The patient had a turbulent clinical course, including 2 prolonged hospitalizations in which clinical status, laboratory values, skin lesions, and lymphadenopathy waxed and waned in parallel (Table). The pertinent laboratory value peaks included a C-reactive protein level of 360 mg/L (reference range, 0-10 mg/L) (to convert to nanomoles per liter, multiply by 9.524), vascular endothelial growth factor (VEGF) level of 354 pg/mL (reference range, 9-86 pg/mL), interleukin 6 (IL-6) level of 12.3 pg/mL (reference range, 0-6 pg/mL), and interleukin 8 level of 241 pg/mL (reference range, 0-5). Additional pertinent laboratory studies included normal immunoglobulin levels, negative urine protein electrophoresis, negative serum protein electrophoresis, negative light chain restriction, negative fluorescent in situ hybridization/cytogenetics, negative cryoglobulins, and negative HHV-8 quantitative polymerase chain reaction. Hemangiomata diameter peaked at 0.5 to 1.0 cm. He was treated with a combination of rituximab, intravenous immunoglobulin, siltuximab (IL-6 monocolonal antibodies), bortezomib, methylprednisolone, thalidomide, doxorubicin hydrochloride, cyclophosphamide, and etoposide phosphate, yielding substantial improvement in clinical status, laboratory values, and cherry hemangioma involution. At 1 year after discharge, he has had no recurrence of either ECH or MCD.