Auricular epithelioid hemangioendothelioma: Two cases first diagnosed as auricular pseudocyst

Epithelioid hemangioendothelioma (EHE) is a rare soft-tissue vascular neoplasm with a prevalence of one in one million. The present study firstly reports two cases of EHE occurring in the auricle. The clinical, histopathological and immunohistochemical features of two patients with auricular EHE are described, and the associated literature are reviewed. Two adult male patients each presented with an asymptomatic, unilateral soft skin-colored noninflammatory swelling of the auricle. Based on their clinical manifestations, both patients were initially diagnosed with auricular pseudocysts. Auricular excision surgery was performed under general anesthesia. The resected specimens were sent for pathological examination. Immunohistochemical examination showed that the specimens were positive for CD31, CD34, friend leukemia integration 1 (FLI-1), coagulation factor 8 and E26 transformation-specific-related gene, which was consistent with EHE. Follow-up after surgery showed no evidence of tumor recurrence. It may be concluded EHEs of low malignancy should be included in the differential diagnosis of patients with auricular pseudocysts. EHEs can be diagnosed based on their morphological and histological characteristics, with immunohistochemical positivity for FLI-1 and CD31 being suggestive of a diagnosis of EHE.