Bismuth Benjamin, Castel Hélène, Boleslawski Emmanuel, Buob David, Lambert Marc, Declerck Nicole, Canva Valérie, Zafrani Eli-Serge, Mathurin Philippe, Pruvot François-René, Dharancy Sébastien
Service des Maladies de l'Appareil Digestif et de la Nutrition;
Rare Tumors. 2009 Dec 28;1(2):e31. doi: 10.4081/rt.2009.e31.
Primary sarcomas of the liver are rare tumors and their diagnosis is difficult to assess, particularly on percutaneous liver biopsy. Epithelioid hemangioendothelioma (EHE) is an infrequent indication for liver transplantation, and angiosarcoma (AS) is a widely recognized contraindication because of its poor prognosis. We report the case of a young woman who underwent liver transplantation (LT) for an infiltrative hepatic tumor with several features suggestive of EHE, although the analysis of the native liver revealed AS. Everolimus was used as the main immunosuppressive drug. More than two years after LT, her physical condition remained stable despite a local recurrence at 10 months. In this setting, the ranking of new immunosuppressive agents belonging to the family of the proliferation signal inhibitors will need to be precise, but their intrinsic properties suggest a potential use in treatments after LT for atypical malignancies.
肝脏原发性肉瘤是罕见肿瘤,其诊断难以评估,尤其是在经皮肝活检时。上皮样血管内皮瘤(EHE)是肝移植的罕见适应证,而血管肉瘤(AS)因其预后不良是广泛认可的肝移植禁忌证。我们报告一例年轻女性患者,她因具有一些提示EHE的特征的浸润性肝肿瘤接受了肝移植(LT),尽管对其原肝的分析显示为AS。依维莫司被用作主要免疫抑制药物。肝移植两年多后,尽管在10个月时出现局部复发,但她的身体状况仍保持稳定。在这种情况下,属于增殖信号抑制剂家族的新型免疫抑制剂的排序需要精确确定,但其内在特性表明它们在肝移植后治疗非典型恶性肿瘤方面具有潜在用途。