Skin nonmelanocytic tumor

Vascular tumors

Hemangioendothelioma-retiform



Topic Completed: 1 August 2012

Minor changes: 16 April 2021

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PubMed search: retiform hemangioendothelioma skin

Christopher S. Hale, M.D.
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Cite this page: Hale CS. Hemangioendothelioma-retiform. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocytichemangioendotheliomaretiform.html. Accessed December 6th, 2021.
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 (Am J Surg Pathol 1994;18:115)
Case reports
Treatment
  • Wide local excision
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

Case #107

Various images


CD31

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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