Hepatic Epithelioid Hemangioendothelioma: Is Hepatitis C Viral Infection an Etiologic Factor?

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Introduction: Hepatic Epithelioid Hemangioendothelioma (HEHE) is an infrequent vascular tumor of endothelial cell origin. There is no clearly established risk factor for its development. It behaves as a lowgrade malignant vascular tumor with slow progressive phenotype. Liver transplantation should be considered the first-line of therapy given the large tumor burden and favorable long-term outcome. Case: We report a 48-year-old Caucasian female who complained of abdominal pain and weight loss. She has a history of hepatitis C viral infection that was treated with interferon and ribavirin and subsequently became RNA-negative on repeated follow-up testing pre-transplant. Her work-up revealed multiple confluent infiltrating bilobar liver masses diagnosed as HEHE (biopsy-proven) and cirrhosis. She underwent a successful liver transplant and is tumor-free without evidence of recurrent HCV infection 22 months post-transplant. Conclusion: Liver transplant provides remarkable long-term survival for HEHE/HCV cirrhotic patient considering the large tumor burden and lack of evidence of recurrent tumor and/or HCV infection.Figure: [CT of the Abdomen]Figure: [Photomicrograph of HEHE in Hep C cirrhosis]