Epithelioid hemangioma of distal femoral epiphysis in a patientwith congenital talipes equinovarus
- Author:
Asit Ranjan Mridha
;
Prateek Kinra
;
Mukund Sable
;
Meher Chand Sharma
;
Shishir Rastogi
;
Shah Alam Khan
;
Shivanand Gamanagatti
- Publication Type:Case Reports
- Keywords:
epithelioid hemangioma, congenital talipes equinovarus, chondroblastoma, femoral epiphysis
- From:The Malaysian Journal of Pathology
2014;36(1):63-66
- CountryMalaysia
- Language:English
-
Abstract:
Epithelioid hemangioma (EH) is a rare benign vascular lesion of soft tissue and bone,
characterized by endothelial cells with epithelioid or histiocytoid appearance. Though tubular bones,
flat bones, vertebra and short bones are common sites for this lesion, the epiphyseal involvement
is extremely rare. We present an unusual case of EH of the distal femur in a young boy. Case
report: A 12-year-old boy who had congenital talipes equinovarus of the right foot presented with
progressively increasing pain in the right lower thigh for six months. Physical examination revealed
muscular atrophy of the right lower limb and a moderately tender swelling in the medial aspect
of the right knee without restriction of knee movement. An X-ray revealed an osteolytic lesion,
which appeared iso- and hypointense on T1W and hyperintense on T2W MRI images in the distal
epiphysis and adjacent metaphysis of the right femur. A radiological diagnosis of chondroblastoma
was entertained. The patient was treated with curettage and bone grafting. Histopathology showed a
tumor composed of thin-walled arteriolar capillaries lined by large, polyhedral epithelioid endothelial
cells with vesicular nuclei, finely distributed nuclear chromatin, and moderate amount of eosinophilic
cytoplasm. The endothelial cells were strongly immunopositive for CD34. Mitotic activity was
low and the Ki-67 proliferative rate was <2%. A diagnosis of EH was made. EH is a benign
lesion and it should be differentiated from its histologically similar malignant counterparts such as
epithelioid hemangioendothelioma and epithelioid angiosarcoma as the lesion can be successfully
treated with curettage or resection.
- Full text:P020141218367755926169.pdf
