Vascular tumors of bone
Epithelioid hemangioendothelioma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 27 October 2016, last major update June 2005

Copyright: (c) 2003-2016,, Inc.

PubMed search: epithelioid hemangioendothelioma [title] bone

Cite this page: Epithelioid hemangioendothelioma. website. Accessed December 15th, 2018.
Definition / general
  • Inconsistent use by pathologists - some include epithelioid hemangioma or angiosarcoma
  • Better use is to define as borderline or low grade malignancy affecting bone, soft tissue, liver, lung
  • Rare tumor
  • 22 - 55% are multicentric, may be associated with nearby skin or soft tissue lesions
  • Associated with pain
  • Sites: femur, occasionally vertebrae
Radiology description
  • Osteolytic appearance without bony expansion, may have peripheral sclerosis
  • Infiltration is associated with higher grade lesions
Prognostic factors
  • Poor
  • Visceral involvement
Case reports
  • Surgical excision, may respond to radiation therapy
Microscopic (histologic) description
  • Cohesive growth pattern of cells with eosinophilic and often cytoplasmic vacuolization, some vacuoles contain erythrocytes
  • Vesicular nuclei, some with prominent grooves, mild atypia
  • Recent and old hemorrhage
  • Variable eosinophils, vasoformative features may be primitive and accompanied by myxohyaline stroma
  • No / rare mitotic activity, no anastomosing channels
Microscopic (histologic) images
Images hosted on other servers:

Epithelioid cells with cytoplasmic vacuoles

Negative stains
Differential diagnosis
Additional references