Hepatic epithelioid hemangioendothelioma: long-term results of surgical management.
OBJECTIVE
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular neoplasm of the liver. Its therapeutic management remains difficult to define in curative intent. The aim of this study was to report long-term results of surgically managed patients.


METHODS
From 1990 to 2006, nine patients (25-64 years) were retrospectively enrolled in this study. Intrahepatic disease extent was monolobar and bilobar in two and seven patients, respectively. As primary treatment, liver resection (LR) and liver transplantation (LT) were performed in three (two monolobar and one bilobar extent) and six patients, respectively.


RESULTS
Postoperative mortality was nil. During a median follow-up of 117 months, four patients developed intrahepatic and/or extrahepatic recurrence. One resected patient (with bilobar extent) presented with intrahepatic recurrence was secondary treated by LT. At the time of the follow-up, seven out of the nine patients treated (two after LR, and five after LT) were alive and disease-free.


CONCLUSIONS
Surgical treatment offers good long-term results in patients suffering from HEHE when LR is tailored to the intrahepatic disease extent: LT has to be considered in patients with bilobar intrahepatic disease whereas LR should be strictly limited to patients presenting with localized and monolobar intrahepatic disease.
Mosoia
Liviu
L
Department of Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Lyon, France.
Mabrut
Jean-Yves
JY
Adham
Mustapha
M
Boillot
Olivier
O
Ducerf
Christian
C
Partensky
Christian
C
Baulieux
Jacques
J
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018323:Hemangioendothelioma, Epithelioid / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome