Diffuse Hepatic Epithelioid Hemangioendothelioma with Multiple Splenic Metastasis and Delayed Multifocal Bone Metastasis After Liver Transplantation on FDG PET/CT Images: A Case Report

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Jun 1

PMID 29851777

Citations 8

Authors

Yanlin Tan

Xiaohuang Yang

Chuning Dong

Zhe Xiao

Hongbo Zhang

Yunhua Wang

Affiliations

Soon will be listed here.

Abstract

Rationale: Malignant hepatic epithelioid hemangioendotheliom (HEH) is a rare vascular tumor of endothelial origin, with multiple metastases to the spleen. This report describes a diffuse HEH with splenic metastasis on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) images and delayed mutifocal bone metastasis after liver transplantation (LTx).

Patient Concerns: A 30-year-old male was admitted to our hospital with a complaint of abdominal distension, fatigue, and anorexia for 2 months.

Diagnoses: Mild to moderate FDG uptake in the whole liver, and multifocal FDG uptake in the spleen were observed on 18F-FDG PET/CT scan. Ultrasound guided liver biopsy was performed, and a diagnosis of HEH was confirmed.

Interventions: The patient underwent LTx and splenectomy.

Outcomes: The patient developed low back pain due to unknown etiology, 3 months after surgery. A follow-up 18F-FDG PET/CT scan demonstrated multifocal bone destruction. Unfortunately, the patient died 12 months after surgery.

Lessons: It is noteworthy that despite liver transplantation for the treatment of HEH, there may be a risk of recurrence. For these patients with extrahepatic lesions, adjuvant chemotherapy may be a useful alternative treatment method for the prevention of recurrence.

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