Surgical management of an epithelioid hemangioendothelioma of the superior vena cava protruding into the right atrium

Epithelioid hemangioendothelioma of the right atrium invaded the superior vena cava: case report and review of literature

Epithelioid hemangioendothelioma (EHE) is a rare hemangioma that can occur anywhere in the body. It occurs most commonly in the liver and lungs, rarely from the heart, and the etiology or risk factors are unclear. So far, timely detection and radical resection is a more acceptable treatment. Reviewing the literature, few cases of cardiac EHE have been reported. We present a rare case of EHE of the right atrium invaded the superior vena cava.

Surgical treatment of asymptomatic epithelioid hemangioendothelioma originating from the superior vena cava: A case report

RATIONALE

Epithelioid hemangioendothelioma is a rare endothelial tumor with a low-grade malignancy. This tumor can be treated with complete resection.

PATIENT CONCERNS

A 20-year-old Korean man visited our hospital due to an abnormal finding on standing chest PA X-ray. He did not have any past medical history.

DIAGNOSIS

Chest computed tomography shows a well-defined, oval-shaped tumor invading the brachiocephalic vein and superior vena cava. A malignant tumor of vascular origin was diagnosed by a percutaneous needle biopsy.

INTERVENTIONS

We performed en-bloc resection including the great vessels for complete resection of the tumor. Histologic evaluation confirmed the lesion to be a hemangioendothelioma and the surgical margins were free from tumor invasion.

OUTCOMES

Fourteen days later, the patient was discharged without any complication. Thirty months after surgery, recurrences, or metastasis were not detected.

LESSONS

Epithelioid hemangioendothelioma is a rare malignant endothelial tumor in the central vein. Surgery is the treatment of choice and shows good results. We introduce and appropriate surgical method to ensure successful treatment for rare disease.

Haemangioendothelioma: a disease with surgical options from robotic surgery to open superior vena cava replacement

Epithelioid haemangioendothelioma is a malignant tumour of vascular origin that can occur in the mediastinum. Operative treatment techniques may vary depending on the localization. Our goal was to focus on different surgical techniques, ranging from simple stapling of the vascular structure to replacement of the superior vena cava.