Musculoskeletal haemangioendothelioma

Haemangioendotheliomas, along with haemangiopericytomas and angiosarcomas, are tumours that arise from vascular structures. In the case of haemangioendotheliomas, the cell of origin is the endothelial cell, and they range from benign to frankly malignant lesions.

They typically occur in young patients.

They occur especially in the soft tissues of the limbs and are often closely related to veins, from which they are thought to arise.

Less frequently they can arise in bone (osseous haemangioendothelioma), in which case they are most often seen in the calvaria, spine or lower limbs.

Radiologically they appear the same as angiosarcomas and haemangiopericytomas.

Plain film

Nonspecific soft tissue mass. When involving bone, they are predominantly lytic, and may mimic haemangiomas with a coarse honeycomb appearance.

Angiography

Dense, well-circumscribed areas of enhancement with early draining veins and shunting. Hemangiopericytomas are described as having a pedicle formed by the arteries supplying the tumor from which vessels branch to encircle the tumour.

CT

Non specific soft tissue mass, with density similar to muscle but demonstrating bright contrast enhancement. CTA may demonstrate large feeding vessels.

MRI

Brightly enhancing soft tissue mass, often hyperintense on T2WI, with prominent flow voids, most marked in haemangiopericytomas.

Bone tumours

The differential diagnosis for bone tumours is dependent on the age of the patient, with a very different set of differentials for the paediatric patient.

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Article information

rID: 1414
Section: Pathology
Tags: refs, cases
Synonyms or Alternate Spellings:
  • Osseous haemangioendothelioma
  • Skeletal haemangioendothelioma
  • Haemangioendothelioma (MSK)

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