Ischemic Stroke as the First Manifestation of Hepatic Epithelioid Hemangioendothelioma

Zis, Panagiotis; A, Assi; Kravaritis, Dimitrios; Sevastianos, V.

doi:10.1016/j.jstrokecerebrovasdis.2013.09.030

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…Some rare manifestations of the disease, such as an ischemic vascular event, have also been reported. 5 The HEE is negative for AFP, ACE, and CA 19-9, which agrees with the patient presented in our case. MRI in the T1W1 sequence shows hypointense lesions with low signal intensity in the center and intermediate to high in T2W2.…”

Section: Discussionsupporting

confidence: 92%

⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

et al. 2019

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Hemangioendothelioma epithelioid is a rare tumor that originates in soft tissues. Imaging evaluation with conventional modalities (tomography and magnetic resonance) is difficult. Novel radiotracers which capably evaluate angiogenesis may have a higher impact on the therapeutic decisions. A 45-year-old man underwent workup for thrombosis and was diagnosed with hemangioendothelioma epithelioid based on the results of liver pathology and immunohistochemistry. The decision of the multidisciplinary board was to begin with thalidomide. After 4 months, progression of disease was documented and right hepatectomy was performed. A 68 Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography scan showed residual lesions. After documented angiogenesis by 68 Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography, nintedanib was administrated. And 1 year later, progression of the disease was documented by positron emission tomography–computed tomography. Ipilimumab plus nivolumab was started and partial response and excellent clinical response were documented. Molecular imaging with 68 Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography is a good biomarker of the response of hemangioendothelioma epithelioid, and ipilimumab plus nivolumab therapy demonstrated a good response.

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Section: Discussionsupporting

confidence: 92%

⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

et al. 2019

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“…The extrahepatic sites included lungs (8.5%), regional lymph nodes (7.7%), peritoneum (6.1%), bone (4.9%), spleen (3.2%), and diaphragm (1.6%). Several rare first manifestation of this disease, such as an ischemic stroke, were also observed as reported by Zis et al 5 . In our case, HEHE occurred in liver and was widely metastasized to the peritoneum, lung, and bone.…”

Section: Discussionsupporting

confidence: 65%

Aggressive primary hepatic epithelioid hemangioendothelioma: a case report and literature review

Afrit

Nasri

Labidi

et al. 2017

Cancer Biology & Medicine

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A new case of epithelioid hemangioendothelioma is reported to have occurred to a 67-year-old patient who consulted for right-sided chest pain. The work-up showed multiple right pulmonary lesions associated with bilateral moderate pleural effusion and left-sided pleural thickening and three hypodense nodules in the right lobe of the liver, peritoneal thickening, ascites, and multiple vertebral lytic lesions. The diagnosis of an epithelioid hemangioendothelioma was concluded through a histological examination of a computed tomography scan guided biopsy of the liver. The patient received a primary mono-chemotherapy with Adriamycin (75 mg/m2 every three weeks) and intravenous bisphosphonates without response and general status impairment. The patient died after 16 months of follow-up.

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“…Furthermore, we searched in PubMed/MEDLINE using the MeSH term of “Trousseau's syndrome, cerebral infarction/ischemic stroke, and tumor/cancer/malignancy” for literature concerning about Trousseau's Syndrome presenting with cerebral infarction and summarized 19 cases including the three cases in our institution [ Table 1 ]. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ]…”

Section: Case Reportsmentioning

confidence: 99%

Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review

Chen

2018

Brain Circ

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Ischemic stroke as an initial presentation of malignancy is extremely rare and the underlying etiology is often ignored. The aim of this study is to outline the clues to occult malignancy in patients presenting with cerebral infarction initially. The clinical characteristics of total 19 patients with Trousseau's Syndrome presenting with cerebral infarction initially were analyzed. Among those patients, no conventional vascular risk factors were detected in 68% (13/19) of patients, and infarction occurring in multiple vascular distributions was found in 84% (16/19). Blood test showed thrombophilia in 79% (15/19) of patients with significantly elevated D-dimer, disseminated intravascular coagulopathy (DIC) in 59% (11/19), and elevated levels of tumor makers in 47% (9/19). The prognosis of the 19 patients was poor, with 68% (13/19) of patients undergoing a relapse of stroke in short interval, and 84% (16/19) being reportedly to die in 6 months. In patients, who developed unexplained recurrent brain infarction involving multiple arterial territory, with laboratory evidence suggesting hypercoagulability (higher level of D-dimer, or DIC), Trousseau's Syndrome should be considered, and investigation for an occult malignancy was required.

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Ischemic Stroke as the First Manifestation of Hepatic Epithelioid Hemangioendothelioma

Cited by 8 publications

References 15 publications

⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

Aggressive primary hepatic epithelioid hemangioendothelioma: a case report and literature review

Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review

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Ischemic Stroke as the First Manifestation of Hepatic Epithelioid Hemangioendothelioma

Cited by 8 publications

References 15 publications

68Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

68Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

Aggressive primary hepatic epithelioid hemangioendothelioma: a case report and literature review

Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review

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Product

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⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid

⁶⁸Ga-DOTA-E-[c(RGDfK)]2 positron emission tomography–computed tomography in the evaluation of hepatic hemangioendothelioma epithelioid