Back to Search
Start Over
Hepatic epithelioid hemangioendothelioma metastasized to the peritoneum, omentum and mesentery: a case report.
- Source :
-
International journal of clinical and experimental pathology [Int J Clin Exp Pathol] 2015 May 01; Vol. 8 (5), pp. 5883-9. Date of Electronic Publication: 2015 May 01 (Print Publication: 2015). - Publication Year :
- 2015
-
Abstract
- Epithelioid hemangioendothelioma (EHAE) is a malignant vascular tumor derived from endothelial cell often misdiagnosed as Hepatic carcinoma on the basis of radiological features. Till now etiology of this rare curiosity is unknown but it is related with use of oral contraceptives pills (OCP), liver trauma, exposure to vinyl chloride and hepatitis. We herein report on a case which failed to be diagnosed by cytopathology, computed tomography (CT) and magnetic resonance imaging (MRI). Patient was a 46 yr old man presented with abdominal distension for a month. Initial liver function test (LFT) was increased whereas renal function test (RFT) and alpha-fetoprotein (AFP) were normal. His abdominal ultrasound revealed multiple hypoechoic nodules and multiple liver calcifications. Subsequently laparoscopic omental biopsy and Ultrasound guided liver biopsy was done showing the neoplastic cells scattered in fibrous stroma. The immunohistochemistry for endothelial tumor cells stained positive for Vimentin (+++), CD10 (+++), CD34 (++), CD31 (+), Factor VIII antigen (focal) (+) and low proliferative activity for ki-67. Our case is very interesting in which patient admitted with nonspecific symptoms of abdominal pain and diagnosed to be a Malignant Hepatic EHAE metastasized to the peritoneum, omentum and mesentery. The patient was on thalidomide 50 mg/day and increased to 100 mg/day. 5-Flurouracil (FU) intraperitoneal chemotherapy and other symptomatic and supportive treatment was given to the patient. Our case highlights on the importance of immunohistopathological diagnosis, compare the radiological findings of this disease and discuss the treatment strategy with review of available literature.
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols therapeutic use
Biomarkers, Tumor analysis
Biopsy
Diagnosis, Differential
Fluorouracil therapeutic use
Hemangioendothelioma, Epithelioid chemistry
Hemangioendothelioma, Epithelioid therapy
Humans
Immunohistochemistry
Liver Neoplasms chemistry
Liver Neoplasms therapy
Male
Mesentery chemistry
Middle Aged
Omentum chemistry
Peritoneal Neoplasms chemistry
Peritoneal Neoplasms therapy
Predictive Value of Tests
Thalidomide therapeutic use
Tomography, X-Ray Computed
Treatment Outcome
Hemangioendothelioma, Epithelioid secondary
Liver Neoplasms pathology
Mesentery pathology
Omentum pathology
Peritoneal Neoplasms secondary
Subjects
Details
- Language :
- English
- ISSN :
- 1936-2625
- Volume :
- 8
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of clinical and experimental pathology
- Publication Type :
- Academic Journal
- Accession number :
- 26191313