Galvão F H F, Bakonyi-Neto A, Machado M A C, Farias A Q, Mello E S, Diz M E, Machado M C C
Transplantation and Liver Surgery Unit, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo, Brazil.
Transplant Proc. 2005 Dec;37(10):4354-8. doi: 10.1016/j.transproceed.2005.11.022.
Hepatic epithelioid hemangioendothelioma is a rare malignant tumor of vascular origin with frequent multifocal appearance. Liver resection may cause tumor spread. Liver transplantation has been indicated for unresectable nodules. We hypothesized that adjuvant interferon treatment is effective to prevent metastasis after liver resection. We report a case of multifocal hepatic epithelioid hemangioendothelioma successfully treated with interferon pulse therapy and bilobar hepatic resection.
CT scan and magnetic resonance imaging diagnosed three nodules in the liver (segments IV, VI and VII). Histopathology and specific immunostaining of a percutaneous nodule biopsy confirmed the diagnosis of hepatic epithelioid hemangioendothelioma. The treatment protocol included daily interferon alpha 2b 9 weeks before and 1 week after resection of liver segments IV, VI and VII.
The postoperative outcome was complicated by a self-limited biliary fistula. The patient remains tumor free at 3 years after liver resection and currently enjoys excellent health.
Interferon pulse therapy and hepatic resection was a good option to treat multifocal bilobar hepatic epithelioid hemangioendothelioma; it may prevent metastasis dissemination.
肝上皮样血管内皮瘤是一种罕见的血管源性恶性肿瘤，常呈多灶性表现。肝切除可能导致肿瘤播散。肝移植适用于不可切除的结节。我们推测辅助性干扰素治疗对预防肝切除术后转移有效。我们报告一例多灶性肝上皮样血管内皮瘤患者，经干扰素脉冲治疗和双侧肝叶切除成功治愈。
CT扫描和磁共振成像诊断肝脏有三个结节（IV、VI和VII段）。经皮结节活检的组织病理学和特异性免疫染色确诊为肝上皮样血管内皮瘤。治疗方案包括在切除IV、VI和VII段肝叶前9周及切除后1周每日使用干扰素α-2b。
术后出现自限性胆瘘。患者肝切除术后3年无肿瘤复发，目前健康状况良好。
干扰素脉冲治疗和肝切除是治疗多灶性双侧肝上皮样血管内皮瘤的良好选择；它可能预防转移扩散。
