Kaposiform hemangioendothelioma involving the neck

Zhi-Jun Sun , Lu Zhang , Wen-Feng Zhang , Xin-Ming Chen , Fernand Mac-Moune Lai , Yi-Fang Zhao
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引用次数: 7

Abstract

Kaposiform hemangioendothelioma is a rare locally aggressive vascular neoplasm of infancy and childhood. An 18-month-old Chinese infant with a rapidly enlarging mass in the neck was presented here. Physical examination revealed a dark-red, firm mass measuring 7.0 × 4.5 cm in the anterior neck. No associated with KMS was observed despite its size. Morphologically, the tumor consisted of dense spindle cells with a nodular growth pattern, with hypocellular areas of hyalinized fibrous stroma. Immunohistochemically, both spindle and epithelioid were immunoreactive to CD34, CD31 and UEA-1, while negative to GLUT1, EMA, cytokeratin or S-100 protein. The well-formed capillaries and mature vessels but not spindle tumor cell showed reactivity for FVIII-Rag. α-SMA were detected in pericysts surrounding spindle cells. Large vessels in the tumor were positive for VEGFR3. Recurrence occurred 6 month after first operation. Wide resection was performed a second time, the patient was still alive during the 7-year follow-up period.

累及颈部的卡泊样血管内皮瘤
卡波西样血管内皮瘤是一种罕见的婴儿期和儿童期的局部侵袭性血管肿瘤。一例18个月大的中国婴儿颈部肿块迅速增大。体格检查显示前颈部有一深红色坚硬肿块,尺寸为7.0 × 4.5 cm。尽管其大小,但未观察到与KMS相关。形态学上,肿瘤由致密的梭形细胞组成,呈结节状生长模式,并伴有透明化纤维间质的低细胞区。免疫组化结果显示纺锤体和上皮样细胞对CD34、CD31和UEA-1均有免疫反应,而对GLUT1、EMA、细胞角蛋白和S-100蛋白均无免疫反应。形成良好的毛细血管和成熟血管对FVIII-Rag有反应,梭形肿瘤细胞对FVIII-Rag无反应。在梭形细胞周围的包囊中检测到α-SMA。肿瘤大血管VEGFR3阳性。术后6个月复发。第二次行大范围切除,7年随访期间患者仍然存活。
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