[Malignant epithelioid hemangioendothelioma of the liver. Results of surgical treatment strategies].
BACKGROUND
Malignant epithelioid hemangioendothelioma is a rare vascular tumor described mostly in soft tissue, lungs, or liver. The outcome after a wide variety of therapeutic measures, ranging from extended surgical therapy to no therapy, is reported to be variable. Therefore, we reviewed our experience with resective therapy for this rare liver tumor, including orthotopic liver transplantation.


METHODS
During a period of 5 years, seven patients with the histological diagnosis of hepatic epithelia hemangioendothelioma were seen. In five of them, the liver pathology was detected at random, and all patients were prospectively followed. The therapeutic measures and course of disease are given as case reports.


RESULTS
Three patients received formal liver resection and two received liver grafts, one partial and one whole. One further patient is scheduled for transplantation and one is undergoing alternative therapy, with the tumor remaining stable. All resected patients recovered quickly and are alive and well 2 months to 4 years later without signs of tumor recidivism.


CONCLUSIONS
Anatomic liver resection, or in the case of diffuse tumor spread, orthotopic liver transplantation, show favorable long-term results for the treatment of hepatic epithelioid hemangioendothelioma. Therefore, surgical therapy is proposed as the treatment of choice for this entity.
Langrehr
J M
JM
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité -- Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin. jan.langrehr@charite.de
Petersen
I
I
Pfitzmann
R
R
Lopez-Hänninen
E
E
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006390:Hemangioendothelioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome