Pseudomyogenic hemangioendothelioma (PHE) is an intermediate malignant vascular tumor primarily affecting soft tissues in children and young adults. The molecular basis of this neoplasm is unknown. Chromosome banding analysis, fluorescence in situ hybridization (FISH), mRNA sequencing, RT-PCR, and quantitative real-time PCR have shown that PHEs are characterized by a balanced translocation t(7;19)(q22;q13), resulting in the fusion of the SERPINE1 and FOSB genes. The role of SERPINE1, which is highly expressed in vascular cells, in this gene fusion is probably to provide a strong promoter for FOSB. FOSB encodes a transcription factor belonging to the FOS family of proteins, which together with members of the JUN family of transcription factors are major components of the Activating Protein 1 (AP-1) complex. Keywords Pseudomyogenic hemangioendothelioma; SERPINE1; FOSB; translocation
Clinics and pathologyNote Newly recognised entity. Rare. Exact incidence not known.
EtiologyNot known.
EpidemiologyOften young adults. Predominantly male (4.6:1)
ClinicsTwo thirds of the lesions seen in limbs followed by trunk and head and neck. Size 0.3-5.5 cm. Often multifocal and ill circumscribed. Situated subcutanously but often in different tissue planes, including bone. Painful nodules in 50% of the cases. Locally aggressive and often recurring but rarely distant metastases.
PathologySpindle cells in fascicles and sheets. Vesicular nuclei. Distinct eosinophilic cytoplasm. Cells often show a rhabdomyoblast-like appearance.