Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1353-1358
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1353
Femoral epithelioid hemangioendothelioma detected with magnetic resonance imaging and positron emission tomography/computed tomography: A case report
Hong-Guang Zhao, Ke-Wei Zhang, Sen Hou, Yu-Yin Dai, Song-Bai Xu
Hong-Guang Zhao, Sen Hou, Yu-Yin Dai, Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Ke-Wei Zhang, Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Song-Bai Xu, Department of Neurosurgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Zhao HG was a major contributor to the writing of the manuscript; Zhang KW and Hou S carried out data collection and analysis; Dai YY wrote the paper; Xu SB edited the manuscript and provided critical comment; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors of this work have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript has been prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Song-Bai Xu, MD, Doctor, Department of Neurosurgery, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. xusongbai@jlu.edu.cn
Received: August 10, 2020
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
Abstract
BACKGROUND

Epithelioid hemangioendothelioma (EHE) is an uncommon low-grade aggressive vascular tumor. It can occur in almost all locations, but is rarely encountered in bone.

CASE SUMMARY

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.

CONCLUSION

The definitive diagnosis of femoral EHE can be established aided by the MRI and PET/CT findings.

Keywords: Bone radiography, Hemangioendothelioma, Epithelioid, Vascular tumor, Pathology, Case report

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.