Hemangioendotelioma epitelióide da pleura: sobrevida de 29 meses

Epithelioid haemangioendothelioma of the pleura: 29 months survival

 

Coordenadora: Lina Carvalho

Anabela Oliveira¹

Lina Carvalho²

 

Resumo

O hemangioendotelioma epitelióide da pleura é uma neoplasia rara, com crescimento rápido, de difícil diagnóstico imagiológico e histológico e raramente submetido a tratamento cirúrgico atempado e curativo devido à sobrevida muito curta que condiciona. Em 2005 estavam descritos 31 casos de tumores vasculares na pleura, sendo 11 hemagioendoteliomas epitelióides, aos quais se acrescenta o actual, de uma doente de 52 anos que sofreu um traumatismo toraco-abdominal. Revelou tempo de sobrevida longo (29 meses) após o diagnóstico histológico, ocorrido ocasionalmente por biópsias efectuadas em exame toraco-videoscópico para drenagem de hemotórax. Eram evidentes as lesões vasculares características na pleura direita, sem tradução imagiológica, e houve desenvolvimento de lesão nodular, documentado um mês antes do falecimento da doente.

Palavras-chave: Pleura, hemangioendotelioma epitelióide.

 

 

Abstract

Epithelioid haemangioendothelioma of the pleura is a rare neoplasia with a very poor prognosis due to aggressive involvement of the pleura and incomplete surgical treatment. Histological diagnosis and imagiology is also controversial, related to discrete development of the lesions that later reveal nodules. In 2005 there were 31 cases of vascular tumours described in the pleura. Eleven were epithelioid haemangioendotheliomas. This is another case, a 52 year old woman who suffered a traumatism and died 29 months after the histological diagnosis because CAT revealed discrete pleural involvement and a 2cm nodule was seen only one month before death.

Key-words: Pleura, epithelioid haemangioendothelioma.

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

Bibliografia

1. Travis W, Brambilla E, Muller-Hermelink H, Harris C. Tumours of the Lung, Pleura, Thymus and Heart Patthology & Genetics. WHO, IARCPress, Lyon 2004.        [ Links ]

2. Lauffer J, Zimmermann A, Krahenbuhl L, Triller J, Baer H. Epithelioid hemangioendothelioma of the liver: a rare hepatic tumor. Cancer 1996; 1(78):2318-2327.

3. Fagen K, Silverman ED, Cole RL. Detection of a pulmonary epithelioid hemangioendothelioma by FDG PET scan. Clin Nucl Med 2004; 29(11):758-759.

4. Endo T, Su CC, Numagami Y, Shirane R. Malignant intracranial epithelioid hemangioendothelioma presumably originating from the lung – case report. J Neuro-Oncology 2004; 67(3):337-343.

5. Crotty E, McAdams H, Erasmus J, Sporn T, Roggli V. Epithelioid hemangioendothelioma of the pleura – clinical and radiological features. AJR 2000; 175:1545-1549.

6. Massera F, Delfani R, Rocco G, Antonelli P, Donghi M, Robustellini M. Pulmonary epithelioid haemangioendothelioma mimicking bronchogenic carcinoma. J Cardiovasc Surg 2004; 45(4):397-398.

7. Jang K, Jin G, Lee Y, Lee H, kang M, Choi H, Chung M. Pulmonary epithelioid hemangioendothelioma – a tumor presented as a single cavitary mass. Journal of Korean Medical Science 2003; 18(4):599-603.

8. Diaz R, Segura A, Calderero V, Cervera I, Aparício J, Jorda M, Pellin L. Central nervous system metastases of a pulmonary epithelioid haemangioendothelioma. Eur Resp J 2004; 23(3):483-486.

9. Chartier A, Barbier C, Thumerelle C, Santos C, Desfachelles A, Devisme L, Deschildre A. Hypertrophic pulmonary osteo-arthropathy revealed by a pulmonary epithelioid hemangioendothelioma in a 15-year-old girl. Arch Ped 2003; 10(7):626-628.

10. Hristova E, Krishnamurthy S, Ro J, Ayala A. Pulmonary epithelioid hemangioendothelioma with prominent signet ring features mimicking metastatic adenocarcinoma. Annals Diag Pathol 2003; 7(3):160-164.

11. Joomaye Z, Lecam-savin C, Tabardel-Maurizot M, Dambrom P, Ramdani M, Gislon J, Duhamel O. Pulmonary epithelioid hemangioendothelioma – a tumor with an atypical course not to be unrecognized. Rev Med Int 2001; 22(9): 889-890.

12. Mhoyan A, Weidner N, Shabaik A. Epithelioid hemangioendothelioma of the lung diagnosed by transesophageal endoscopic ultrasound-guided fine needle aspiration – a case report. Acta Cytologica 2004; 48(4):555-559.

13. Cronin P, Arenberg D. Pulmonary epithelioid hemangioendothelioma – an unusual case and review of the literature. Chest 2004; 125(2):789-793.

14. Mukundan G, Urban B, Askin F, Fishman E. Pulmonary epithelioid hemangioendothelioma - atypical radiologic findings of a rare tumor with pathologic correlation. Journal Computer Assisted Tomography 2000; 24(5):719-720.

15. Zhang P, Livolsi V, Brooks J. Malignant epithelioid vascular tumors of the pleura – report of a series and literature review. Human Pathology 2000; 31(1):29-34.

16. Takahashi K, Nishimura M. A unique collision of a epithelioid hemangioendothelioma and bronchioloalveolar carcinoma in a 54-year-old Japanese woman. Jap J Thorac & Cardiovasc Surg 2003; 51(7):311-313.

17. Machida E, Honda T, Kurai M, Yamanda T, Haniuda M, Amano J. Pulmonary epithelioid hemangioendothelioma coexistent with pulmonary metastasis of thyroid cancer. Int Med 2001; 40(8):772-774.

18. Nind N, Attanoos R, Gibbs A. Unusual intraparenchymal growth patterns of malignant pleural mesothelioma. Histopathology 2003; 42(2):150-155.

19. Lin B, Colby T, Gowen A, Hammar S, Mertens R, Churg A, Battifora H. Malignant vascular tumors of the serous membranes mimicking mesothelioma – a report of 14 cases. Am J Surg Path 1996; 20(12):1431-1439.

20. Bevelaqua F, Valensi Q, Hulnick D. Epithelioid hemangioendothelioma – a rare tumour with variable prognosis as a pleural effusion. Chest 1993; 3:665-302.

21. Makhlouf H, Ishak K, Goodman Z. Epithelioid hemangioendothelioma of the liver – a clinicopathologica study of 137 cases. Cancer 1999; 85:562-582.

22. Paciocco G, Caterino U, D’Auria D. Epithelioid hemangioendothelioma of the luna – a high malignancy case. Monaldi Archives for Chest Disease 1999; 54(3):231-233.

23. Dechambre S, Coche E, Roisin P, Van Eeckhout P, D’Odemont J. Epithelioid hemangioendothelioma with solitary bone location associated to multiple lung and liver lesions – a case report. Acta Radiologica 1999; 40(2):217-219.

24. Kitaichi M, Nagai S, Nishimura K, Itoh H, Asamoto H, Izumi T, Dail D. Pulmonary epithelioid haemangioendothelioma in 21 patients, including three with partial spontaneous regression. Eur Resp J 1998; 12(1):89-96.

25. Pinet C, magnan A, Garbe L, Payan M, Vervloet D. Aggressive form of pleural epithelioid haemangioendothelioma – complete response after chemotherapy. Eur Respir J 1999; 14(1):237-238.

26. Lantuejoul S, Esvant H, Brambilla C, Brambilla E. Pulmonary epithelioid hemangioendothelioma (or IVBAT) – report of a case of exclusively myxoid form. Annales de Pathologie 1997; 17(2):120-122.

27. Corrin B, Dewar A, Simpson C. Epithelioid hemangioendothelioma of the lung. Ultrastructural Pathology 1996; 20(4):345-347.

 

 

¹ Assistente Eventual de Medicina Interna do Hospital Distrital de Aveiro

² Professora de Anatomia Patológica da Faculdade de Medicina de Coimbra

 

Recebido para publicação/received for publication: 06.03.31

Aceite para publicação/accepted for publication: 06.04.22