2017 Volume 31 Issue 4 Pages 470-476
Epithelioid hemangioendothelioma (EHE) arising from the chest wall is extremely rare. We report a case of rapidly growing EHE that originated from the chest wall. A 29-year-old woman with back pain that developed after delivery was admitted to our hospital for further examination of erosion of the right rib on a chest roentgenogram. Chest CT revealed a mass in the chest wall measuring 5 cm in diameter involving the right 7th rib and a nodule measuring 2 cm in diameter in the lower lobe of the left lung. It was difficult to definitively diagnose her by transbronchial lung biopsy of the left lung nodule. The patient underwent resection of the chest wall tumor with reconstruction of the chest wall and partial resection of the left lower lobe under thoracoscopic surgery. Because intraoperative findings demonstrated some subpleural nodules in the bilateral lungs, we also resected all nodules. The chest wall tumor and pulmonary nodules were diagnosed pathologically as EHE; therefore, we diagnosed the patient with EHE originating from the chest wall and bilateral lung metastases. Although radiotherapy and systemic chemotherapy were performed after the operation, she died 12 months after the operation due to the development of multiple metastases and malignant pericardial and pleural effusion.