EPITHELIOID HEMANGIOMA OF SMALL TUBULAR BONES - A REPORT OF 3 CASES, 2 OF THEM ASSOCIATED WITH PREGNANCY

We report three cases of epithelioid hemangioma of small tubular bones in women aged 20, 24, and 50 years, In two patients, the turner appea red during or shortly after pregnancy. We studied clinical data, radio graphs, and hematoxylin- and eosin-stained slides, and we performed im munohistochemical and now cytometric DNA analysis, The tumor was in di stal phalanges of the fingers in two patients and in metatarsal bone i n one, Cortical bone destruction with infiltration of the surrounding soft tissue was seen in all of the patients, Light microscopic examina tion showed characteristic morphology, highlighted by epithelioid endo thelial cells with different degrees of vasoformativity, Immunohistoch emically, the epithelioid cells showed strong positive reaction for Fa ctor Vm in all three patients, for CD31 in two, and for CD34 in one. U lex europaeus antigen and keratins were negative. Laminin and collagen IV delineated innumerable predominantly abortive vascular structures, which were encircled by cells that presumably were pericytic and that were positive for smooth muscle actin. A relatively high degree of im munostaining for proliferating cell. nuclear antigen and Ki67 contrast ed with the low mitotic rate and low percentage of cells in S phase, P rogesterone and estrogen receptors were negative, Epithelioid hemangio mas of small tubular bones are rare lesions that are characterized by early bone destruction and infiltration of soft tissues, Their associa tion with pregnancy may be fortuitous; if any gestation-related prolif erative stimulation exists, it does not seem to be mediated through st eroid receptors.