Malignant hemangioendothelioma presenting as multifocal intraskeletal lesions during pregnancy - A case report

BACKGROUND: Malignant hemangioendothelioma is a neoplasm of vascular origin characterized by irregular vascular channels lined with atypical endotheli al cells. CASE: A gravida at 32 weeks' gestation presented with diffuse back and lowe r leg pain and was diagnosed with multifocal malignant hemangioendothelioma of bone. Computed tomography of the chest also demonstrated a small right atrial density. Three weeks later the patient became septic, and cesarean s ection was performed. After several cycles of chemotherapy, clinical improv ement was noted. However, disease progression was noted thereafter, and the patient died one and a half years after the diagnosis. CONCLUSION: Our case was a primary multifocal malignant hemangioendotheliom a of bone arising during pregnancy. Considering the absence of pulmonary in volvement, it is unlikely that the skeletal lesions represented metastatic deposits from a cardiac primary. With such extensive skeletal disease, the right atrial density probably was a metastatic deposit.