Soft tissue
Vascular: intermediate (locally aggressive / rarely metastasizing)
Retiform hemangioendothelioma


Topic Completed: 1 November 2012

Revised: 9 September 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed search: Retiform hemangioendothelioma

Vijay Shankar, M.D.
Page views in 2018: 1,386
Page views in 2019 to date: 1,216
Cite this page: Shankar V. Retiform hemangioendothelioma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/softtissuehemangioendotheliomaretiform.html. Accessed November 16th, 2019.
Definition / general
  • Low grade variant of angiosarcoma
  • Usually distal extremities of young individuals
  • Weiss and Goldblum use term "hobnail hemangioendothelioma" for retiform and Dabska type tumors, which they believe to be closely related
  • Rarely multiple (Am J Dermatopathol 1996;18:606)
  • 2 / 3 recur, particularly without wide local excision; low rate of metastases, no tumor related deaths
Case reports
Treatment
  • Wide local excision
Clinical images
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Finger

Scalp

Gross description
  • Lesion of reticular dermis and subcutaneous tissue
Microscopic (histologic) description
  • Retiform (net-like, similar to rete testis) pattern of blood vessels that disperse through reticular dermis and subcutis
  • Vessels lined by monomorphic hobnail endothelial cells with scant cytoplasm and rounded, naked type nuclei
  • Often prominent lymphocytic infiltrate
  • No epithelioid areas or cytoplasmic vacuoles (Am J Surg Pathol 1994;18:115)
Microscopic (histologic) images
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Courtesy of Dr. Mark R. Wick



Case of the Week #107:

Case of Week #107

Case of Week #107, CD31



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Finger

Scalp

Positive stains
Negative stains
Differential diagnosis
  • Angiosarcoma: may focally have low grade features, but also exhibits areas of marked atypia and pleomorphism; also dissects between individual collagen bundles and has mitotic activity
  • Hobnail hemangioma: smaller, more superficial and more localized, with papillary dermal vessels that disappear into reticular dermis
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