Intravascular papillary endothelial hyperplasia I99

Author: Prof. Dr. med. Peter Altmeyer

Last updated on: 03.08.2021

Synonym(s)

Hemangioendotheliomas vegetante intravasculaire; intravascular papillary endothelial hyperplasia; Masson`s tumour; Pseudoangiosarcoma Masson

History
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Masson, 1923

Definition
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Reactive (benign) endothelial proliferation occurring during the organisation of a thrombosed vessel, primarily endovascular, less frequently extravascular (e.g. during the organisation of a haematoma), in stages. Extension to the perivasal connective tissue is possible in later stages. This proliferation mechanism may also occur in preexisting vascular tumors or malformations, e.g., hemangiomas, granuloma pyogenicum, or nevus flammeus.

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Dermatology

Acquired, Idiopathic, Patterned ...

Idiopathic, acquired and mottled facial pigmentation are probably physiological (non-inflammatory) pigmenta...

Localization
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Mostly skin or subcutis of extremities (fingers), head, neck, or shoulder; also in oral mucosa (Vieira CC et al. 2021); rarely in genital area.

Clinical features
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A blue-red, deep dermal or subcutaneously located, firm, slowly enlarging nodule of varying size (Ø max. 4-5 cm), usually associated with a larger vessel, which is not necessarily clinically recognizable as a vascular lesion.

Histology
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Mostly still recognizable, larger venous vessels with thrombotic material interspersed with endothelium-lined septa and papillae. Sponge-like aspect with bizarre, communicating cavities. No endothelial mitoses, no multilayering.

Differential diagnosis
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From the histological aspect all neoplasias with endothelial papillae, e.g. angiosarcoma, retiform hemangioenthelioma, endovascular papillary angioendothelioma.

Literature
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Branton PA et al (2003) Papillary endothelial hyperplasia of the breast: the great impostor for angiosarcoma: a clinicopathologic review of 17 cases. Int J Surg Pathol 11: 83-87
Han Yet al. (2019) Intravascular papillary endothelial hyperplasia occurring in the foot: A case report and review of literature. Medicine (Baltimore) 98:e16391.
Mahapatra QS et al. (2015) Intravascular papillary endothelial hyperplasia: An unusual histopathological entity. Indian Dermatol Online J 6: 277-279.
Masson P (1923) Hemangioendothelioma vegetant intravasculaire. Bull Soc Anat 93: 517-523
Pegado PF et al (2015) Intravascular papillary endothelial hyperplasia (Masson tumor) mimicking a sarcoma and developing from an arteriovenous hemodialysis fistula. Skeletal Radiol 44:859-862.
Renshaw AA, Rosai J (1993) Benign atypical vascular lesions of the lip. A study of 12 cases. Am J Surg Pathol 17: 557-565.
Shah HC et al (2014) Intravascular papillary endothelial hyperplasia (Masson's tumor) of the scalp with intracranial extension. J Pediatr Neurosci 9: 260-262.
Vieira CC et al. (2021) Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review. J Oral Pathol Med 50:103-113.
Yamamoto T et al (2000) Recurrent intravascular papillary endothelial hyperplasia of the toes. Dermatology 200: 72-74