Liver Transplantation for Epithelioid Hemangioendothelioma With Diffuse Intraperitoneal Metastases: A Case Report

Aim. To evaluate results of liver transplantation and ex situ liver resection and autotransplantation in patients with unresectable parasitic and tumor liver lesions. Matherial and methods. A total of 22 orthotopic liver transplants and 4 ex situ liver resection and autotransplantations were performed. Liver transplants performed in 10 cases of unresectable hepatocellular carcinoma, 8 cases of alveolar echinococcosis, 4 cases of hepatic epithelioid haemangioendothelioma. Ex situ liver resection and autotransplantation were performed in 3 cases of alveolar echinococcosis and in 1 case of cholangiocarcinoma. Results. Postoperative complication developed in 38,4% patients. Mortality rate was 19.2%. Patients with alveolar echinococcosis were most complicated group with 36,3% early mortality rate. Mortality in hepatocellular carcinoma group was 10%. There were no early mortality in haemangioendothelioma and cholangiocarcinoma patients. Median overall survival for hepatocelluler carcinoma, alveolar echinococcosis and hepatic epithelioid haemangioendothelioma groups was 48, 36, 20 months respectively. Patient after ex situ liver resection for cholangiocarcinoma alive for 24 months and still disease free. Conclusion. Liver transplantation and ex situ liver resection and autotransplantation is the only opportunity for radical treatment for unresectable alveolar echinococcosis and some oncological diseases of the organ. Patients with unresectable alveolar echinococcosis is a high risk group of postoperative complications due to initial poor physical status, long-time disease, chronically infections and parasitic invasion.

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Transplantation and autotransplantation of the liver in radical treatment of unresectable liver tumors and parasitic diseases

Новрузбеков

Олисов

Гуляев

et al. 2020

Ann. hir. gepatol.

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Diagnosis of epithelioid hemangioendothelioma of the liver. Lecture and analysis of own cases

Розенгауз

Долбов

Караханова

2020

Medicinskaâ vizualizaciâ

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Epithelioid hemangioendothelioma of the liver (EHEL) is a rare (1 case per 1 000,000 people) primary malignant neoplasm from the group of mesenchymal tumors. EHEL is the most aggressive representative of the hemangioendothelioma range with metastatic response and relapse rate, and therein is close to angiosarcoma.The purpose of this publication is to summarize our own experience in comparison with published data and to describe a disease symptom that was not investigated before.Materials and methods. We studied five cases of epithelioid hemangioendothelioma of the liver, confirmed by histological examination. All patients underwent standard computer tomography with bolus contrast agent.Results. The analysis of the images revealed typical for this pathology symptoms such as local retraction of the liver contour, a specific contrast pattern – “the lollipop sign”. We have revealed a new symptom: “the beading sign”, which was detected in four of five cases. In three of five cases, this symptom allowed us to determine the nature of the disease before histological examination.Conclusion. EHEL is a difficult disease to diagnose due to its rare frequency and similarity to other focal liver lesions. In aspect of radiology, it is advisable to focus on specific symptoms of this pathology: retraction of the contour, “lollipop-sign” and “beading-sign”.

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Liver Transplantation for Epithelioid Hemangioendothelioma With Diffuse Intraperitoneal Metastases: A Case Report

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Transplantation and autotransplantation of the liver in radical treatment of unresectable liver tumors and parasitic diseases

Transplantation and autotransplantation of the liver in radical treatment of unresectable liver tumors and parasitic diseases

Diagnosis of epithelioid hemangioendothelioma of the liver. Lecture and analysis of own cases

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