TN09 HEPATIC EPITHELOID HAEMANGIOENDOTHELIOMA: TWO CONTRASTING CASES

Abstract

Epitheloid Haemangioendothelioma of the liver is a rare mesenchymal tumour the recommended treatment of which is either liver resection or hepatic transplantation, if diffuse without metastases. The Australian National Liver Transplant Unit, Sydney has assessed and treated 2 patients with this tumour found to be limited to the liver after extensive investigation.The first case was a 43‐year‐old woman at the time of her operation in 1990. She underwent liver transplantation for a solitary biopsy proven right anterior hepatic lobe haemangioendothelioma. She has been routinely followed up for 16 years and remains recurrence free at last review.The second case was operated upon in 2004. This 59 years old woman present with an incidental radiological finding of multiple biopsy proven Epitheloid Haemangioendothelioma, limited to the right hepatic lobe and anatomically considered resectable. A right hemi‐hepatectomy was performed, however an addition wedge resection of a non‐radiologically recognised deposit in segment III was required. Resection was planned on the basis that no evidence of liver function impairment was evident and so an extended period on the transplantation waiting list might be anticipated. It was also believed that resection would not preclude latter listing for transplantation. Suitability of the tumour for this approach was suggested by low tumour activity on PET scan. This patient has been regularly reviewed for over 3 years with no evidence of recurrence.We will review our experience of this neoplasm in relation to the literature surrounding its management in the liver.