Fourteen-Year Course of Multiple Recurrent and Distantly Metastatic Hepatic Epithelioid Hemangioendothelioma With Serial Ki-67 Evolution: A Case Report.
Zhe Tang, Fan Gao, Jie Lian et al.
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Case in brief
A 48-year-old woman with hepatic epithelioid hemangioendothelioma (HEHE) underwent right partial hepatectomy after a liver lesion was found incidentally. Histological analysis confirmed the diagnosis. After 7 years, she experienced recurrence requiring further surgery. Over 14 years, she had multiple recurrences and metastases, with Ki-67 levels rising from 5% to 40%, indicating increased tumor proliferation. The patient ultimately succumbed to the disease.
What made this case unusual
The case illustrates a prolonged 14-year course of HEHE with multiple recurrences and distant metastases, highlighting the dynamic nature of the disease and the significance of serial Ki-67 assessments.
Diagnostic / clinical pearl
Clinicians should consider the Ki-67 index as a valuable biomarker for monitoring the progression of hepatic epithelioid hemangioendothelioma and guiding treatment decisions.
Why it matters
This case underscores the need for regular long-term follow-up in patients with HEHE due to its unpredictable behavior and potential for late recurrence and metastasis.