A Spindle Cell Hemangioendothelioma on the Head Resembling an Arteriovenous Malformation

Abstract

A spindle cell hemangioendothelioma is a relatively uncommon lesion, especially on the head and neck. Recurrence occurs after local excision of 50% to 60% of these lesions; therefore, it is important to recognize this unusual neoplasm and avoid misdiagnosis. Here, we report a rare case of a spindle cell hemangioendothelioma of the head. A 37-year-old woman presented with a soft subcutaneous mass, 2.5 cm in size, on her right occipital region. The mass pulsated strongly and a thrill was present. Magnetic resonance imaging showed that some dilated feeding arteries flowed into the mass and that a flow-void sign was present. The lesion looked like an arteriovenous malformation, and a marginal resection was performed. Histologically, there was a mix of cavernous vascular cavities and Kaposi sarcomalike spindle cell vascular zones, which is compatible with a spindle cell hemangioendothelioma.

A case of extramedullary subdural spindle cell hemangioendothelioma of the thoracic spinal cord treated curatively with radiation therapy

“…Spindle cell hemangioendothelioma (SCH) is considered to be uncommon benign vascular tumor. It was first reported by Weiss et al [ 5 ]in 1986 and could occur in all age groups, mostly in superficial soft tissues, and has been reported in various locations such as limbs, trunk, head and neck [ [6] , [7] , [8] , [9] ]. However, it is extremely rare in the spinal cord.…”

Characteristic appearance of spindle cell hemangiomatosis, often misdiagnosed as venous malformation: A retrospective study of 11 cases

“…It mostly affects the dermis and subcutaneous tissues of the distal extremities. In some rare cases, individual lesions also occur in the head and neck region, bone or internal organs 4–6 . Interestingly, most of the cases that occurred in the distal extremities were multifocal lesions.…”

“…In some rare cases, individual lesions also occur in the head and neck region, bone or internal organs. [4][5][6] Interestingly, most of the cases that occurred in the distal extremities were multifocal lesions. Only a few case reports have described this disease occurring in the distal extremities recently, which has increased awareness of diagnosis and differential diagnosis of this disease.…”