Case of high-risk epithelioid hemangioendothelioma of the neck

Head Neck. 2013 Oct;35(10):E317-20. doi: 10.1002/hed.23160. Epub 2012 Sep 28.

Abstract

Background: Epithelioid hemangioendotheliomas (EHEs) of the head and neck region are uncommon malignant neoplasms that exhibit various biologic behaviors characteristic of both low- and high-grade malignancy. A subgroup of EHEs identified as "high-risk" EHEs because of their size and mitotic activity is associated with an unfavorable clinical course and poor prognosis.

Materials and results: We describe the treatment of the first and, in terms of size, largest case of high-risk EHE arising from the neck. Despite wide excision, recurrence occurred 9 months after surgery, as had been expected. However, the tumor was found to express both vascular endothelial growth factor (VEGF) and VEGF receptor 2, indicating the potential of anti-VEGF therapy in the treatment of such cases.

Conclusion: The finding that a high-risk EHE arising from the head and neck region is characterized by expression of VEGF and its receptor provides further support for the development of targeted molecular therapies.

Keywords: angiosarcoma; epithelioid hemangioendothelioma; neck; vascular endothelial growth factor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Biopsy, Needle
  • Follow-Up Studies
  • Gene Expression Regulation, Neoplastic / drug effects
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery
  • Hemangioendothelioma, Epithelioid / diagnosis
  • Hemangioendothelioma, Epithelioid / surgery*
  • Humans
  • Immunohistochemistry
  • Male
  • Molecular Targeted Therapy / methods*
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Palliative Care / methods
  • Risk Assessment
  • Vascular Endothelial Growth Factor A / drug effects*
  • Vascular Endothelial Growth Factor A / genetics
  • Vascular Endothelial Growth Factor Receptor-2 / drug effects*
  • Vascular Endothelial Growth Factor Receptor-2 / genetics

Substances

  • Antineoplastic Agents
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factor Receptor-2