Spindle cell hemangioendothelioma in association with epithelioid hemangioendothelioma

A forty-two-year-old man presented with a twelve-year history of a multilobular, firm, but nonulcerated tumor (6 by 4.5 cm) of the dorsum of the right foot. He had capillary telangiectasia of both ankles but no lymphedema. Results of tests for human immunodeficiency viruses I and II were nonreactive. The tumor showed a complex combination of features of spindle cell hemangioendothelioma, epithelioid hemangioendothelioma, and areas suggestive of a possible well-differentiated (lymph) angiosarcoma. The tumor was completely excised with minimal healthy margin. There was no evidence of local or distant lesion at one-year follow-up examination.