Epithelioid hemangioendothelioma of the anterior mediastinum: a case report

Epithelioid hemangioendothelioma (EHE) is a subtype of hemangioendothelioma which is a kind of vascular tumor with the biologic behavior between a hemangioma and a conventional angiosarcoma. Among the 6 subtypes of the hemangioendothelioma, EHE is the most aggressive member of this family and may cause distant metastasis and even death in a minority of cases. We herein present one case of EHE exhibiting prominent eosinophils in the background, which happened in a 29-year-old Chinese male patient. Contrast-enhanced computed tomography (CT) scanning revealed a solitary mass in the anterior mediastinum adherent to pleura and multiple scattered small nodules in the both lung lobes. Histologically, the tumor was predominately composed of vast eosinophils and scattered histiocytoid tumor cells. The unusual histological appearance maybe misdiagnosed as inflammatory pseudotumor or epithelioid hemangioma, especially if the specimen is limited or from fine-needle aspiration.