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Malignant epithelioid hemangioendothelioma arising in an intramuscular lipoma
Background:
A malignant epithelioid hemangioendothelioma (EH) developed within a peripheral intramuscular lipoma. It was seen as a painful calf mass. At the time of biopsy and en bloc resection, lung metastases were observed.
Methods:
Radiologic, histologic, immunohistochemical, and ultrastructural features of the neoplasm are described, and the literature pertaining to EH is reviewed.
Results:
The features of this tumor permitted its classification as a malignant EH.
Conclusions:
This case illustrates the potential for aggressive behavior in an EH, often considered to be a low-grade malignant neoplasm. Because such tumors can metastasize, they should be removed with wide margins whenever possible. This malignant neoplasm was located within a benign intramuscular lipoma, demonstrating the diagnostic problem that may exist in such a complex lesion.
