Activity of lenalidomide in metastatic hepatic epithelioid hemangioendothelioma (HEH): A case report

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e21527-e21527
Author(s):  
G. Schilling ◽  
G. Schuch ◽  
J. P. Panse ◽  
M. Sterneck ◽  
C. Bokemeyer
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Stable Disease ◽  
Locally Advanced ◽  
Angiogenesis Inhibitors ◽  
Epithelioid Hemangioendothelioma ◽  
Extrahepatic Manifestations ◽  
First Case ◽  
Daily Dose ◽  
Higher Doses

e21527 Background: HEH is a rare tumor of the liver with an unpredictable malignant potential. Surgical resection or liver transplantation is recommended in locally advanced disease and has been successfully performed in selected cases with extrahepatic manifestations. Systemic therapy, however, is not standardized. Small cohorts have been treated with interferon, chemotherapy and angiogenesis inhibitors such as thalidomide with various results. Case report: A 33-year old caucasian previously healthy male was admitted to hospital with newly diagnosed suspicious lesions in liver and spleen. Further analyses showed additional pulmonal nodules. Biopsy revealed a tumor with predominant epithelioid cells, positive for CD31 and CD34 and negative for CD117, HHV8, AFP and CEA, classified as a HEH. Disease progressed during first line treatment with adriamycin and ifosfamide (2 cycles given). Based on a case report with encouraging results with thalidomide we treated our patient with lenalidomide, which is known to have less side effects while being more effective in the myeloma setting. After 6 courses of lenalidomide 25mg daily (21/28), regression of the splenic lesions was detected. Retrospective analysis after 9 cycles demonstrated stable disease in comparison to the recent investigation, but an overall progression of 22% according to RECIST criteria in the liver was observed. Due to the excellent tolerance we increased the daily dose to 30 mg (21/28) and 6 months later a slight regression in the lung and overall stable disease in the liver was observed. The splenic lesion disappeared completely. The patient was listed for liver transplantation and after another 4 months on lenalidomide 30 mg, he was successfully transplanted recently. Because of the remaining extrahepatic lesions it is planned to continue lenalidomide therapy in combination with the immunosuppressant rapamycine. Conclusions: We report the first case of successful therapy with lenalidomide in HEH. Higher doses than 25mg seem to be more effective. We grateful thank Celgene for offering us lenalidomide for this off label use. No significant financial relationships to disclose.

scholarly journals Living-related liver transplant to treat epithelioid hemangioendothelioma – a case report

2005 ◽  
Vol 8 (4) ◽  
pp. 449-451
Author(s):  
Marcelo A. F. Ribeiro Jr ◽  
Christian Evangelista Garcia ◽  
Telma Eugênio dos Santos ◽  
Adavio de Oliveira e Silva ◽  
Regina Leitão ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Liver Transplant ◽  
Soft Tissues ◽  
Liver Tumors ◽  
Epithelioid Hemangioendothelioma ◽  
Low Grade ◽  
Living Related Liver Transplant ◽  
Transplantation Technique ◽  
Living Related

Introduction: Epithelioid hemangioendothelioma of liver is a rare, low-grade neoplasm of vascular origin that has an unpredictable malignant potential. It preferentially arises in soft tissues and bones, and seldom in the liver. Biologically, it trends to be multi-focal and often unresectable. Objective: The outcome of a patient submitted to a living-related liver transplant to treat epithelioid hemangioendothelioma of the liver. Case report: The reported case involves a 39-year old female patient with an immense epithelioid hemangioendothelioma of the liver, involving segments III, IV, V, VII, and VIIl. The prognostic to any kind of treatment was considered unfavorable, and the decision of submitting her to a liver transplant was made. It was suggested a living-related liver transplant. The donor was the patient’s 36-year old brother, who donated his right liver lobe (segments V, VI, VII, VIII). The recipient´s original liver was large, presenting very solid consistence and no node evidence. The transplant itself was performed using the conventional living-related liver transplantation technique. The recovery was good, and she was discharged from hospital on the 15th postoperative day using micophenolate mofetil, tacrolimus, and corticoid. Conclusion: Liver transplantation for epithelioid hemangioendothelioma of the liver can be performed with acceptable survival rate. The living related liver transplant opens a great perspective to that group of patients presenting liver tumors and who are unfeasible to wait for an organ on a waiting list.

scholarly journals First case report of spigelian hernia containing the appendix after liver transplantation: Another cause for chronic abdominal pain

2020 ◽  
Vol 72 ◽  
pp. 533-536
Author(s):  
Lucas Faraco Sobrado ◽  
Lucas Ernani ◽  
Daniel Reis Waisberg ◽  
Luiz Augusto Carneiro-D’Albuquerque ◽  
Wellington Andraus
Keyword(s):  
Liver Transplantation ◽  
Abdominal Pain ◽  
Case Report ◽  
Chronic Abdominal Pain ◽  
Spigelian Hernia ◽  
First Case

First Case Report of Locally Advanced Malignant Nodular Hidradenoma of the Scrotum

Onkologie ◽  
2010 ◽  
Vol 33 (12) ◽  
pp. 701-703 ◽  
Author(s):  
Binay K. Shah ◽  
Yusuf Qamruzzaman ◽  
Karina Serban ◽  
Ervin Hire ◽  
Shan-Ching Ying
Keyword(s):  
Case Report ◽  
Locally Advanced ◽  
First Case ◽  
Nodular Hidradenoma

Interesting antitumor activity of lenalidomide in a patient with hepatic epithelioid hemangioendothelioma (HEH).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e21511-e21511
Author(s):  
Maria Caterina Pallotti ◽  
Maria A. Pantaleo ◽  
Cristian Lolli ◽  
Margherita Nannini ◽  
Maristella Saponara ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Stable Disease ◽  
Case Reports ◽  
Angiogenesis Inhibitors ◽  
Abdominal Ultrasound ◽  
Epithelioid Hemangioendothelioma ◽  
Hepatic Lesion ◽  
Long Time ◽  
Hepatic Lesions ◽  
Colliquative Necrosis

e21511 Background: Epithelioid hemangioendothelioma (HEH) is a rare malignant vascular soft tissue tumor occurring mostly in the liver. The molecular background is still unkonwn and therefore the medical treatment has not been established. Some case reports treated with angiogenesis inhibitors are described. Lenalidomide has anti-proliferative and cytotoxic effects, immunomodulatory properties but also anti-angiogenic activity. In literature there are few case of patient with solid tumors treated with lenalidomide.We report a patient affected by HEH treated with lenalidomide for long time. Methods: In 2010, a 73 year old man arrived our attention with multiple hepatic lesions diagnosed with contrast computed tomography (CT), abdominal magnetic resonance (MR) imaging and contrast enhanced ultrasound (CEUS) of the liver. An ultrasound guided biopsy of an hepatic lesion was made and histopathology exam deposed for the diagnosis of HEH. We decided to treat the patient with lenalidomide 25 mg daily on 1- 21 every 28 days, because a liver transplantation was not inidcated for the age of the patient. The follow up of disease was made by abdominal ultrasound and MR every three/four months. Results: The patient was treated with lenalidomaide for thirty months totally. After six months the imaging showed a stable disease and after ten months MR also demonstrated an intralesional structure modification as colliquative necrosis. In February 2012, after 24 months of continuos therapy, we decide to stop the treatment for fatigue and for other comorbidity of the patient. After five months of suspension, the ultrasound showed a dimensional increase of a target hepatic lesion & so we restarted lenalidomide for other six months. MR imaging demonstrated a stable disease and abdominal ultrasound showed a decrease of the dimension of a target hepatic lesion. The patient is still under treatemnt with a control of disease. Conclusions: HEH is a rare tumors with probably an indolent natural history but this case report suggests an interesting activity of lenalidomide and antiangiogentic drugs in the treatment of this solid tumor. More patients treated with lenalidomide are encouraged and a small phase II study should be proposed.

scholarly journals Case Report: Response to Intra-arterial Cisplatin and Concurrent Radiotherapy Followed by Salvage Surgery in a Patient With Advanced Primary Sinonasal Low-Grade Non-intestinal Adenocarcinoma

2020 ◽  
Vol 7 ◽  
Author(s):  
Hirohiko Tachino ◽  
Hiromasa Takakura ◽  
Hideo Shojaku ◽  
Michiro Fujisaka ◽  
Katsuichi Akaogi ◽  
...  
Keyword(s):  
Case Report ◽  
Salvage Surgery ◽  
Histopathological Examination ◽  
Locally Advanced ◽  
Middle Turbinate ◽  
Lymphocytic Infiltration ◽  
Low Grade ◽  
Fractionated Radiotherapy ◽  
First Case ◽  
Positron Emission

Background: The clinical usefulness of concurrent chemoradiotherapy before surgery in the treatment of primary, locally advanced sinonasal low-grade, non-intestinal type adenocarcinoma (LG non-ITAC) is unclear.Methods: We present the first case report of the efficacy of super-selective intra-arterial cisplatin (CDDP) infusion concurrent with conventional fractionated radiotherapy (RT) for LG non-ITAC in a Japanese patient.Results: A white, rugged-marginal mass that was histopathologically diagnosed as LG non-ITAC occupied the right nasal cavity. Based on the imaging findings, including computed tomography, magnetic resonance imaging, and positron emission tomography, the tumor was diagnosed as T4aN0M0, stage IVa. After treatment, the nasal tumor disappeared leaving only a small bulge in the medial wall of the middle turbinate. The patient also underwent right transnasal ethmoidectomy performed as salvage surgery. A histopathological examination revealed that the lesion was replaced by granulation tissue with lymphocytic infiltration and hemosiderin-laden macrophages, and no viable tumor cells remained. In the seven years after treatment, the patient has not experienced any local recurrence or regional or distant metastasis.Conclusions: Super-selective intra-arterial CDDP infusion concurrent with conventional fractionated RT followed by salvage surgery might be useful for the management of sinonasal LG non-ITAC.

LIVING RELATED LIVER TRANSPLANTATION FOR EPITHELIOID HEMANGIOENDOTHELIOMA – A CASE REPORT

2004 ◽  
Vol 78 ◽  
pp. 722
Author(s):  
M A.F. Ribeiro ◽  
C E. Garcia ◽  
T E. dos Santos ◽  
J M. P. Manceiro ◽  
J L.M. Copstein ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Epithelioid Hemangioendothelioma ◽  
Living Related Liver Transplantation ◽  
Living Related

scholarly journals Donor acquired visceral leishmaniasis following liver transplantation

2021 ◽  
pp. flgastro-2020-101659
Author(s):  
Amritpal Dhaliwal ◽  
Abhishek Chauhan ◽  
Dinesh Aggarwal ◽  
Pretin Davda ◽  
Miruna David ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Visceral Leishmaniasis ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Donor ◽  
Solid Organ ◽  
The United Kingdom ◽  
First Case ◽  
Route Of Transmission

Patients who undergo solid organ transplantation are at risk of opportunistic infection associated with immunosuppression. We report a case of confirmed donor derived visceral leishmaniasis (VL), in a patient following liver transplantation causing fever and pancytopenia. The diagnosis was confirmed by bone marrow biopsy, with confirmed positive donor serology, with no other route of transmission. To our knowledge, this is the first case report in the United Kingdom and Europe, of confirmed organ donor transmission of VL. This case report highlights an important consideration of donor derived infections, in the context of solid organ transplantation.

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