Soft tissue
Vascular
Intermediate (locally aggressive / rarely metastasizing)
Retiform hemangioendothelioma
Author: Vijay Shankar, M.D.
Topic Completed: 1 November 2012
Minor changes: 20 January 2021
Copyright: 2002-2022, PathologyOutlines.com, Inc.
PubMed search: Retiform hemangioendothelioma
Table of Contents
Definition / general | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Shankar V. Retiform hemangioendothelioma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuehemangioendotheliomaretiform.html. Accessed January 19th, 2022.
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
- 20 year old man with mass in middle phalynx of finger (Arch Plast Surg 2012;39:80)
- 37 year old man with skin lesion on back (Case #107)
- 44 year old man with thigh mass (Sarcoma 2010;2010:756246)
- 61 year old woman with painful lesion on scalp (Int J Clin Exp Pathol 2010;3:528)
Treatment
- Wide local excision
Clinical images
Images hosted on other servers:
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
Contributed by Mark R. Wick, M.D.
Case #107
Case #107
Case #107, CD31
Images hosted on other servers:
Finger
Scalp
Negative stains
- Endothelial cells: keratin
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
