Solid epithelioid hemangioma of the heart: Report of a case with unusual threadlike bridging strands

Abstract

Jan Koren, Michal Zamecnik

We present a rare case of solid epithelioid hemangioma (EH) which was found in the left atrium of the heart in a 77-year-old man. The tumor measured 20 mm. Histologically, it was composed of a solid proliferation of epithelioid endothelial cells. Some cells contained intracytoplasmic lumina with the appearance of vacuoles. Focally, several of such cells, closely adjacent to one another, created small vascular space with thin transverse bridge of cytoplasm, resembling strongly so-called threadlike bridging strands which are typical of adenomatoid tumor. Therefore, the adenomatoid tumor was considered in differential diagnosis of this lesion. However, immunohistochemical expressions of CD31 and ERG protein, and negative results with mesothelial markers confirmed endothelial nature of the tumor. Cardiac EH with solid pattern and with threadlike bridging strands is extremely rare lesion which should not be confused with the adenomatoid tumor.