Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.
Clin Exp Dermatol. 2009 Dec;34(8):e802-6. doi: 10.1111/j.1365-2230.2009.03529.x.
A 48-year-old woman presented with red papules on the thigh. Histopathological examination indicated pyogenic granuloma, and the patient was treated with total excision in 2003 and electrocauterization in 2005. Three months later, upon recurrence of the lesions, a diagnosis of composite haemangioendothelioma (CHE) was made. The patient was treated by total excision and lymph-node dissection, which revealed inguinal lymph-node metastasis. Despite the surgery, a further local recurrence occurred, subsequently treated by wide excision en bloc, with adjuvant radiotherapy and chemotherapy. Although CHE is defined as a vascular tumour with low-grade malignancy, the local recurrences and lymph-node metastases resulted in treatment difficulties in this case. Unlike earlier cases, the tumour in our patient presented as localized numerous small papulonodules, and lymph-node metastasis was detected within a relatively short time. Dermatologists and pathologists should be aware of this rare condition and include it in the differential diagnosis of vascular lesions.
一位 48 岁女性大腿出现红色丘疹。组织病理学检查提示为化脓性肉芽肿，患者于 2003 年接受了全切除手术，2005 年接受了电灼治疗。3 个月后，病变复发，诊断为复合性血管内皮细胞瘤（CHE）。患者接受了全切除和淋巴结清扫术，发现腹股沟淋巴结转移。尽管进行了手术，仍出现进一步的局部复发，随后进行了广泛切除整块切除术，并辅助放疗和化疗。虽然 CHE 被定义为具有低度恶性的血管肿瘤，但本例的局部复发和淋巴结转移导致治疗困难。与早期病例不同，该患者的肿瘤表现为局限性的许多小结节，并且在相对较短的时间内发现了淋巴结转移。皮肤科医生和病理学家应该意识到这种罕见的情况，并将其纳入血管病变的鉴别诊断中。
