McCollum Kasey J, Al-Rohil Rami N
Department of Pathology, Duke University Medical Center, Durham, NC 27710-0001, USA.
Department of Dermatology, Duke University Medical Center, Durham, NC 27710-1000, USA.
Biology (Basel). 2021 Nov 9;10(11):1160. doi: 10.3390/biology10111160.
Neoplasms of uncertain biological behavior present physicians with a genuine conundrum in practice. Cutaneous vascular neoplasms within this category are exceedingly rare, possessing significant gaps and uncertainty in many facets of clinical practice. Firstly, lesions were selected for review based on their categorization as indeterminate behavior, indicating the potential for local recurrence and rarely metastasize. After identification of the target lesions, a comprehensive review of the literature using national databases produced several landmark studies and case series regarding these neoplasms. Limiting the review to only cutaneous limited tumors narrowed the pool of studies; however, quite a large sum of papers remained. Examination of each paper yielded beneficial results on diagnosing, effective treatments, follow-up findings, and prognosis for each indeterminate lesion discussed. Overall, the literature search combined the molecular, histologic, immunohistochemical, surgical strategies to develop an up-to-date and comprehensive framework to guide physicians when encountering such lesions. The tumors reviewed include: kaposiform hemangioendothelioma, endovascular papillary angioendothelioma, pseudomyogenic hemangioendothelioma, retiform hemangioendothelioma, epithelioid hemangioendothelioma, and composite hemangioendothelioma.
生物学行为不确定的肿瘤在临床实践中给医生带来了真正的难题。这类皮肤血管肿瘤极为罕见,在临床实践的许多方面存在重大差距和不确定性。首先,根据病变归类为行为不确定来选择病变进行综述,这表明有局部复发的可能性且很少发生转移。确定目标病变后,利用国家数据库对文献进行全面综述,产生了几项关于这些肿瘤的具有里程碑意义的研究和病例系列。将综述仅限于皮肤局限性肿瘤缩小了研究范围;然而,仍有相当多的论文。对每篇论文的审查得出了关于所讨论的每个不确定病变的诊断、有效治疗、随访结果和预后的有益结果。总体而言,文献检索结合了分子、组织学、免疫组织化学和手术策略,以建立一个最新的综合框架,在医生遇到此类病变时为其提供指导。所综述的肿瘤包括:卡波西样血管内皮瘤、血管内乳头状血管内皮瘤、假肌源性血管内皮瘤、网状血管内皮瘤、上皮样血管内皮瘤和复合性血管内皮瘤。