ArticleRadiology case reports2026
Anterior mediastinal epithelioid hemangioendothelioma associated with myelolipoma and extramedullary hematopoiesis mimicking a mature teratoma: A radiologic-pathologic correlation.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Epithelioid hemangioendothelioma (EHE) is an ultra-rare vascular neoplasm with variable biologic behavior. Mediastinal EHE is particularly uncommon and may mimic more prevalent prevascular mediastinal tumors. We report a 52-year-old man with a 10.5 × 8.9 × 9.6 cm mixed-density left upper anterior mediastinal mass containing macroscopic fat, soft-tissue components, and coarse calcification. FDG PET/CT demonstrated mild-to-moderate uptake (SUVmax 4.8) without nodal or distant metastatic disease, and the imaging appearance favored mature teratoma. Resection demonstrated a 9.5 cm conventional EHE intimately associated with a myelolipomatous component containing extensive extramedullary hematopoiesis and metaplastic ossification. The neoplastic cells expressed endothelial markers, and RNA fusion analysis detected WWTR1::CAMTA1. Surgical margins were negative, early postoperative and abdominopelvic imaging showed no residual or metastatic disease, and multidisciplinary review recommended surveillance without adjuvant therapy. Although similar EHE-myelolipoma/extramedullary hematopoiesis associations have been reported, this case emphasizes the multimodality imaging mimic of mature teratoma and provides direct radiologic-pathologic correlation of the fat-containing, solid, and ossified components.
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