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Case Reports
. 2017 Dec;11(4):525-530.
doi: 10.1007/s12105-016-0770-1. Epub 2016 Nov 22.

Pseudomyogenic Hemangioendothelioma: A Vascular Tumor Previously Undescribed in the Oral Cavity

Yeshwant B Rawal  1 , Kenneth M Anderson  2 , Thomas B Dodson  3
Affiliations
Case Reports

Pseudomyogenic Hemangioendothelioma: A Vascular Tumor Previously Undescribed in the Oral Cavity

Yeshwant B Rawal et al. Head Neck Pathol. 2017 Dec.

Abstract

The pseudomyogenic hemangioendothelioma (PMH) is a low-grade malignant vascular neoplasm of different tissue planes including skin and soft tissue. Primary tumors in the skeletal muscle and bone have also been diagnosed. The PMH was introduced into the WHO classification of tumors of soft tissue and bone in 2013. This is the first description of oral involvement. A 21-year-old female presented with a 2-month old swelling of her gingiva. The swelling appeared red in color and was soft in consistency. A clinical diagnosis of a pyogenic granuloma was made and an incisional biopsy was submitted for histopathological evaluation. The lesion consisted of a proliferation of spindle and epithelioid looking cells. Cells were arranged in loose fascicles and sheets. Rhabdomyoblast-like cells were also seen. No mitotic figures were present. Lesional cells were reactive to cytokeratin AE1/AE3 and CD31. Lesional cell reactivity to S100 protein, HMB 45, SMA, Desmin and CD34 was negative. Following the diagnosis, a wide excision for clear margins was performed. No recurrence has been reported 2 years since the removal. The PMH is a cutaneous tumor that behaves in an indolent fashion. This is the first report of oral involvement by this neoplasm. Recognition of its histopathological features and immunohistochemical reactivity will prevent misadventures in the diagnosis of oral lesions.

Keywords: CD31; Cytokeratin; Epithelioid sarcoma; Hemangioendothelioma; Mucosal; Oral; Pseudomyogenic; Rhabdomyoblast.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest associated with this report.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. UTHSC IRB 16-04954-NHSR.

Figures

Fig. 1
Fig. 1
A subepithelial proliferation of spindle and epithelioid cells. H&E 10×
Fig. 2
Fig. 2
Plump spindle cells are arranged in loose fascicles and sheets. H&E 20×
Fig. 3
Fig. 3
Many rhabdoid and rhabdomyoblast-like cells are seen. There are no mitotic figures. H&E 40×
Fig. 4
Fig. 4
Lesional cells are diffusely and strongly reactive to cytokeratin AE1/AE3
Fig. 5
Fig. 5
Lesional cells are diffusely and strongly reactive to CD31
See this image and copyright information in PMC

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