Epithelioid angiomatous nodule of head and neck

Epithelioid vascular proliferations comprise a wide morphologic spectrum, ranging from reactive hyperplasia via benign tumor to malignant conditions. Epithelioid angiomatous nodule (EAN) is a recently recognized benign vascular proliferation with distinct clinical and pathological features. We review the literature and present six additional EANs in the head and neck examined by immunohistochemistry. This series comprised an equal number of males (n=3) and females (n=3) aged 13-45 years (mean 25.8 years). The sites of origin included the tongue (n=2), skin of the lip (n=2), periorbital and temporal skin (n=1), and nose (n=1). A painless solitary nodule (n=4) was the most common presentation. The lesions were distributed in the epidermis and subcutis, with a characteristic unilobular solid proliferation of polygonal epithelioid endothelial cells with intracytoplasmic primitive lumina. The distinction of EAN from other lesions of the heterogeneous group with epithelioid vascular proliferation can usually be made on the basis of the clinical and morphological features. This series indicates that the distribution of EAN in the head and neck region is not uncommon, which is in contrast to what was initially thought. EAN may be a variant of epithelioid hemangioma.