Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2017; 23(1): 185-190
Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.185
Spontaneous rupture of hepatic epithelioid hemangioendothelioma: A case report
Jun-Wu Yang, Yong Li, Kai Xie, Wei Dong, Xian-Tong Cao, Wei-Dong Xiao
Jun-Wu Yang, Yong Li, Wei Dong, Xian-Tong Cao, Wei-Dong Xiao, Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Kai Xie, Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Yang JW wrote the report; Li Y, Dong W, Cao XT and Xiao WD performed the surgery; Xie K helped to collect the relevant data.
Supported by The First Affiliated Hospital of Nanchang University, Jiangxi Province, China.
Institutional review board statement: The study was reviewed by the Institutional Review Board of the First Affiliated Hospital of Nanchang University, Nanchang, China.
Informed consent statement: The patient in this study provided informed written consent prior to the manuscript preparation.
Conflict-of-interest statement: The authors declared that there is no conflict of interest related to this report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yong Li, MD, Professor, Department of General Surgery, The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zhengjie, Nanchang 330006, Jiangxi Province, China. yfyly@163.com
Telephone: +86-791-88694131 Fax: +86-791-88694131
Received: July 21, 2016
Peer-review started: July 25, 2016
First decision: September 20, 2016
Revised: September 27, 2016
Accepted: October 27, 2016
Article in press: October 27, 2016
Published online: January 7, 2017
Processing time: 167 Days and 13.1 Hours
Abstract

Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor of vascular endothelial origin. Spontaneous rupture of HEH is a life-threatening complication and is extremely rare. HEH has variable malignant potential, and the clinical diagnosis remains challenging. Here we report a case of HEH with spontaneous rupture. A 44-year-old man presented with constant cutting pains over the right upper abdomen after eating. He had hemoptysis 11 d previously. Diagnostic abdominal puncture demonstrated active bleeding. Chest and abdominal computer tomography scan showed multiple ground-glass nodules over the lungs, multiple low-density intrahepatic nodules and massive hemorrhage. Transcatheter arterial embolization and exploratory laparotomy were performed and subsequent immunohistochemical examination confirmed a diagnosis of HEH.

Keywords: Hepatic epithelioid hemangioendothelioma; Spontaneous rupture

Core tip: Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor of vascular endothelial origin. Spontaneous rupture of HEH is a life-threatening complication and very few cases have been reported. We report a case of HEH with spontaneous rupture. Transcatheter arterial embolization and exploratory laparotomy were performed, and subsequent immunohistochemical examination confirmed a diagnosis of HEH. The patient died 6 mo after surgery. We also reviewed the literature and described the diagnosis and treatment of this disease.