Epitheloid Hemangioendothelioma Originating in the Greater Omentum: Report of a Case

Hideo Terashima, Masahiro Saitoh^*, Satsuki Takahashi^* and Katsu Hirayama

Department of Surgery, Hiraka General Hospital, ^*Depertment of Pathology, Hiraka General Hospital

We report a rare case of an epitheloid hemangioendothelioma of the greater omentum. A 58-year-old woman admitted with periumbilical discomfort was found to have an elastic palpable soft mass of about 5cm close to the abdominal wall in the periumbilical region. Abdominal ultrasonography (US) showed a heterogenous hypoechoic tumor with cyst-like components mobile horizontally with respiration. Contrast-enhanced computed tomography (CT) showed a well-circumscribed tumor about 4 cm in diameter with low focal attenuation areas near the stomach and transverse colon. Endoscopy and barium enema detected no lesions in the gastrointestinal tract. These findings suggested a primary peritoneal tumor. As it showed displacement with respiration, we considered that it may have arisen from the greater omentum. The patient underwent sugery on November 22, 1999. The tumor presented in the greater omentum in firm contact with the gastric wall, necessitating total extirpation of the tumor combined with partial resection of the involved gastric wall. Microscopically, the tumor had features consistent with epitheloid hemangioendothelioma, and had infiltrated the gastric muscular layer. Immunohistochemically, endothelial markers CD34 and Factor VIII were partially expressed in tumor cells. The final pathological diagnosis was epitheloid hemangioendothelioma originating from the greater omentum. The patient's postoperative course was uneventful, with no evidence of recurrence after 30 months. Epitheloid hemangioendothelioma of the greater omentum is extremely rare. A search of the English literature on the Internet showed only 1 previous report, making the presentation of this case significant and necessary.

Key words
epitheloid hemangioendothelioma, greater omentum

Reprint requests
Hideo Terashima Department of Surgery, Hiraka General Hospital 1-30 Ekimae-cho, Yokota, 130-8610 JAPAN

Accepted
September 25, 2002

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