RETIFORM HEMANGIOENDOTHELIOMA OF LEG IN 24 YEARS OLD MAN:A CASE REPORT

Introduction Retiform hemangioendothelioma(RH) is a rare vascular neoplasm with a high rate of local recurrence and low metastatic potential.Until now from 50 cases of the RH which introduced world wide,6 of them originated on the lower limb. This hemangiomas,commonly seen in 2P nd P - 4P th P decade of life. This vascular neoplasia behave in an intermediate condition between benign hemangiomas and malignant angiosarcomas.Here we describe a 24-year-old man admitted to Fatemi hospital of Ardabil. The most common signs of patient were lymphedema of the left leg, erythma and a mass on his leg,without any vascular varicose. Method Physical examination defined 4+lymphedema of lower limb,specially in the middle of the calf with more extensive swelling to the ankle. MRI confirmed that tumor extended to the subcutaneous tissue but there was not any extension to muscular layer. In addition to the retiform pattern of the vascular endothelioma,the pathological slide also contained solid area with focal epithelioid cells. Slides demonstrated rare mitotic figures and no necrosis was noted.Arborizing blood vessels lined by cells with scanty cytoplasm resembling match stick or hobnail appearance .Occasionally,intra vascular hyaline cores were seen that there were ca 2+ deposites around them. Immunohistochemical tests revealed cells reacting with CD31,CD34,D2-40 (D2-40 is not imminent),which consistent of an endothelial cell origin. Result Post operative diagnose confirmed RH. In curation Moh s micrographic surgery is the best treatment of RH.Conclusion Lesions in most cases are typically nodular and plaque, but our patient hadn t any nodules or plaques on his erythema. This types of tumors is extremely rare and most cases are accompanied by epithelioid hemangioendotheliuma and angiosarcoma.in this types of tumor, biopsy is the best method for diagnosing.

Keywords:

retiform hemangioendotheliuma , neoplasia , lower limb