Hemangioendothelioma

Bone
Vascular tumors of bone
Hemangioendothelioma

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

Revised: 27 October 2016, last major update June 2005

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

PubMed search: hemangioendothelioma [title] bone

Table of Contents

Cite this page: Hemangioendothelioma . PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonehemangioendothelioma.html. Accessed July 14th, 2017.

Definition / general

Some authors combine with angiosarcoma
See also epithelioid hemangioendothelioma
<100 cases reported
Borderline or intermediate grade malignancy
Wide age distribution
Often multiple, associated with similar skin and soft tissue lesions located nearby
Prolonged clinical course; only rarely metastases
Tend to develop in long tubular bones, but may occur in any bone; 50% are multifocal

Radiology description

Lytic, expansile, may erode cortex and infiltrate soft tissue
Variable margins

Treatment

Curettage, en bloc resection and radiotherapy
Protracted clinical course with 20% dying of disease

Gross description

2 - 10 cm, solid, tannish white

Microscopic (histologic) description

Sheets or cords of epithelioid or histiocyte-like epithelial cells with abundant eosinophilic cytoplasm, often vacuolated, with large vesicular nucleus, nuclear atypia less than angiosarcoma
Variable nuclear grooves, rare / no mitotic activity, well formed vessels but no / rare anastomosing channels, new / old hemorrhage, no lobular growth pattern
Stroma is hyalinized or basophilic, may appear chondroid, variable eosinophilic and lymphocytic infiltrate, may have osteoclast-like giant cells

Positive stains

CD31, CD34, factor VIII related antigen (usually)

Negative stains

Keratin (usually)

Additional references

Hum Pathol 2003;34:680