Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.185
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
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.
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.