Surgical strategies for hepatic epithelioid hemangioendothelioma: resection or transplantation?

Purpose: Hepatic Epithelioid Hemangioendothelioma (HEH) is a rare vascular tumour: its aetiology is unknown. A standardized treatment algorithm for HEH already does not exist, due to its infrequency and variable prognosis. Hepatic Resection (HR) could be performed in patients with unifocal lesions, while Liver Transplantation (LT) could be preferred in well-selected patients with multifocal lesions, obtaining optimal disease-free and overall-survivals. Methods: We report one HR and two LT for HEH performed at "Sapienza" University of Rome. Results: After HR the patient is alive and disease-free after 12 months; after LT tumoral recurrence was documented in 1 case, while in the other case the patient is alive and disease-free after 130 months. Conclusions: HR and LT represent an excellent therapy for this tumor. Recurrence is possible: adequate predictive parameters of biological aggressiveness are required.