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A case study of radiotherapy as a treatment option for multifocal pseudomyogenic hemangioendothelioma of the lower extremity.

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Title: A case study of radiotherapy as a treatment option for multifocal pseudomyogenic hemangioendothelioma of the lower extremity.
Authors: Montemayor, Brenda1 (AUTHOR), Labbe, Amber1 (AUTHOR), Laskorski, Laura1 (AUTHOR), Lenards, Nishele1 (AUTHOR) nlenards@uwlax.edu, Hunzeker, Ashley1 (AUTHOR), Michels, Machele1 (AUTHOR)
Source: Medical Dosimetry. 2026, Vol. 51 Issue 3, p375-378. 4p.
Subjects: Radiotherapy, Palliative treatment, Physiological effects of radiation, Leg injuries, Therapeutics, Sarcoma, Multiple tumors, Soft tissue tumors
Abstract: Pseudomyogenic hemangioendothelioma (PMHE) is a rare vascular neoplasm of intermediate malignancy with limited literature to guide radiation therapy planning, particularly in multifocal presentations. Researchers in this case study describe the clinical application of palliative radiation therapy for diffuse PMHE of the lower extremity and evaluate treatment effectiveness and treatment-related toxicity. A 24-year-old male with multifocal PMHE of the left foot and lower leg involving both soft tissue and bony structures was treated using 3D conformal radiation therapy with parallel-opposed oblique fields and circumferential 1.0 cm bolus. A total dose of 39 Gy in 13 fractions was selected to balance palliation with soft tissue sarcoma-based radiobiologic principles. The treatment achieved full target coverage and symptomatic relief. However, the absence of a skin-sparing strip, combined with preexisting infection and delayed wound healing, likely contributed to the development of post-treatment lymphedema. This case demonstrates the feasibility of using sarcoma-aligned palliative radiation dosing for multifocal PMHE but also highlights the risk of lymphedema when circumferential fields are used without lymphatic preservation techniques. Further case reporting is needed to refine field design and dose selection strategies for this rare entity. [ABSTRACT FROM AUTHOR]
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Database: Engineering Source
Description
Abstract:Pseudomyogenic hemangioendothelioma (PMHE) is a rare vascular neoplasm of intermediate malignancy with limited literature to guide radiation therapy planning, particularly in multifocal presentations. Researchers in this case study describe the clinical application of palliative radiation therapy for diffuse PMHE of the lower extremity and evaluate treatment effectiveness and treatment-related toxicity. A 24-year-old male with multifocal PMHE of the left foot and lower leg involving both soft tissue and bony structures was treated using 3D conformal radiation therapy with parallel-opposed oblique fields and circumferential 1.0 cm bolus. A total dose of 39 Gy in 13 fractions was selected to balance palliation with soft tissue sarcoma-based radiobiologic principles. The treatment achieved full target coverage and symptomatic relief. However, the absence of a skin-sparing strip, combined with preexisting infection and delayed wound healing, likely contributed to the development of post-treatment lymphedema. This case demonstrates the feasibility of using sarcoma-aligned palliative radiation dosing for multifocal PMHE but also highlights the risk of lymphedema when circumferential fields are used without lymphatic preservation techniques. Further case reporting is needed to refine field design and dose selection strategies for this rare entity. [ABSTRACT FROM AUTHOR]
ISSN:09583947
DOI:10.1016/j.meddos.2026.03.010