OVERVIEW
Hepatic epithelioid angioendothelioma is a rare hepatic vascular tumor with slow growth and variable prognosis, biologically a critical tumor, intermediate between benign and malignant hemangiomas.
Etiology
The etiology is unclear. Whether it is related to autoimmunity is not certain.
Symptoms
Patients have loss of appetite, anorexia, nausea, episodes of vomiting, epigastric pain, and weight loss. Physical signs may reveal hepatosplenomegaly, jaundice in a few patients, systemic failure in advanced patients, and occasional manifestations similar to Budd-chiari syndrome.
Examination
1. blood ALP, GGT can be increased, AFP, CEA is normal.
2. Abdominal plain film shows that the liver is covered with calcified areas, similar to liver metastasis of colon cancer.
3. Ultrasound shows multiple nodules with uneven echogenicity.
4. CT shows various manifestations, including multiple low-density areas with moderate enhancement of peripheral vascular shadows, multiple low-vessel points in the tumor, sometimes small bile ducts are dilated, some intrahepatic portal vein branches are not visible, and the contour of the liver remains unchanged.
5. Angiography shows multiple hypovascular masses in the liver.
Diagnosis
Currently, the only way to make a definitive diagnosis is to rely on liver pathology.
Treatment
Most of the disease is characterized by multiple intrahepatic foci with little chance of surgical resection; therefore, chemotherapy and radiotherapy are the mainstay of treatment. Liver transplantation has also been reported in this disease.
Prognosis
The prognosis of this disease is unpredictable, and it can survive for a long time without treatment after the onset of the disease, which is better than that of primary hepatocellular carcinoma.