Dr. Munir Alam, Dr. Michael Moriarty, Dr. Susan Kennedy, Dr. Sean M Carroll
For descriptive purpose the term “composite hemangioendotheloima (HE)” is used to include the features of more than one subtype of HE. Composite HE rarely undergoes malignant transformation and does not usually metastasise. A 57 year old man who first presented with a soft swelling on the dorsum of his right hand 13 years ago. It was excised and recurred on multiple occasions regionally on the right hand and forearm. The histological features consistently remained as a composite hemangioendothelioma for 10 years. Thirteen years later it recurred again on forearm and arm which is managed with wide excision and free rectus abdominus muscle flap reconstruction. However, histology showed a features suggestive of frank angiosarcoma.