Intravascular papillary endothelial hyperplasia of the skull base and intracranial compartment

Histology showed thickened, hyalinized vessels with focal calcifications, and proliferation of endothelial-lined spaces containing red blood cells and fibrin with mixed acute and chronic inflammation and focal necrosis (Fig. 3D). No residual lesion was seen on post-operative MRI and the patient was discharged to a skilled nursing facility due to his baseline neurologic comorbidities, where he has continued with physical and speech therapy during the six months since lesion resection. 3 Discussion IPEH represents approximately 2% of vascular tumors and subcutaneous lesions in the head and neck, extremities and digits, lips, tongue, and buccal mucosa [4,5]. Clues on histology that help to differentiate IPEH from angiosarcoma include the lesion's intravascular location, as well as the absence of cellular atypia, necrosis, excessive number of mitoses, nuclear pleomorphism, and overt invasion of adjacent structures [5].