized by the development of sporadic clear cell renal carcinoma, pheochromocytomas, retinal angioma, pancreatic cysts, and CNS hemangioblastomas. Glomeruloid hemangioma is a vascular lesion, previously considered to be specifically associated with POEMS (polyneuropathy, organomegaly, endocrinopathy/edema, M-protein and skin abnormalities) syndrome. However, there are reports of solitary glomeruloid hemangioma in patients without POEMS syndrome. We report the case of a 39-year-old male with VHL disease, with known bilateral clear cell renal carcinomas, CNS hemangioblastoma and pancreatic cysts. The patient presented with a0.35 cmred papule on the left lateral neck, which was easily irritated, and bleed frequently. Histopathologically, there were irregular areas of ectatic vascular channels of small capillaries, resembling renal glomeruli, surrounded by actin-positive pericytes, within the dermis. These findings were consistent with a glomeruloid hemangioma. Fluorescent in-situ hybridization studies confirmed a deletion in the 3p25.3 region. As per clinical tests, no evidence of POEMS syndrome was found in this patient. Only six reports of glomeruloid hemangioma have been previously reported in patients without POEMS syndrome and this constitutes the first report of glomeruloid hemangioma in a patient with VHL.

Keywords

Von Hippel-Lindau (VHL); Glomeruloid Hemangioma; POEMS; Immunohistochemical Stain;Fluorescent in Situ Hybridization (FISH) Analysis

Conflicts of Interest

The authors declare no conflicts of interest.

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