Triple whammy: a rare case of epithelioid hemangioendothelioma with synchronous angiomyomatous hamartoma complicated by Actinomyces meyeri

Nariman Khan, Saadia Waheed, Rahaf Alkhateb

Abstract


Epithelioid hemangioendothelioma is a rare vascular malignancy that originates from vascular endothelial or pre-endothelial cells and is composed of epithelioid or histiocytoid cells. This malignancy has an incidence of approximately one per one million individuals and can occur in various regions of the body including the lungs, liver, bones, and soft tissues. The behavior of this cancer can range from indolent to aggressive and diagnosis and treatment are often delayed due to variable presentations and lack of established treatment guidelines. Here we present the case of a 27-year-old Hispanic male that presented with right groin pain, abdominal pain, and a fifty-pound weight loss over one year. The patient had a complex hospital course during which he was found to have an angiomyomatous hamartoma of his right groin area, postsurgical right inguinal wound infection with Actinomyces meyeri, and epithelioid hemangioendothelioma distal to the right iliac bifurcation. The patient is currently pending further imaging studies to evaluate candidacy for surgical resection and following with oncology for chemotherapeutic options.


Keywords


epithelioid hemangioendothelioma; angiomyomatous hamartoma; wound infection; Actinomyces meyeri

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References


Schuetze SM, Jones R. Uncommon sarcoma subtypes. In: UpToDate, Maki R (Ed), UpToDate, Waltham, MA [https://www.uptodate.com/contents/uncommon-sarcoma-subtypes#! available at 09/09/2021].

Sardaro A, Bardoscia L, Petruzzelli MF, Portaluri M. Epithelioid hemangioendothelioma: an overview and update on a rare vascular tumor. Oncol Rev 2014; 8:259. doi:10.4081/oncol.2014.259

Treska V, Daum O, Svajdler M, Liska V, Ferda J, Baxa J. Hepatic epithelioid hemangioendothelioma - a rare tumor and diagnostic dilemma. In Vivo 2017; 31(4):763-767. doi:10.21873/invivo.11128

Murali R, Zarka MA, Ocal IT, Tazelaar HD. Cytologic features of epithelioid hemangioendothelioma. Am J Clin Pathol 2011; 136(5):739-746. doi:10.1309/AJCP5NK0FJCGHTFM

Requena L, Kutzner H. Hemangioendothelioma. Semin Diagn Pathol 2013; 30(1):29-44. doi:10.1053/j.semdp.2012.01.003

Patrini D, Scolamiero L, Khiroya R, et al. Mediastinal hemangioendothelioma: Case report and review of the literature. Respir Med Case Rep 2017; 22:19-23. doi:10.1016/j.rmcr.2017.05.005

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. doi:10.1097/PAS.0000000000000511

Moh M, Sangoi AR, Rabban JT. Angiomyomatous hamartoma of lymph nodes, revisited: clinicopathologic study of 21 cases, emphasizing its distinction from lymphangioleiomyomatosis of lymph nodes. Hum Pathol 2017; 68:175-183. doi:10.1016/j.humpath.2017.08.035

Vaglio A, Palmisano A. Clinical manifestations and diagnosis of retroperitoneal fibrosis. In: UpToDate, Tonelli M, Curhan G (Ed), UpToDate, Waltham, MA [https://www.uptodate.com/contents/clinica l-manifestations-and-diagnosis-of-retroperitoneal-fibrosis?search=clinical%2 available at 09/06/2021].

Ha HK, Lee HJ, Kim H, et al. Actinomycosis: CT findings in 10 patients. AJR Am J Roentgenol 1993; 161:791-794. doi:10.2214/ajr.161.4.8372760

Garner JP, Macdonald M, Kumar PK. Abdominal actinomycosis. Int J Surg 2007; 5:441-448. doi:10.1016/j.ijsu.2006.06.009




DOI: http://dx.doi.org/10.22551/2021.32.0803.10187

Copyright (c) 2021 Nariman Khan, Saadia Waheed, Rahaf Alkhateb

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