[A man with epitheloid hemangioendothelioma. The suspicion of a vascular tumor often occurs late].

A 58-year-old man presented at the dermatology outpatient clinic with a subcutaneous nodule on his left hand. The patient could not recall a previous injury. Excision revealed an epithelioid hemangioendothelioma, a rare and malignant vascular tumour, characterized by slow progression and often located on the upper and lower extremities. The patient was referred to a specialist group for soft-tissue tumours. He underwent excision, after which the wound was closed using a non-invasive adhesive wound closure. Since the excision was not very extensive, supplementary radiotherapy was given. Four years later there was no relapse or occurrence of metastases. Invasive investigation of a soft-tissue tumour, such as skin biopsy or diagnostic excision, may interfere with potential MRI - the diagnostic imaging tool indicated in the guidelines. However, a soft-tissue tumour is often only suspected at the last moment. When a soft-tissue tumour is suspected, the doctor should refer the patient to one of the specialist groups for soft-tissue tumours for further diagnosis and therapy.