Multicentric Epithelioid Hemangioendothelioma of the Bone: Histologic and Radiographic Features

A multicentric epithelioid hemangioendothelioma (EHE) of the bone is reported which affected the right femur, the right patella and the right fibula of a 56-year-old man. Plain radiographs demonstrated purely lytic multicentric lesions with well-defined sclerotic borders. Computed tomography (CT) scans showed multiple osteolytic lesions in a honeycomb pattern at the epiphyseal lesion of the right femur; the other lesions of the right femoral shaft, the right patella and the right fibula were punched out sharply. Magnetic resonance (MR) images showed that the tumors contained mixed signal intensities: low intensity for T1-weighted images and high intensity for T2-weighted images. Histologically, the tumor was discerned as EHE with a spectrum of endothelial tumor, with the added feature of epithelioid hemangioma in a limited area. As for the initial treatment, curettage and bone cementing were performed for the epiphyseal tumor of the right femur, followed by surgical resections of the other tumors. Neither recurrence nor metastasis was observed 3 years after resection.