PALATE EPITHETIOD HEMANGIENDOTHELIOMA, CASE REPORT.

Abstract

Introduction Epithelioid hemangioendothelioma (EHE) is considered as a borderline vascular neoplasm between hemangioma and angiosarcoma. It represents less than 1% of all vascular tumors and was described in 1975 by Dail and Liebow, but the term EHE was introduced in 1982 by Weiss and Enzinger. EHE is characterized by a proliferation of epithelioid endothelial neoplastic cells. This lesion is rare reported in oral cavity. Clinically, it presents as gingival swelling. Case Report 59 years old male presents with asymptomatic left palatal swelling of 3 years of evolution, the lesion was previously diagnosis as granular cell tumor by a hospital Pathologist. Excisional biopsy was done. Microscopically are epithelioid hyperchromatic cells with vacuolated cytoplasm and lumen formation, arranged in nests and closely associated with blood vessel. Neoplastic cells were positive for the CD31, CD34, D2-40, FVIII and INI1; Ki67 Discussion The EHE is an uncommon vascular neoplasm with less of 50 cases reported in oral cavity in the English literature. The most common location is gingiva, in middle age patients. Histologically, the presence of vacuolated cells may cause confusion in the diagnosis and therefore the use of other tools such as immunohistochemistry is important for the appropriate diagnosis of this lesion and correct treatment. Conclusion EHE can turn into malignancy and metastasize to regional lymph nodes, therefore wide margins surgical excision and long term follow up of the patient is highly recommended because the 10-15% rate of recurrence, the survival rate is 76% true 5 years of follow-up.