Hepatic epithelioid hemangioendothelioma managed with minimally invasive surgery: A case report

Abstract

BACKGROUND

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare malignant vascular liver tumor diagnosed by histopathological evaluation. Standardized treatment is challenging because of its rarity; hepatectomy is preferred for solitary lesions and multiple transplantations. There is no consensus on the optimal treatment for HEHE; however, surgical excision is often considered effective. This report presents a case of initially suspected cholangiocarcinoma or renal cell carcinoma (RCC) metastasis, which was later confirmed as HEHE, with no recurrence during follow-up.

CASE SUMMARY

A 52-year-old man with a history of left nephrectomy for RCC presented with an incidentally detected liver mass and nonspecific abdominal discomfort. Imaging revealed a 3-cm centripetal enhancing lesion in the right hepatic dome with indeterminate malignant potential. The patient underwent a laparoscopic right anterior sectionectomy and remained recurrence-free without complications during the 3-year follow-up period.

CONCLUSION

Managing HEHE is challenging. Accurate diagnosis and surgical options, such as resection or transplantation, are essential with tailored multidisciplinary follow-up. The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).

Keywords: Antiangiogenic drug; Surgical treatment; Right anterior sectionectomy; Hepatic epithelioid hemangioendothelioma; Liver neoplasm; Case report

Core Tip: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor often misdiagnosed as other malignancies. This case highlights the role of surgical resection not only for definitive diagnosis but also for effective management of resectable HEHE, achieving long-term recurrence-free outcomes and ensuring safe follow-up.