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Pulmonary epithelioid haemangioendothelioma and bevacizumab.
J Thorac Oncol. 2008 May;3(5):557-8
Authors: Belmont L, Zemoura L, Couderc LJ
PMID: 18449015 [PubMed - in process]
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Pulmonary epithelioid haemangioendothelioma and bevacizumab.
J Thorac Oncol. 2008 May;3(5):557-8
Authors: Belmont L, Zemoura L, Couderc LJ
PMID: 18449015 [PubMed - in process]
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[Infantile hepatic hemangioendothelioma. A multifocal, bilobular and asymptomatic case with spontaneous regression.]
An Pediatr (Barc). 2008 May;68(5):507-10
Authors: Araújo AR, Maciel I, Costa JC, Vieira A, Enes C, Santos Silva E
Infantile hepatic hemangioendothelioma is a severe disease with a high mortality rate. Nevertheless these vascular lesions may experience spontaneous regression within 12 to 18 months. The decision of trying a specific treatment and the choice among the several therapeutic options remains controversial, particularly in those asymptomatic cases of multifocal, bilobular involvement. We describe a case of multifocal, bilobular and asymptomatic infantile hepatic hemangioendothelioma, untreated, and with spontaneous regression before 2 years of age.
PMID: 18447999 [PubMed - in process]
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[Oropharyngeal kaposiform hemangioendothelioma.]
Acta Otorrinolaringol Esp. 2008 Apr;59(4):198-9
Authors: Maseda E, Blanco R, Ablanedo A, Iglesias E
The kaposiform hemangioendothelioma is a very infrequent tumor proceeding from the endothelial-derived spindle cells, more often found on the limbs, although peritoneal, retroperitoneal and sacrum locations are also prevailing. Head and neck are exceptional locations. The kaposiform hemangioendothelioma is almost exclusively found in children and early adolescents, and it is highly associated with the Kasabach-Merritt syndrome and lymphangiomatosis. The main treatment is the tumor surgical removal, including wide margins, plus supporting therapy when Kasabach-Merritt syndrome is linked. We report an isolated oropharyngeal kaposiform hemangioendothelioma 9-10-year old male case.
PMID: 18447980 [PubMed - in process]
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Vanishing liver tumours.
Clin Radiol. 2008 Mar;63(3):329-39
Authors: Peddu P, Huang D, Kane PA, Karani JB, Knisely AS
Spontaneous resolution of liver tumours is a rare, but recognized entity that has been reported to occur within the spectrum of benign and malignant liver tumours occurring in both adult and paediatric population. The aetiology of this unusual phenomenon is not clearly understood. In this article we present case examples of various benign and malignant liver tumours that have regressed spontaneously without treatment together with a review of the literature, and a summary of the current understanding of the pathogenesis of these tumours.
PMID: 18275874 [PubMed - indexed for MEDLINE]
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Intravascular epithelioid hemangioendothelioma of the inferior vena cava: case report of an unusual and unpredictable vascular tumor.
Cardiovasc Pathol. 2008 Apr 14;
Authors: Scordi-Bello IA, Snyder A, Schwartz M, Fallon JT
Vascular neoplasms are uncommon and pose a diagnostic and treatment challenge to the pathologist and surgeon, respectively. Epithelioid hemangioendothelioma is a rare neoplasm of vascular origin with an unknown etiology. Its biologic behavior lies somewhere between that of a benign hemangioma and that of a malignant angiosarcoma; however, it is unpredictable at best. Intravascular epithelioid hemangioendotheliomas have been described more often in veins than arteries, and there are only about 30 reports in the English literature. We report here the case of an epithelioid hemangioendothelioma of the inferior vena cava, which presented with abdominal pain, ascites and pedal edema.
PMID: 18417368 [PubMed - as supplied by publisher]
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Development of a Google-Based Search Engine for Data Mining Radiology Reports.
J Digit Imaging. 2008 Apr 5;
Authors: Erinjeri JP, Picus D, Prior FW, Rubin DA, Koppel P
The aim of this study is to develop a secure, Google-based data-mining tool for radiology reports using free and open source technologies and to explore its use within an academic radiology department. A Health Insurance Portability and Accountability Act (HIPAA)-compliant data repository, search engine and user interface were created to facilitate treatment, operations, and reviews preparatory to research. The Institutional Review Board waived review of the project, and informed consent was not required. Comprising 7.9 GB of disk space, 2.9 million text reports were downloaded from our radiology information system to a fileserver. Extensible markup language (XML) representations of the reports were indexed using Google Desktop Enterprise search engine software. A hypertext markup language (HTML) form allowed users to submit queries to Google Desktop, and Google's XML response was interpreted by a practical extraction and report language (PERL) script, presenting ranked results in a web browser window. The query, reason for search, results, and documents visited were logged to maintain HIPAA compliance. Indexing averaged approximately 25,000 reports per hour. Keyword search of a common term like "pneumothorax" yielded the first ten most relevant results of 705,550 total results in 1.36 s. Keyword search of a rare term like "hemangioendothelioma" yielded the first ten most relevant results of 167 total results in 0.23 s; retrieval of all 167 results took 0.26 s. Data mining tools for radiology reports will improve the productivity of academic radiologists in clinical, educational, research, and administrative tasks. By leveraging existing knowledge of Google's interface, radiologists can quickly perform useful searches.
PMID: 18392657 [PubMed - as supplied by publisher]
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Hemangioendothelioma.
J La State Med Soc. 2007 Nov-Dec;159(6):307-8
Authors: Ibrahim H, Hussein S, Bagga B, Sangster G, Kayass AA
PMID: 18390267 [PubMed - in process]
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Coexistence of two rare sarcomas: primary leiomyosarcoma of bone and epithelioid hemangioendothelioma of the liver.
Sarcoma. 2008;2008:416085
Authors: Gonzalez-Billalabeitia E, Quintela-Fandino M, Alemany I, López-Alonso G, Ruiz-Ollero A, Martinez-Tello F, Hitt R
A 33-year-old woman sought medical attention for a painful swelling of the left ankle. Plain radiographs revealed an osteolytic lesion involving the left distal tibia. An excisional biopsy provided the diagnosis of leiomyosarcoma in the tibia. A staging work-up was performed and an abdominal CT showed 4 liver hypodense lesions in both lobes with peripheral contrast enhancement. A liver biopsy confirmed the diagnosis of epithelioid hemangioendothelioma of the liver. No association between these two entities has been described before. This case introduces the importance of the pathological confirmation of apparent metastatic lesions in low grade sarcomas and provides a review of the literature of both tumours.
PMID: 18382610 [PubMed - in process]
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Composite cutaneous haemangioendothelioma treated with interferon.
J Eur Acad Dermatol Venereol. 2008 Apr;22(4):503-5
Authors: Utaş S, Canöz O, Ferahbaş A, Ozcan N
PMID: 18363918 [PubMed - indexed for MEDLINE]
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Cutaneous epithelioid angiomatous nodule: a case series and proposed classification.
Am J Dermatopathol. 2008 Feb;30(1):16-20
Authors: Sangüeza OP, Walsh SN, Sheehan DJ, Orland AF, Llombart B, Requena L
Cutaneous epithelioid angiomatous nodule is a peculiar and recently recognized vascular proliferation. Clinically, these lesions affect different areas of the body and histologically are characterized by a well-circumscribed, mainly unilobular, solid proliferation of endothelial cells with prominent epithelioid features. The cytoplasm is abundant and eosinophilic, and many of the neoplastic cells contain prominent vacuoles. Inflammatory infiltrates are variable. All the cases reported thus far have followed a benign course. We report 10 additional cases of this curious entity, including 2 which presented in an eruptive fashion and 5 that were located on the head and neck. We also discuss the histological differential diagnoses with other epithelioid proliferations and propose categorization within the spectrum of epithelioid hemangioma.
PMID: 18212538 [PubMed - indexed for MEDLINE]
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Vascular changes in merkel cell carcinoma based on a histopathological study of 92 cases.
Am J Dermatopathol. 2008 Apr;30(2):106-11
Authors: Vazmitel M, Michal M, Shelekhova KV, Sima R, Mukensnabl P, Kazakov DV
Although prominent vascular proliferation is a known feature of various neuroendocrine tumors, it has not been systematically studied in Merkel cell carcinoma (MCC) of the skin. The purpose of this study was to fully characterize the light microscopic, immunohistochemical, and ultrastructural features of vascular changes associated with MCC and to determine their frequency and differential diagnostic implications. Additionally, the presence of human herpesvirus 8 DNA in the lesional tissue was investigated. Of 92 studied cases of MCC, 18 cases (20%) were found to exhibit foci of prominent vascular changes which were classified into the following 6 patterns: pericyte hyperplasia, pyogenic granuloma-like, hemangioendothelioma-like, epithelioid hemangioma-like, peliosis-like, and follicular dendritic cell tumor-like pattern. In addition, Azzopardi phenomenon was observed. These changes occurred singly or in combination. Human herpesvirus 8 DNA was identified by polymerase chain reaction in none of the 18 cases. It is concluded that prominent vascular proliferations may be seen in 20% of MCC, and thereby, MCC resembles neuroendocrine tumors in other organs. When unduly prominent and encountered in a limited biopsy specimen, vascular alterations may represent a potential diagnostic pitfall, but, on the other hand, they themselves may serve as a clue to the correct diagnosis. Human herpesvirus 8 does not play a role in angiogenesis in MCC.
PMID: 18360111 [PubMed - in process]
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Duodenal epithelioid angiosarcoma: immunohistochemical and clinical findings. A case report.
Tumori. 2007 Nov-Dec;93(6):619-21
Authors: Mignogna C, Simonetti S, Galloro G, Magno L, De Cecio R, Insabato L
Angiosarcomas are uncommon malignant tumors of vascular endothelium that represent less than 1% of all sarcomas. The epithelioid variant of angiosarcomas is exceptionally rare, and the gastrointestinal tract is rarely involved. Angiosarcomas mainly involve skin and soft tissue and rarely occur in breast, liver, bone, and spleen. We present the case of a 30-year-old man who underwent an upper gastrointestinal endoscopy for melena. A duodenal reddish polypoid lesion was found, which on microscopic examination turned out to be an epithelioid angiosarcoma. The immunohistochemical features of the lesion supported this diagnosis. The patient died eight months after the diagnosis. Epithelioid angiosarcoma is an aggressive variant of angiosarcoma and must be considered in the differential diagnosis of gastrointestinal tumors.
PMID: 18338501 [PubMed - indexed for MEDLINE]
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Tufted angioma-associated Kasabach-Merritt syndrome treated with embolization and vincristine.
Plast Reconstr Surg. 2008 Feb;121(2):692-3
Authors: Yesudian PD, Parslew R, Klafowski J, Gould D, Pizer B
PMID: 18301012 [PubMed - indexed for MEDLINE]
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Fine needle aspiration cytology of epithelioid angiosarcoma: a case report.
Acta Cytol. 2008 Jan-Feb;52(1):109-13
Authors: Siddaraju N, Soundararaghavan J, Bundele MM, Roy SK
BACKGROUND: Malignant vascular tumors are rare. Few studies have described cytomorphologic features of hemangioendothelioma and angiosarcoma on fine needle aspiration cytology (FNAC). Malignant vascular tumor with epithelioid morphology can create diagnostic difficulty, as the cytology may simulate that in other nonvascular malignant tumors. We describe epithelioid angiosarcoma, diagnosed on FNAC, in which a differential diagnosis of histiocytosis and inflammatory granulation tissue was considered. CASE: A 20-year-old man presented with forehead and scalp swellings. The forehead lesion was radiologiocally associated with a lytic lesion in the bone. FNA resulted in high cellular yield, and smears revealed prominent vascular pattern with endothelial cell atypia and histiocytoid/epithelioid neoplastic cells, occasional mitotic figures and a few cells displaying nuclear grooving. Smear background showed a significant number of neutrophils. Epithelioid hemangioendothelioma/angiosarcoma, histiocytosis and inflammatory granulation tissue were considered. A cytologic diagnosis of epithelioid angiosarcoma/epithelioid hemangioendothelioma was suggested and confirmed on histopathologic and immunohistochemical examination. CONCLUSION: Cellular aspirates from malignant epithelioid endothelial tumors involving bone may be cytologically mistaken for histiocytosis and, rarely, inflammatory granulation tissue. However, prominent vascular pattern with striking endothelial cell atypia, presence of mitotic figures and careful search for presence of endothelial differentiation are helpful in accurate cytologic diagnosis.
PMID: 18323286 [PubMed - in process]
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CD99 - much ado about nothing?
J Cutan Pathol. 2008 Jan;35(1):86-7
Authors: Pozdnyakova O, Mahalingam M
PMID: 18096002 [PubMed - indexed for MEDLINE]
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[Prosthetic supply of tissue defects in head and neck surgery]
Laryngorhinootologie. 2007 Dec;86(12):854-60
Authors: Volkenstein S, Dazert S, Jahnke K, Schneider M, Neumann A
BACKGROUND: Cancer surgery, malformation or trauma may cause broad facial defects that cannot be covered by patients because of their exposed site. Such defects lead to functional deficits and enormous psychological strain and require rehabilitation at all ages. Prosthetic supply has been developed into a functional and aesthetic alternative to plastic and reconstructive surgery. METHODS AND PATIENTS: The condensed experience with prosthetic supply after persistent surgical defects of more than twenty patients during the recent years is described. RESULTS: Efficient prosthetic supply in the exposed facial area requires a well scheduled and close cooperation between the surgeon and anaplastologist. Preoperative diagnostic evaluation and operative filling of the magnetic fixation in cooperation with the anaplastologist provide a satisfying functional and cosmetic prosthetic outcome for the patient. Advantages of this procedure combine early cosmetic rehabilitation with the option to directly investigate the tumor site after resection. Novel magnet systems provide a high degree of flexibility combined with confident fixation. CONCLUSIONS: Prosthetic rehabilitation should be offered and discussed with patients ahead of cancer surgery in the head and neck area. This procedure should be considered in particular in patients that reject or are not feasible for multi-step reconstructive surgery.
PMID: 18183648 [PubMed - indexed for MEDLINE]
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Multifocal recurring epithelioid hemangioendothelioma of the penis.
Urology. 2008 Feb;71(2):351.e9-351.e10
Authors: Zastrow S, Baretton GB, Wirth MP
We present a case of epithelioid hemangioendothelioma of the penis in a 57-year-old man, and its treatment. Differential diagnoses and treatment of this rare disease are discussed.
PMID: 18308123 [PubMed - in process]
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Bright-dark ring sign in MR imaging of hepatic epithelioid hemangioendothelioma.
J Magn Reson Imaging. 2008 Feb 26;
Authors: Economopoulos N, Kelekis NL, Argentos S, Tsompanlioti C, Patapis P, Nikolaou I, Gouliamos A
We describe the imaging findings in a rare case of multifocal nodular form of hepatic epithelioid hemangioendothelioma on ultrasound (US) and dynamic contrast-enhanced spiral computed tomography (CT) and MRI. The nodules showed multilayered target appearance on MR images with prominent peripheral rim with high signal intensity (SI) on T1-weighted and very low SI on T2-weighted images, corresponding to thrombosed vascular channels. The above combination of imaging findings is to our knowledge distinct and should suggest the diagnosis of hepatic epithelioid hemangioendothelioma. J. Magn. Reson. Imaging 2008. (c) 2008 Wiley-Liss, Inc.
PMID: 18302206 [PubMed - as supplied by publisher]
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Primary epithelioid hemangioendothelioma of the lumbar spine.
Spine J. 2008 Mar-Apr;8(2):385-90
Authors: Christodoulou A, Symeonidis PD, Kapoutsis D, Iordanidis F
BACKGROUND CONTEXT: Primary epitheliod hemangioendotheliomas of the lumbar spine are extremely rare tumors with an unpredictable clinical course. PURPOSE: To present a case of primary lumbar epithelioid hemangioendothelioma and its treatment protocol. STUDY DESIGN/SETTING: A tertiary Spinal Unit. PATIENT SAMPLE: A previously healthy adult with persisting low back pain and neurologic deficit. METHODS: The diagnosis was confirmed by core needle biopsy. The patient was treated with preoperative embolization followed by staged surgery which included wide tumor resection and spinal fixation, using a cage system and a titanium plate anteriorly and a transpedicular fixation system posteriorly. RESULTS: Three years postoperatively the patient remains free of symptoms with no evidence of recurrence. CONCLUSIONS: The treatment of these unpredictable tumors should be dictated by adherence to general oncologic principles.
PMID: 18299105 [PubMed - in process]
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Vaginal haemangioendothelioma: an unusual tumour.
Ir J Med Sci. 2008 Feb 21;
Authors: Mohan H, Shireen R, Hayes B, Canney A, Mooney EE, Murphy J
Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.
PMID: 18288571 [PubMed - as supplied by publisher]
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Vascular proliferations of the breast.
Histopathology. 2008 Jan;52(1):30-44
Authors: Brodie C, Provenzano E
Vascular proliferations of the breast are uncommon but potentially diagnostically challenging lesions. Clinically apparent processes are more likely to be malignant; however, a range of benign entities which must be differentiated from angiosarcoma also exists. This review discusses first, breast lesions of apparent vascular origin, then benign and histologically bland perilobular, cavernous and capillary haemangiomas. Subsequently, more diagnostically challenging, atypical haemangiomas, papillary endothelial hyperplasia, angiomatosis and angiolymphoid hyperplasia with eosinophilia (epithelioid haemangioma) are considered. In addition, lesions with low-grade malignant potential such as haemangiopericytomas and epithelioid haemangioendotheliomas may rarely present in the breast. However, primary angiosarcomas and radiation-associated vascular lesions are reviewed in depth, as these entities are of greatest clinical and pathological significance.
PMID: 18171415 [PubMed - indexed for MEDLINE]
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Composite hemangioendothelioma of the oral cavity: Case report and review of the literature.
Head Neck. 2008 Feb 19;
Authors: Fasolis M, Iaquinta C, Montesco MC, Garzino-Demo P, Tosco P, Tanteri G, Bonandini E, Ninfo V, Berrone S
BACKGROUND: Composite hemangioendothelioma is a rare histopathologic feature, which is part of the hemangioendothelioma family. This is a heterogeneous group of vascular neoplasiae with a high tendency to local relapse but a rare predisposition to metastatic spread. Composite hemangioendothelioma mainly affects adults and is usually localized in the distal extremity of the limbs. To date, only 1 case has been detected in the oral cavity. METHODS: A case of composite hemangioendothelioma in a 38-year-old man is reported. The lesion was localized in the left cheek vestibular mucosa. It was surgically excised with a 1-cm safety margin. Reconstruction was performed with a platysma myocutaneous flap. RESULTS: At present, the patient is free from recurrence. The aesthetic and functional outcomes are satisfactory. CONCLUSION: This case demonstrates how a composite hemangioendothelioma histological diagnosis can be difficult to achieve. Furthermore, therapy must be surgical and excision should be wide. (c) 2008 Wiley Periodicals, Inc. Head Neck, 2008.
PMID: 18286494 [PubMed - as supplied by publisher]
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Microsatellite stable genome in an epithelioid hemangioendothelioma: An example of a microsatellite stable tumor.
J Am Acad Dermatol. 2008 Mar;58(3):519-21
Authors: Boyd AS, Vnencak-Jones CL, Pennington B
PMID: 18280360 [PubMed - in process]
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Meningel intracranial epithelioid hemangioendothelioma: case report and literature review.
J Neurooncol. 2008 Feb 16;
Authors: Parajón A, Vaquero J
Intracranial epithelioid hemangioendothelioma (EH) is a very rare vascular neoplasm. We describe a case of meningeal intracranial tumor in a 58 year old man, located in the greater wing of the sphenoid bone. The tumor was completely excised via pterional approach and the pahological analysis showed a hemorrhagic lesion with capillary-sized vessels lined by atypical-appearing endothelial cells that expressed CD31, CD34 and Factor VIII antigens. A diagnosis of EH was established, and one year after surgery the patient is symptom-free, without tumor recurrence or residual tumor. A review of the literature disclosed other 34 cases of intracranial EH. In these tumors, total resection is mandatory if possible, otherwise radiotherapy is recommended. Outcome is favorable in the majority of cases.
PMID: 18278439 [PubMed - as supplied by publisher]
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Omental lipoblastoma.
Pathol Res Pract. 2008 Feb 12;
Authors: Koplin SA, Twohig MH, Lund DP, Hafez GR
A large intra-abdominal mass was discovered in a 6-month-old boy during a routine well-child examination. Imaging studies revealed a solid mass which appeared to arise from the left lobe of the liver, extending caudally and filling the entire pelvis. At the time of surgical excision, the mass was found to be unassociated with the liver, but was instead localized to the omentum. Histologic examination revealed adipocytes of varying stages of maturation arranged in a lobular architecture, consistent with a lipoblastoma. This unusual tumor is only the eighth reported omental lipoblastoma [J. Hicks, A. Dilley, D. Patel, J. Barrish, S. Zhu, M. Brandt, Lipoblastoma and lipoblastomatosis in infancy and childhood: histologic, ultrastructural, and cytogenetic features. Ultrastruct. Pathol. 25 (2001) 321-333; J. Harrer, G. Hammon, T. Wagner, M. Bolkenius, Lipoblastoma and lipoblastomatosis: a report of two cases and review of the literature. Eur. J. Pediatr. Surg. 11 (2001) 342-349; S. Weiss and J. Goldblum, Enzinger and Weiss's Soft Tissue Tumors, fourth ed., Mosby, St. Louis, MO, 2001, pp. 601-605, 670-686; S. Soin, S. Andronikou, R. Lisle, K. Platt, K. Lakhoo, Omental lipoblastoma in a child; diagnosis based in CT density measurements. J. Pediatr. Hematol. Oncol. 28(1) (2006) 57-58; A. Prando, S. Wallace, J.L. Marins, R.M. Pereira, E.R. de Oliveira, M. Alvarenga, Sonographic features of benign intraperitoneal lipomatous tumors in children-report of 4 cases. Pediatr. Radiol. 20(8) (1990) 571-574; C. Blank, E. Schoenmakers, P. Rogalla, E. Huys, A. Van Rijk, N. Drieschner, J. Bullerdiek, Intragenic breakpoint within RAD51L1 in a t(6;14)(p21.3;q24) of a pulmonary chondroid hamartoma. Cytogenet. Cell Genet. 95 (2001) 17-19; S. Ingraham, R. Lynch, S. Kathiresan, A. Buckler, A. Menon, hREC2, a RAD51-like gene, is disrupted by t(12;14)(q15;q24.1) in a uterine leiomyoma. Cancer Genet. Cytogenet. 115 (1999) 56-61]. Cytogenetics revealed a karyotype of 46,XY,t(8;14)(q13;q24). While lipoblastomas characteristically involve 8q, only one prior case has been reported with 14q24 as its fusion partner [M. He, K. Das, M. Blacksin, J. Benevenia, M. Hameed, A translocation involving the placental growth factor gene is identified in an epithelioid hemangioendothelioma. Cancer Genet. Cytogenet. 168 (2006) 150-154]. We report this unique case of an omental lipoblastoma with a focus on its unusual karyotype, as well as its differentiation from myxoid liposarcoma.
PMID: 18276084 [PubMed - as supplied by publisher]
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Hepatic malignant epithelioid hemangioendothelioma: a case report and review of the literature.
Am Surg. 2008 Jan;74(1):64-8
Authors: Woodall CE, Scoggins CR, Lewis AM, McMasters KM, Martin RC
Malignant epithelioid hemangioendothelioma is a rare hepatic tumor of vascular origin. It is most commonly found in young to middle aged women, and the tumors vary in reported malignant potential. Compounds such as oral contraceptive pills, poly vinyl chloride, and Thorotrast have been identified as risk factors for subsequent disease development. Radiologic ("lollipop" sign, capsular flattening) and pathologic (Factor-VIII antigen staining positive) evaluation aids in the diagnosis. As with most mesenchymal tumors, surgical resection is the most effective means of controlling local disease and preventing distant metastasis, though adjuvant therapies have been offered for those that are unresectable or not transplant candidates. We present our case of a hepatic malignant epithelioid hemangioendothelioma and a review of the English-language literature.
PMID: 18274433 [PubMed - in process]
DetNews.com, MI - May 6, 2008 ... war for the past six years with one of the world's rarest forms of liver cancer -- epithelioid hemangioendothelioma -- needs strength to keep fighting. ... |