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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Mediastinal Epithelioid Hemangioendothelioma Invading Superior Vena Cava: A Case Report and Review of Literature

Author(s): Su Hong Kim, Young Seon Kim*, Min Hye Jang and Hee Jung Kwon

Volume 15, Issue 3, 2019

Page: [349 - 352] Pages: 4

DOI: 10.2174/1573405614666180124141817

Price: $65

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Abstract

Introduction: Epithelioid Hemangioendothelioma (EHE) is a rare vascular neoplasm. Common locations of EHE are the bone, soft tissue, liver, and lung, but the mediastinal location is extremely rare. Few cases of mediastinal EHE, invading the Superior Vena Cava (SVC) have been reported.

Case Presentation: We report a case of a 21-year-old man with EHE invading the SVC, which was incidentally detected on performing chest radiography. A contrast-enhanced chest Computed Tomography (CT) scan demonstrated a well-defined, oval mass located on the right side of the anterior mediastinum. The mass showed homogeneous enhancement with punctate calcifications, and it invaded the SVC at the confluence area of the right and left brachiocephalic veins.

Conclusion: Mediastinal EHE invading the SVC may present as a homogeneously enhancing mass with punctate calcifications. It should be added to the differential diagnosis of tumors of the mediastinum. Accurate preoperative diagnosis of EHE is critical for surgical planning; therefore, knowledge of the radiologic features of EHE is important.

Keywords: Epithelioid hemangioendothelioma, mediastinal tumor, superior vena cava, computed tomography, radiography, punctate calcifications.

Graphical Abstract
[1]
Weiss SW, Enzinger FM. Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Cancer 1982; 50(5): 970-81.
[2]
Fletcher CD. The evolving classification of soft tissue tumours-an update based on the new 2013 WHO classification. Histopathology 2014; 64(1): 2-11.
[3]
Suster S, Moran CA, Koss MN. Epithelioid hemangioendothelioma of the anterior mediastinum. Clinicopathologic, immunohistochemical, and ultrastructural analysis of 12 cases. Am J Surg Pathol 1994; 18(9): 871-81.
[4]
Ferretti GR, Chiles C, Woodruff RD, et al. Epithelioid hemangioendothelioma of the superior vena cava: Computed tomography demonstration and review of the literature. J Thorac Imaging 1998; 13(1): 45-8.
[5]
Wan Q, Zhou J, Yu Y, et al. Epithelioid hemangioendothelioma of right innominate vein mimics a teratoma. A case report Medicine 2017; 96(9): e6142.
[6]
Weidner N. Atypical tumor of the mediastinum: Epithelioid hemangioendothelioma containing metaplastic bone and osteoclastlike giant cells. Ultrastruct Pathol 1991; 15(4-5): 481-8.
[7]
Lahon B, Fabre D, De Montpreville V, et al. Epithelioid haemangioendothelioma of the superior vena cava. Interact Cardiovasc Thorac Surg 2012; 15(1): 186-7.
[8]
Blanco M, Gil P, Jove P. Mediastinal epithelioid hemangioendothelioma mimicking a teratoma. Arch Bronconeumol 2011; 47(7): 376-7.
[9]
Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging 2010; 32(6): 1325-39.
[10]
Strollo DC, Rosado-de-Christenson ML. Primary mediastinal malignant germ cell neoplasms: Imaging features. Chest Surg Clin N Am 2002; 12(4): 645-58.
[11]
Carter BW, Benveniste MF, Madan R, et al. ITMIG classification of mediastinal compartments and multidisciplinary approach to mediastinal masses. Radiographics 2017; 37(2): 413-36.
[12]
Li XM, Lin XY, Xu HT, et al. Mediastinal epithelioid hemangioendothelioma with abundant spindle cells and osteoclast-like giant cells mimicking malignant fibrous histiocytoma. Diagn Pathol 2013; 8: 103.
[13]
Yang Liu, Yue-Feng Jiang, Ye-Lin Wang, et al. Epithelioid hemangioendothelioma of the anterior mediastinum: A case report. Int J Clin Exp Pathol 2016; 9(5): 5746-52.
[14]
Brill JB, Schwartz IE, Prescher LM, et al. A case of an epithelioid hemangioendothelioma arising from the innominate vein mimicking cervical metastatic lymphadenopathy. Case Rep Surg 2016; 2016: 4238575.
[15]
Anderson T, Zhang L, Hameed M, et al. Thoracic epithelioid malignant vascular tumors: a clinicopathologic study of 52 cases with emphasis on pathologic grading and molecular studies of WWTR1-CAMTA1 fusions. Am J Surg Pathol 2015; 39(1): 132-9.
[16]
Doyle LA, Fletcher CD, Hornick JL. Nuclear expression of CAMTA1 distinguishes epithelioid hemangioendothelioma from histologic mimics. Am J Surg Pathol 2016; 40(1): 94-102.
[17]
Mentzel T, Beham A, Calonje E, et al. Epithelioid hemangioendothelioma of skin and soft tissues: Clinicopathologic and immunohistochemical study of 30 cases. Am J Surg Pathol 1997; 21(4): 363-74.
[18]
Deyrup AT, Tighiouart M, Montag AG, et al. Epithelioid hemangioendothelioma of soft tissue: A proposal for risk stratification based on 49 cases. Am J Surg Pathol 2008; 32(6): 924-7.
[19]
De Palma A, Pagliarulo V, Ardo N, et al. Surgical treatment of a rare case of epithelioid hemangioendothelioma of the azygos vein. Interact Cardiovasc Thorac Surg 2012; 14(1): 91-3.
[20]
Yu L, Gu T, Xiu Z, et al. Primary pleural epithelioid hemangioendothelioma compressing the myocardium. J Card Surg 2013; 28(3): 266-8.

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