Chemotherapy for epithelioid hemangioendothelioma – pro

Hepatic epithelioid hemangioendothelioma is a rare, low-grade malignant vascular tumor that was first described as a distinct entity by Weiss and Enzinger in 1982. Since then less than 200 cases ahve been reported.Most of teh attemtps at cure invovle hepatic trasnplantation. There is no single effective treatment, though spontaneous regression and response to chemotherapy and interferon are reported. Complete response to six courses of carboplatin plus etoposide chemotherapy in a patient with pleural EHE is also described, with full remission at 18-month follow-up. There are several case reports of patients with EHE achieving partial or more complete remission after treatment with interferon There is certainly no credible prospective evidence  beyond case reports. I did nto find any reports of using Avastin. Under these circumstances, I cannot accept Avastin as a proven treatment.

Frank Earnest, IV, and C. Daniel Johnson
Case 96: Hepatic Epithelioid Hemangioendothelioma
Radiology 2006 240: 295-298.

Pinet, C, Magnau, A, Garbe, C, et al Aggressive form of pleural epithelioid haemangioendothelioma: complete response after chemotherapy. Eur Respir J 1999;14,237-238

Kayler, LK, Merion, RM, Arenas, JD, et al Epithelioid hemangioendothelioma of the liver disseminated to the peritoneum treated with liver transplantation and interferon -2B. Transplantation 2002;74,128-130

Rosenthal, DI, Treat, ME, Mankin, HJ, et al Treatment of epithelioid hemangioendothelioma of bone using a novel combined approach. Skeletal Radiol 2001;30,219-222

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