Case Number : Case 1439- 29 December Posted By: Guest

spiradenoma

Epithelioid hemangioma.

Agree completely with Romualdo, although the unusual site: ALHE.

What about cutaneous epithelioid angiomatous nodule?

Dermal based vascular proliferation. Vessels lined by plump epithelioid cells. Abundant lymphoid tissue, along with scattered eosinophils- angiolymphoid hyperplasia with eosinophilia.

Cutaneous epithelioid angiomatous nodule did cross my mind, but the vessels in this condition are usually not well formed.

Given the well circumscribed nature of the lesion, would prefer EAN

Agree that Epithelioid hemangioma comes in the differential. I would still perform CD34, CD31, vimentin, CK and EMA. I think that epithelioid sarcoma comes to the differential also  because it can have highly inflammed áreas.

Cutaneous epithelioid angiomatous nodule is a nice suggestion, but this lesion (today's case) was described as a subcutaneous nodule. CEAN are typically located at superficial dermis and deep dermis and subcutaneous tissue are generally not involved.

Cutaneous epithelioid angiomatous nodule. This was not an intravascular lesion and was very well circumscribed. The lesion was located in the superficial subcutis. Vascular markers were positive but keratin markers were negative. Unusual site for EH and usually this entity has more eosinophils.  Importantly, this is not hemangioendothelioma or angiosarcoma.