Letters To The Editor
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2016; 22(41): 9247-9250
Published online Nov 7, 2016. doi: 10.3748/wjg.v22.i41.9247
Hepatic epithelioid hemangioendothelioma: Dilemma and challenges in the preoperative diagnosis
Hai-Jie Hu, Yan-Wen Jin, Qiu-Yang Jing, Anuj Shrestha, Nan-Sheng Cheng, Fu-Yu Li
Hai-Jie Hu, Yan-Wen Jin, Anuj Shrestha, Nan-Sheng Cheng, Fu-Yu Li, Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Qiu-Yang Jing, Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Anuj Shrestha, Department of General Surgery, Gandaki Medical College, Pokhara 33700, Nepal
Author contributions: Hu HJ and Jin YW contributed equally to this paper; Hu HJ and Jin YW contributed to data acquisition and drafted the manuscript; Jing QY contributed to data acquisition; Shrestha A and Cheng NS were involved in the revision of the manuscript; Li FY conceived and designed the study and revised the manuscript.
Supported by National Nature Science of China, No. 30801111; Science and Technology Support Project of Sichuan Province, No. 2014SZ0002-10.
Informed consent statement: The patient gave written informed consent prior to the study inclusion.
Conflict-of-interest statement: The authors declared that there is no conflict of interest related to this study.
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: Fu-Yu Li, MD, PhD, Department of Biliary Surgery, West China Hospital of Sichuan University, 37 Guoxue Xiang, Wuhou District, Chengdu 610041, Sichuan Province, China. lfy_74@hotmail.com
Telephone: + 86-28-85422465 Fax: +86-28-85422465
Received: June 3, 2016
Peer-review started: June 5, 2016
First decision: July 29, 2016
Revised: August 9, 2016
Accepted: August 23, 2016
Article in press: August 23, 2016
Published online: November 7, 2016
Abstract

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare category of vascular tumor with uncertain malignant potential. It commonly presents nonspecific and variable clinical manifestations, ranging from asymptomatic to hepatic failure. In addition, laboratory measurements and imaging features also lack specificity in the diagnosis of HEHE. The aim of the present study is to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging. In these patients, HEHE should at least be considered in the differential diagnosis.

Keywords: Hepatic epithelioid hemangioendothelioma, Vascular tumors, Diagnosis, Dilemma, Challenges

Core tip: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare category of vascular tumor with uncertain malignant potential. In the present study, by illustrating a case, we aimed to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging. In these patients, HEHE should at least be considered in the differential diagnosis.