PROGRESSION OF HEMANGIOENDOTHELIOMA

Unpredictability

Often, hemangioendotheliomas are made up of cells that are inactive and so the tumor grows very slowly. However, sometimes the tumors are made up of cells that are more active (atypical or malignant). These cells look different when examined under the microscope and may be more likely to spread to other sites of the body (metastasize). Therefore, the clinical course is unpredictable and different treatment modalities are offered depending on the patient’s condition.

The lack of predictability is especially true for EHE.

In cases of multifocal EHE (many of sites that are simultaneously affected) some of the lesions may disappear (at least by imaging) and reoccur later. Others may grow and later spontaneously regress. Importantly, some cases remain totally asymptomatic (no adverse symptoms), for more than 15 or 20 years – although routine monitoring should be performed as a precaution in case the indolent tumors become active.

After a surgical intervention

particularly when the tumor could not be fully resected, hemangioendotheliomas can recur at the original site, or in close proximity. However, whenever a total resection is possible, such as may be the case with EHE confined to a limb, or one part of the liver, then tumor recurrence is much less common. Almost a third of epithelioid hemangioendotheliomas have multiple affected sites in lymph nodes, lungs, liver or bones. Notably, some cases of EHE have been known to go into spontaneous remission.