Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014;5(1):19-21.
doi: 10.1016/j.ijscr.2013.09.019. Epub 2013 Nov 26.

Ileal malignant hemangioendothelioma as a hypervascular lesion on computed tomography scan

Hang Li  1 , Deepa Shah  2 , Abhishek Shah  3 , Xiang Qiu  4 , Dianbo Cao  5
Affiliations

Ileal malignant hemangioendothelioma as a hypervascular lesion on computed tomography scan

Hang Li et al. Int J Surg Case Rep. 2014.

Abstract

Introduction: Malignant epithelioid hemangioendothelioma (EHE) is an uncommon and grave vascular tumor. EHE is frequently angiocentric and is associated with a medium sized vessel, especially a vein. No definite etiological associations have been ascribed to this tumor so far, except an association with oral contraceptives in EHE of liver.

Presentation of case: A 47 year old man presented with the complaint of intermittent black stool over the past two weeks. Occasionally, he experienced pain in left lower abdomen. On Computed Tomography (CT), it showed hypervascular lesion in the ileum with persistent enhancement. An exploratory laparotomy was performed with short segmental resection and functional end-to-end anastomosis. It was diagnosed finally with the histopathological and immunohistochemical analysis as a malignant EHE.

Discussion: EHE is an uncommon endothelial tumor that most frequently arises in soft tissue, liver, lung and skeleton. It behaves biologically in between benign epithelioid hemangioma and the more aggressive epithelioid angiosarcoma. Although a standard systemic treatment for malignant EHE has not been fully established, complete surgical excision is strongly recommended if feasible.

Conclusion: EHE has a variable presentation and CT is helpful in identifying ileal EHE timely in the early stage, even when there is no obvious mass formation, however the diagnosis can be confirmed only after histopathological and immunohistochemical studies.

Keywords: Computed tomography (CT); Epithelioid hemangioendothelioma; Ileum; Immunohistochemical study; Prognosis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Axial section of CT abdomen (arterial phase) showing hypervascular lesion in Ileum.
Fig. 2
Fig. 2
Axial section of CT abdomen (portal phase) showing hypervascular lesion in Ileum.
Fig. 3
Fig. 3
Coronal section of CT abdomen showing hypervascular lesion in ileum.
Fig. 4
Fig. 4
Resected specimen showed to be malignant hemangioendothelioma on the basis of microscopic findings.
Fig. 5
Fig. 5
Resected specimen showed to be malignant hemangioendothelioma on the basis of immunohistological stains of CD31.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Liu Q., Miao J., Lian K., Huang L., Ding Z. Multicentric epithelioid hemangioendothelioma involving the same lower extremity: a case report and review of literature. Int J Med Sci. 2011;8(7):558–563. - PMC - PubMed
    1. Sarma N.H. Epithelioid hemangioendothelioma of soft tissue after pellet injury. J Clin Pathol. 1992;45(7):640–641. - PMC - PubMed
    1. Yasuda S., Hashimoto T., Kanaizumi T., Kuwata H., Matsumoto I., Shiratori T. A case of hemangioendothelioma of the small intestine. Jpn J Surg. 1989;19(1):67–69. - PubMed
    1. Botsford T.W., Crowe P., Crocker D.W. Tumors of the small intestine. A review of experience with 115 cases including a report of a rare case of malignant hemangioendothelioma. Am J Surg. 1962;103:358–365. - PubMed
    1. Akosa A.B., Ali M.H. Epithelioid hemangioendothelioma of terminal ileum after therapeutic irradiation. J Clin Pathol. 1989;42:889–890. - PMC - PubMed