Epithelioid hemangioendotheliomas of the lung and pleura: Report of three cases

Epithelioid hemangioendothelioma (EHE) is a rare malignant neoplasm of endothelial origin with an unpredictable clinical course and prognosis. Primary epithelioid hemangioendotheliomas of the lung and pleura, in particular, are extremely rare. The clinical and radiological manifestations mimic those of mesothelioma and metastatic adenocarcinoma, and an accurate pathological diagnosis is important for appropriate clinical management. Herein, we report one pulmonary and two pleural cases of epithelioid hemangioendothelioma. All three patients were symptomatic at presentation. The symptoms included cough, dyspnea, chest pain, and vocal palsy. Pleural effusion was noted in both pleural cases. Wedge resection was performed in the patient with multiple pulmonary nodules. The postoperative recovery was uneventful. The patient regained normal pulmonary function and was able to return to work after the operation. Both patients with pleural lesions underwent surgical excision of the tumors. Bony metastasis occurred in one of the patients and local recurrence developed in the other. In the previously reported cases and our experience, pleural EHE tends to have more aggressive behavior than tumors in other locations.