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 March 29th, 2017.
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
Micro 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
Micro Images
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Epithelioid cells with cytoplasmic vacuoles

Negative Stains
Differential Diagnosis
Additional References