Haemangioendotheliomas, along with haemangiopericytomas and angiosarcomas, are tumours that arise from vascular structures. In the case of haemangioendotheliomas, the cell of origin is the endothelial cell, and they range from benign to frankly malignant lesions.
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Epidemiology
They typically occur in young patients.
Pathology
They occur especially in the soft tissues of the limbs and are often closely related to veins, from which they are thought to arise.
Less frequently they can arise in bone (osseous haemangioendothelioma), in which case they are most often seen in the calvaria, spine or lower limbs.
Radiographic features
Radiologically they appear the same as angiosarcomas and haemangiopericytomas.
Plain film
Nonspecific soft tissue mass. When involving bone, they are predominantly lytic, and may mimic haemangiomas with a coarse honeycomb appearance.
Angiography
Dense, well-circumscribed areas of enhancement with early draining veins and shunting. Haemangiopericytomas are described as having a pedicle formed by the arteries supplying the tumour from which vessels branch to encircle the tumour.
CT
Non specific soft tissue mass, with density similar to muscle but demonstrating bright contrast enhancement. CTA may demonstrate large feeding vessels.
MRI
Brightly enhancing soft tissue mass, often hyperintense on T2WI, with prominent flow voids, most marked in haemangiopericytomas.
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