title: A "high-risk" epithelioid hemangioendothelioma presenting as a solitary, ulcerated, subcutaneous tumor.
abstract: So-called "high-risk" epithelioid hemangioendotheliomas are uncommon neoplasms that demonstrate classic histopathologic features of epithelioid hemangioendotheliomas and a size larger than 3 cm or >3 mitotic figures per 50 high power fields. These neoplasms show an increased rate of metastasis (25% of cases) and are associated with a poor 5-year survival (59%). They may pose a diagnostic challenge for dermatopathologists as they mimic metastatic carcinoma, malignant mixed tumor, melanocytic neoplasms, epithelioid sarcoma, and epithelioid angiosarcoma. High-risk epithelioid hemangioendothelioma has not been previously reported as a solitary ulcerated mass in the skin. Here, we describe one such lesion that developed as a rapidly growing ulcerative skin tumor in a 33-year-old African American man with a remote history of Burkitt lymphoma. We also review the evolution and controversies in the understanding and classification of this neoplasm.
authors: Department of Pathology, The University of Colorado Denver Health Sciences Center, Aurora, CO, USA. alexandra.hristov@ucsfmedctr.org
authors: Alexandra C
authors: AC
authors: Hristov
authors: Joshua
authors: J
authors: Wisell
mesh_terms: D000328:Adult; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D018323:Hemangioendothelioma, Epithelioid / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008940:Mitotic Index; D009336:Necrosis; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D012883:Skin Ulcer / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor