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Disseminated epitheloid hemangioendothelioma mimicking symptoms of systemic vasculitis
Michael Haap1, Ina Kötter, Marius Horger
1Department of Endocrinology, Metabolism, Clinical Chemistry and Vascular Medicine, University of Tübingen, Germany.
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.
Case Report:
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.
Discussion:
Diseases mimicking systemic vasculitis and the value of PET in this setting are discussed.
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