2021 Volume 61 Issue 1 Pages 45-49
Background. Pulmonary epithelioid hemangioendothelioma (PEH) is a malignant tumor that is derived from the vascular endothelium. It is difficult to determine an appropriate treatment for this tumor because most PEHs are slow-growing. We herein report the case of a rapidly progressive PEH. Case. The patient was a 31-year-old female patient who was found to have an abnormal shadow on a chest radiograph taken during a health examination. Whole-body computed tomography and positron emission tomography revealed a nodule of 2.6 cm diameter in the right lower lobe and multiple small nodules in both lungs. We performed partial resection of the right lower lobe and diagnosed PEH with pleural invasion. At 6 months after surgery, the patient developed buttock pain, and recurrence was detected in the left and right iliac bones and in the resection stump of the right lung. At 10 months, metastasis was detected in the vertebral bones and left femur. Her pain improved after palliative irradiation of bone metastasis. At 13 months, the patient's dyspnea associated with right malignant pleural effusion worsened. We performed pleurodesis but could not control the pleural effusion. She died at 16 months after surgery. Conclusion. Most PEHs are slow-growing malignant tumors; however, rapid progression may occur, as was observed in this case. Patients with PEH require close follow-up and should be treated symptomatically.