title: Our experience of liver Epithelioid Hemangioendothelioma: from a misdiagnosis to liver transplantation with long term follow-up.
abstract: Malignant Hepatic Epithelioid hemangioendothelioma (HEHE) is an uncommon vascular tumor of intermediate malignant potential. HEHE is a rare tumor and it is difficult to diagnose for surgeons, hepatologists, radiologists and pathologists. So, misdiagnosis with a delay of the treatment is not uncommon. We describe a case of a young woman with a diagnosis of HEHE made 6 years after the first evidence of liver mass with a very long term follow-up after surgical treatment. She had two diagnoses of Hepatocellurar carcinoma (HCC) and a diagnosis of Cholangiocarcinoma after three different fine needle biopsies. After clinical observation, a new laparoscopic core biopsy was performed. In a first time approach, considering clinical and radiological patterns, a diagnosis of Budd-Chiari Syndrome was finally made. For that the patient underwent an orthotopicliver transplantation (OLTx). The surgical sample histological analysis allowed a definitive diagnosis of HEHE. At last, at follow up 7 years after three OLTx the patient is still alive and in good health with no evidence of recurrence.
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation,"A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giuliani
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Department of Pathology, A. Cardarelli Hospital, Naples, Italy.
authors.forename: Giuseppina Marino
authors.initials: GM
authors.lastname: Marsilia
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation,"A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation,"A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Santaniello
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation,"A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sodano
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation, "A. Cardarelli" Hospital, Naples, Italy , Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
keywords: Hepatichemangioendothelioma; laparoscopic liver surgery; liver transplantation