Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1353
Peer-review started: August 10, 2020
First decision: November 14, 2020
Revised: December 3, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: February 26, 2021
Epithelioid hemangioendothelioma (EHE) is an uncommon low-grade aggressive vascular tumor. It can occur in almost all locations, but is rarely encountered in bone.
We report a 23-year-old man who presented with left hip pain with no obvious cause. X-ray revealed bone destruction in the left femoral neck with sclerosis at the edges of the lesions. Magnetic resonance imaging (MRI) showed bone destruction in the medullary cavity of the left femoral head and neck. 18F-deoxyglucose-positron emission tomography/computed tomography (PET/CT) imaging showed bone destruction in the left ischium, acetabulum, and left femoral head neck, accompanied by increased radioactive uptake; the maximum standard uptake value was 4.2. Histopathologic examination revealed spindle-shaped mesenchymal tissue hyperplasia with scattered epithelioid cells. The patient underwent left femoral head replacement surgery. No signs of recurrence were observed as of the 18-mo follow-up.
The definitive diagnosis of femoral EHE can be established aided by the MRI and PET/CT findings.
Core Tip: Epithelioid hemangioendothelioma (EHE) is an uncommon low-grade aggressive vascular tumor that rarely occurs in bone. We report a case of femoral EHE which was diagnosed based on magnetic resonance imaging and positron emission tomography/computed tomography findings; the diagnosis was later confirmed by pathological and immunohistochemical examination. Left femoral head replacement was performed. No signs of recurrence were observed as of the 18-mo follow-up.