Epithelioid hemangioendotheliomia as a rare cause of blue toe syndrome

Abstract

Blue toe syndrome (BTS), is a well-known entity of toe gangrene and rest pain secondary to micro emboli lodged within the digital arteries. BTS among young patients should alert physicians to look for causes such as trauma, connective tissue disease, hypercoagulability state, and others. We hereby describe a 32-year-old female with right BTS. A mass obstructing 80% of the right popliteal artery lumen was the source of emboli. The histologic results of the replaced arterial segment revealed a thrombus on top of epithelioid hemangioendothelioma. This is the first description of the association between primary vascular tumor and BTS.

A rare case of intravascular epithelioid hemangioendothelioma of the cephalic vein treated with surgery and postoperative radiation therapy: a case report and review of the literature

“…Forty-three case reports on primary vascular EHE of both veins and arteries (except the aorta) have been described in the literature (Table 1 ). The involved vessels were the thoracic aorta [ 76 , 77 ], aortoiliac segment [ 78 ], radial artery [ 27 ], inferior vena cava [ 79 - 81 ] , superior vena cava [ 82 - 86 ], innominate vein [ 55 , 87 - 91 ], azygos vein [ 92 - 94 ], femoral vein [ 73 , 74 , 78 , 94 - 98 ], femoral artery [ 99 ] iliac veins [ 28 , 100 , 101 ], internal carotid artery [ 24 ], axillary vein [ 102 ], brachial vein [ 103 ] or artery [ 104 - 107 ], popliteal artery [ 108 ], pulmonary artery [ 109 ], occipital artery [ 110 ], temporal artery [ 111 ], meningeal artery [ 112 ], and digital artery [ 113 ]. Age of presentation ranged from 11 to 79 years (mean age was 39 years), and the distribution among the two sexes was almost equal, with a slight predominance of the female sex (59% vs. 41%).…”

Ischemic Toes after Venous Thromboembolism: A Difficult Differential Diagnosis with Good Response to Combination Therapy—A Case Report

“…Vasospasm, vasculitis, hyperviscosity syndrome (cold agglutinin anemia), hypercoagulable state, embolism, calciphylaxis, and toxins (ergot derivatives) are among the most common differential diagnoses. Glucocorticoids and some neoplasms [3] are among the differential diagnoses of blue toe syndrome.…”