Natural History of Epithelioid Hemangioendothelioma of the Liver: CT Findings of 15 Cases

Abstract

Rationale and objectives: Little is known about the natural history of epithelioid hemangioendothelioma (EHE) of the liver. This study aimed to assess the natural history of hepatic EHE by evaluating CT findings of patients with pathologically proven hepatic EHE during follow-up without treatment.

Materials and methods: CT findings of 15 patients (seven men and eight women; median age, 56 years) with pathologically proven hepatic EHE were retrospectively evaluated. The median interval between the baseline and final CT was 36 months (range, 6-144 months). The maximal diameter of the largest hepatic lesion on the baseline CT and the diameter of the same lesion on the final CT were recorded. Change in size of the largest lesion between the two studies was classified as enlargement, no change, and reduction. When a patient with the largest lesion showing reduction developed a new hepatic lesion on the final CT, it was referred to as "unpredictable growth".

Results: CT revealed multiple hepatic lesions in all patients. Enlargement, no change, and reduction of the largest lesion were observed in four, five, and six patients, respectively. Unpredictable growth was observed in five patients.

Conclusion: During the follow-up of untreated patients with hepatic EHE, spontaneous regression and appearance of a new hepatic lesion were occasionally observed in the same patient.

Keywords: CT; Calcification; Epithelioid hemangioendothelioma; Liver; Natural history.