Abstract
BackgroundHepatic epithelioid hemangioendothelioma (HEHE) is an extremely rare borderline tumor of vascular endothelial origin. Laparoscopic resection of HEHE has never been reported.MethodsThe clinical data of eleven patients with HEHE (4 women and 7 men) who were diagnosed and treated at the Union Hospital (Wuhan, China), and Wuhan Asia General Hospital (Wuhan, China), between March 2012 and July 2020 were analyzed retrospectively.ResultsThe mean age of HEHE patients was 42.4 ± 13.9 years (range 22–67 years). All patients underwent laparoscopic surgery alone or in combination with radiofrequency ablation. Most tumors showed aggressive growth or metastasis. By immunohistochemistry, tumor cells were positive for CD31, CD34, ERG, PCK, FLi-1, TFE-3, and Ki-67 (labeling index range, 5–15%). In one of the patients, the tumor was accompanied by partial necrosis with a local appearance of epithelioid angiosarcoma. Postoperative adjuvant treatment included chemotherapy, sorafenib, and Huaier granule. As of July 2020, the median follow-up duration was 36 months (range, 9–60 months), with 2 (18.2%) patients experiencing tumor recurrence.ConclusionsThis is the first report of laparoscopic hepatectomy of HEHE. Curative laparoscopic hepatectomy might be an acceptable treatment for appropriate HEHE patients.
Highlights
Tumors of the liver are common, but the primary or secondary hepatic epithelioid hemangioendothelioma (HEHE) is rare [1]
Laparoscopic resection of HEHE is seldom reported in the literature
This research was approved by the Ethical Review Committee of the Tongji Medical College, and informed consent was obtained from the study participants. Patients and methods This retrospective study included eleven HEHE patients diagnosed on the basis of postoperative histopathology. These patients were treated between March 2012 and July 2020 at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Summary
Tumors of the liver are common, but the primary or secondary hepatic epithelioid hemangioendothelioma (HEHE) is rare [1]. In the majority of HEHE patients, multiple nodules are secondary and result from a systemic spreading of the disease. Epithelioid hemangioendothelioma occurs most frequently in the liver [2], lung [3], and bone [4]. HEHEs are extremely rare borderline tumor, while primary single nodule HEHE is even rarer due to its high metastatic potential. Laparoscopic resection of HEHE is seldom reported in the literature. This report describes cases of curative laparoscopic resection of primary HEHE accompanied by vascular invasion. Hepatic epithelioid hemangioendothelioma (HEHE) is an extremely rare borderline tumor of vascular endothelial origin. Laparoscopic resection of HEHE has never been reported
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