Case for diagnosis

Area of Science:

• Vascular pathology
• Dermatopathology
• Surgical oncology

Background:

• Intravascular papillary endothelial hyperplasia (IPEH) is a rare, benign vascular proliferation.
• It often arises reactively secondary to vascular injury, thrombosis, or inflammation.
• Distinguishing IPEH from malignant vascular tumors like angiosarcoma is clinically crucial.

Observation:

• A 14-year-old male presented with a progressively growing, violet-red tumoral lesion on the occiput.
• Clinical examination revealed a vascular lesion requiring further diagnostic workup.
• Histopathological analysis confirmed the diagnosis of IPEH.

Findings:

• Histopathology demonstrated endothelial cell proliferation characteristic of IPEH.
• Key diagnostic features included the absence of significant cellular atypia and rare mitotic figures.
• Complete surgical excision of the lesion was achieved.

Implications:

• IPEH can mimic angiosarcoma clinically and histologically, necessitating careful differentiation.
• Prompt and complete surgical resection ensures a favorable prognosis with no recurrence.
• Understanding IPEH's benign nature guides appropriate management and reassures patients.