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A biopsy of the left third metatarsal expansile lesion performed during an incision and curettage procedure revealed an epithelioid haemangioma (EHE) of the bone. MRI of the left hip performed in response to the findings on the bone scan showed metastatic disease in the left intertrochanteric region. A prophylactic left hip fixation surgery with an interlocking intramedullary femoral nail was therefore undertaken to avoid a pathological fracture of the left hip from the metastatic disease. Simultaneously, a left hip biopsy was performed, which also revealed an EHE. The patient underwent external beam radiation to the left femoral head and neck. This was followed by fractionated radiosurgery to the left third metatarsal. Once the left foot wound had healed, the patient subsequently received four cycles of doxorubicin and ifosfamide. A restaging positron emission tomography CT carried out after completion of therapy showed no metabolic evidence of residual primary tumour or metastasis. More than 2\u2005years after completing his trimodality therapy, the patient remains fully functional and symptom free.<\/jats:p>","DOI":"10.1136\/bcr-2015-210196","type":"journal-article","created":{"date-parts":[[2015,7,16]],"date-time":"2015-07-16T10:53:39Z","timestamp":1437044019000},"page":"bcr2015210196","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["A trimodality approach in the management of metastatic low-grade epithelioid hemangioendothelioma of the bone"],"prefix":"10.1136","volume":"2015","author":[{"given":"Abhijit","family":"Saste","sequence":"first","affiliation":[{"name":"Division of Hematology-Oncology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Felipe","family":"Cabrera Fernandez","sequence":"additional","affiliation":[{"name":"Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Pathology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Gamalski","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,7,16]]},"reference":[{"key":"2025082701052455000_2015.jul16_1.bcr2015210196.1","unstructured":"Fletcher CDM , Bridge JA , Lee JC . 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