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Case Reports
. 2021 Jul;13(3):164-168.
doi: 10.1055/s-0039-3401381. Epub 2020 Jan 16.

Intravascular Papillary Endothelial Hyperplasia: Case Report of a Recurrent Masson's Tumor of the Finger and Review of Literature

Hannah Jia Hui Ng  1 , Brenton Ruiqin Sio  1 , Vijayadwaja Desai  2 , Kian Ming Chew  3 , Vaikunthan Rajaratnam  1
Affiliations
Case Reports

Intravascular Papillary Endothelial Hyperplasia: Case Report of a Recurrent Masson's Tumor of the Finger and Review of Literature

Hannah Jia Hui Ng et al. J Hand Microsurg. 2021 Jul.

Abstract

Intravascular papillary endothelial hyperplasia (IPEH), often referred to as Masson's Tumor, is an uncommon yet benign vascular disease of the skin and subcutaneous tissues. It usually arises within a blood vessel, but is considered to be a non-neoplastic reactive endothelial proliferation commonly associated with vascular injury. Although it is rare, knowledge of this disease is important as it may mimic other benign and malignant tumors, especially angiosarcoma, which may lead to unnecessary aggressive management. Typically, IPEHs are asymptomatic and are slow growing soft-tissue masses with extremely low-recurrence rates. In this article, we describe a 19-year-old male with a recurrence of Masson's Tumor over the right little finger within 2 months of a routine excision of the lesion. We also present accompanying multimodality clinical, radiological, and pathological imaging. This case illustrates the innocuous nature of the initial lesion easily mistaken for a hemangioma. Awareness of the possibility of a recurrence of a Masson's Tumor is important for clinicians to rule out the presence of malignant vascular lesions.

Keywords: Masson’s Tumor; finger; intravascular papillary endothelial hyperplasia; recurrence.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
( A ) Longitudinal gray scale ultrasound image showing a slightly heterogenous hypoechoic soft tissue lesion with lobulated margins. ( B ) Color Doppler imaging demonstrating mild internal vascularity at the periphery of the lesion. The palmar digital artery sits just deep to the soft tissue lesion. PP, proximal phalanx; MCPJ, metacarpophalangeal joint.
Fig. 2
Fig. 2
Hematoxylin and eosin stain magnified 10x, showing papillary prominence within the vascular lumen.
Fig. 3
Fig. 3
Clinical photograph of the patient’s proximal phalanx of the right little finger. 10 weeks postoperatively, the patient presented with a lump over the previous surgical site.
Fig. 4
Fig. 4
Ultrasonography of the 1.7 × 1.2 cm echogenic lesion with peripheral hypoechoic areas.
Fig. 5
Fig. 5
Intraoperative photograph of the well encapsulated recurrent Masson’s Tumor over the patient’s right little finger.
Fig. 6
Fig. 6
( A, B ) Quaba flap to cover the defect.
Fig. 7
Fig. 7
CD34 immunostaining highlighting the vascular endothelial cells.
See this image and copyright information in PMC

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References

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