Disseminated epitheloid hemangioendothelioma mimicking symptoms of systemic vasculitis.
BACKGROUND
Epitheloid hemangioendothelioma is a rare malignant tumor which can involve bones, liver, lungs, kidneys, deep soft tissue, muscles, dermis, and central nervous system. Multifocal disease occurs in 10% of the cases. The clinical presentation results from occlusion of small blood vessels due to the disease itself or as a paraneoplastic syndrome.


METHODS
We present a patient with symptoms suggesting systemic vasculitis (ESR and CRP elevated, weight loss, arthralgia, livedoid rash, and skin ulcerations) who finally was diagnosed having a disseminated epitheloid hemangioendothelioma when PET scan revealed hypermetabolic multifocal skeletal and soft tissue lesions.


CONCLUSIONS
Diseases mimicking systemic vasculitis and the value of PET in this setting are discussed.
Haap
Michael
M
Department of Endocrinology, Metabolism, Clinical Chemistry and Vascular Medicine, University of Tübingen, Germany.
Kötter
Ina
I
Horger
Marius
M
Thamer
Claus
C
Wehrmann
Manfred
M
Häring
Hans-U
HU
Kanz
Lothar
L
Hartmann
Jörg Thomas
JT
D000368:Aged; D001158:Arteries / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D001799:Blood Sedimentation; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D018450:Disease Progression; D018323:Hemangioendothelioma, Epithelioid / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008218:Lymphocytosis / Q000473:pathology; D008297:Male; D009360:Neoplastic Cells, Circulating; D049268:Positron-Emission Tomography; D012867:Skin / Q000098:blood supply / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology; D040521:Subcutaneous Tissue / Q000098:blood supply / Q000473:pathology; D014657:Vasculitis / Q000175:diagnosis* / Q000473:pathology
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein