Somatostatin receptor expression in multiple hemangiomas

Although hemangiomas frequently occur in the skin, mucosa, liver, and brain, they are rarely observed in the abdominal cavity or retroperitoneum. Moreover, the expression of the somatostatin receptor (SSTR), a member of the G protein-coupled receptor superfamily, in hemangiomas is an uncommon phenomenon. Here, we report the case of a patient with hemangioma expressing somatostatin receptors. To date, this is the second documented case of multiple hemangiomas in which somatostatin receptors are expressed (Chua et al. Clin Nucl Med 47:321-323, 2022; Müssig et al. J Clin Endocrinol Metab 94:4123-4124, 2009).

A 66-year-old female with normal blood pressure and occasional episodes of hypertension but no symptoms, such as headache, chest pain, or palpitations, was found to have multiple hypervascular lesions in the retroperitoneum, rectouterine pouch, abdominal wall, and small bowel wall on pelvic contrast-enhanced CT. On the basis of the imaging findings from the CT and PET scans, the initial diagnosis was metastatic paraganglioma. The patient underwent laparoscopic surgery, and the tumors in the retroperitoneum and abdominal wall were successfully removed. Histopathological diagnosis confirmed hemangioma. Immunohistochemistry revealed positive expression of the endothelial cell markers CD31(+) and CD34(+), as well as expression of somatostatin receptor 2 (SSTR2), in some cytoplasmic cells.

This case highlights the rare expression of somatostatin receptors in hemangiomas, which may provide insights into their biological behavior and potential therapeutic targets. Increased awareness of such atypical presentations can improve diagnostic accuracy and inform clinical management strategies.