Primary cutaneous epithelioid hemangioendothelioma of the temporal region: a case report

Primary cutaneous epithelioid hemangioendothelioma (EHE) is an uncommon low-grade malignant vascular neoplasm that predominantly involves visceral organs, with primary manifestation in the skin, particularly in the head and neck region, being exceptionally rare. This report describes the case of a 70-year-old female presenting with a gradually progressive, intermittently ulcerated plaque on the left temple. Histopathological evaluation revealed characteristic features of EHE, which were further confirmed by strong immunohistochemical expression of endothelial markers CD31 and ERG. Comprehensive systemic assessment demonstrated no evidence of extracutaneous disease. The patient declined surgical intervention due to aesthetic concerns and has been maintained on follow-up every three months. No disease progression has been observed during the six-month follow-up period. This case highlights the importance of including cutaneous epithelioid hemangioendothelioma (EHE) in the differential diagnosis of persistent ulcerative facial lesions and underscores the value of early histopathological biopsy. Early, localized lesions can be completely excised surgically, achieving cure while optimally preserving facial aesthetics.