2023 World Conference on Lung Cancer (Posters)-EP14.03. Lung Epithelioid Hemangioendothelioma with Paraneoplastic Nail Clubbing and Hypertrophic Osteoarthropathy

EP14.03. Lung Epithelioid Hemangioendothelioma with Paraneoplastic Nail Clubbing and Hypertrophic Osteoarthropathy - PDF(Slides)

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Lung epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that affects the lungs. This case study reports on a 35-year-old woman who presented with cough, nail clubbing, and joint pain. Imaging tests, including bone scintigraphy, CT, and PET/CT, were performed to monitor the progression of the disease. The initial bone scan showed features of hypertrophic osteoarthropathy (HOA), suggesting lung malignancy. Subsequent CT and PET/CT confirmed the presence of lung nodules with metastasis to the liver. A biopsy revealed histologic evidence of EHE, and the patient underwent chemotherapy and radiation therapy. Unfortunately, the disease progressed and metastasized to the pleura and bones, leading to the patient's demise.<br /><br />EHE is a low- to intermediate-grade vascular neoplasm that commonly affects adults with a preference for females. CT patterns of EHE include lung nodules, pulmonary reticulonodular opacities, and diffuse infiltrative pleural thickening. In this case, nail clubbing and bone scintigraphy with features of HOA were observed, which are paraneoplastic manifestations associated with EHE. HOA is characterized by periosteal new bone formation, clubbed fingers, arthralgia, and arthritis.<br /><br />The study also discusses the generalities and background of EHE. EHE is a malignant vascular tumor that can affect various sites, including the liver, lung, bone, and soft tissue. It exhibits positivity for endothelial markers and is associated with specific genetic translocations. Female patients in their third decade of life are most commonly affected by EHE.<br /><br />The pulmonary imaging features of EHE are described, including the presence of multiple perivascular nodules on radiographs and CT scans. PET/CT can provide information on the metabolic activity and staging of EHE lesions. The case study includes various images illustrating these imaging features.<br /><br />In conclusion, this case report highlights the clinical and imaging findings of a patient with lung EHE and paraneoplastic manifestations. The disease progressed aggressively, leading to widespread metastasis and ultimately the patient's death.

Asset Subtitle

Ba Nguyen

Meta Tag

Speaker Ba Nguyen

Topic Other Thoracic Malignancy

Keywords

Lung epithelioid hemangioendothelioma

vascular tumor

lung nodules

metastasis

HOA

paraneoplastic manifestations

CT scans

PET/CT

metabolic activity

disease progression