Epithelioid hemangioendothelioma of the liver as a rare indication for liver transplantation

Table 1 Patient data before orthotopic liver transplantations

Patient	AST (U/L)	ALT (U/L)	Bilirubin (mg/dL)	Albumin (g/dL)	GGTP (U/L)	ALP (U/L)	Creatinine (mg/dL)	Urea (mg/dL)	Fibrinogen (mg/dL)	PLT (103/μL)	INR	CEA (ng/mL)	CA 19.9 (IU/mL)	AFP (ng/mL)
1	36	112	1.36	4.20	606	NA	0.88	48.0	NA	314	NA	NA	NA	NA
2	27	36	0.64	3.90	178	206	0.70	17.8	539	291	1.11	0.98	2.73	4.48
3	155	141	0.50	3.40	439	185	0.76	35.8	368	249	NA	1.49	2.00	2.01
4	19	20	0.76	4.70	35	81	0.63	19.0	236	150	0.96	0.8	7.70	1.6
5	13	24	0.71	4.60	28	74	0.99	47.0	250	203	1.01	1	0.70	1.3
6	96	121	1.33	4.40	13	47	0.75	20.0	412	207	1.10	1.2	22.90	1.5
7	56	86	0.67	3.29	297	331	0.69	24.0	332	199	1.01	0.8	18.80	1.9
8	24	28	0.69	4.03	19	79	0.73	25.0	468	42	1.02	1	4.50	1.1
9	26	30	0.85	4.14	78	87	0.89	25.0	356	100	1.10	5.9	12.30	3.1
10	33	32	0.61	3.50	321	329	0.98	37.4	593	290	0.93	0.71	25.80	2.2

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGTP: Gamma-glutamyl transpeptidase; ALP: Alkaline phosphatase; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; PLT: Platelets; INR: International normalized ratio; NA: Not avaible.

Table 2 Patient symptoms

Patient	Symptoms
1	NA
2	NA
3	NA
4	Abdominal pain or discomfort; fatigue
5	None
6	NA
7	Abdominal pain or discomfort
8	NA
9	Abdominal pain or discomfort; fatigue; weight loss; hepatomegaly; dyspnea
10	Abdominal pain or discomfort

NA: Not available.

Table 3 Histopathological and immunological characteristics of the tumors

Patient	Lymph node metastases	Lesions (n)max diameter	Carcinoma cells microembolisms	CD31	CD34	Factor VIII	CK7	MiB	PCNA	Hep	CK19
1	+	Multi focal 60 mm	+	+	+	+	-	-	+	-	NA
2	-	Multi focal 180 mm	NA	NA	+	+	-	NA	NA	-	NA
3	+	Multi focal 55 mm	+	NA	+	NA	-	NA	NA	-	-
4	NA	6 tumors 27 mm	NA	+	+	NA	NA	NA	NA	NA	NA
5	-	9 tumors 30 mm	NA	+	+	+/-	-	NA	NA	-	NA
6	NA	2 tumors 30 mm	NA	NA	+	+	NA	NA	NA	NA	NA
7	-	Multi focal 70 mm	NA	+	+	NA	NA	NA	NA	-	-
8	-	Multi focal 30 mm	NA	NA	+	NA	NA	NA	NA	NA	NA
9	NA	Multi focal 40 mm	NA	+	+	+	NA	NA	NA	-	-
10	-	Multi focal 20 mm	NA	+	+	+	NA	NA	NA	NA	-

NA: Not available.

Table 4 Hepatic epithelioid hemangioendothelioma treatment results summary

Ref.	Year (analyzed period)	Source	Patients		Survival percentage
					OLTx	Liver resection	Chemio radio therapy	TACE	No treatment	All
Recent report	2013 (1989-2013)	Single center	10	3-yr	87.5%	-	-	-	-	-
Rodrigue et al[25]	2008	UNOS	110	1-yr	80%	-	-	-	-	-
				3-yr	68%
				5-yr	64%
Lerut et al[24]	2007	ELTR	59	1-yr	93%	-	-	-	-	-
				5-yr	83%
				10-yr	72%
Mehrabi et al[22]	2006 (1984-2005)	Meta-analysis	286	1-yr	96%	100%	72%	-	40%	83.4%
				3-yr	80%	87%	49%		12%	55.8%
				5-yr	54.5%	75%	30%		4.5%	41.1%
Wang et al[26]	2012 (2004-2011)	Single center	33	3-yr	-	74.1%	-	81.6%	-	73.3%
Grotz et al[27]	2010 (1984-2007)	Single center	30	1-yr	91%	100%	57%	-	57%	-
				3-yr	73%	86%	43%		43%
				5-yr	73%	86%	29%		29%
				10-yr	42.2%	86%	-		-
Nudo et al[28]	2008 (1991-2005)	Multi center	11	5-yr	82%	-	-	-	-	-

OLTx: Orthotopic liver transplantations; TACE: Transarterial chemoembolization; UNOS: United Network for Organ Sharing; ELTR: European Liver Transplant Registry.