Everolimus for the treatment of epithelioid hemangioma: a case report

  • Mururul Aisyi Department of Pediatric Hematology Oncology, Indonesia National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-9754-5696
  • Ayu Hutami Syarif Department of Research and Development, Indonesia National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
  • Dewi Aisyah Mukarramah Department of Plastic Surgery, Indonesia National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
  • Rio Hermawan Department of Radiology, Indonesia National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-8030-4674
  • Dewi Iriani Department of Anatomic Pathology, Indonesia National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
Keywords: blood vessel tumor, everolimus, hemangioma
Abstract viewed: 1999 times
PDF downloaded: 999 times
HTML downloaded: 260 times
EPUB downloaded: 279 times

Abstract

Epithelioid hemangioma is a rare benign vascular tumor manifested as slow-growing subcutaneous or dermal nodules. A previously therapeutic strategy involved surgical excision and sclerotherapy. However, no standard treatment has been established. Here, we reported an atypical case of epithelioid hemangioma that had a locally aggressive behavior and was successfully treated with everolimus, a rapamycin analog used for cancer therapy. A 1-year-old boy presented with an ulcerated lump in the left palmar region. The imaging test results, confirmed through histopathologic examination, suggested a diagnosis of epithelioid hemangioma. Targeted therapy with everolimus was administered orally because of a minimal response to initial transarterial sclerotherapy. The patient achieved a satisfactory response with a significantly reduced lesion size and improved hand function after a 2-year follow-up. This finding showed that patients with locally aggressive forms of epithelioid hemangioma may significantly benefit from everolimus as a potential targeted therapy.

References

  1. Enjolras O, Mulliken JB, Kozakewich HP. Vascular tumors and tumor-like lesions. In: Mulliken JB, Burrows PE, Fishman SJ, editors. Vascular anomalies: Hemangiomas and malformations. 2nd ed. New York: Oxford University Press; 2013. p. 259-324. https://doi.org/10.1093/med/9780195145052.003.0008

  2. Guo R, Gavino AC. Angiolymphoid hyperplasia with eosinophilia. Arch Pathol Lab Med. 2015;139(5):683-6. https://doi.org/10.5858/arpa.2013-0334-RS

  3. Lagha IB, Souissi A. Angiolymphoid hyperplasia with eosinophilia. Treasure Island: StatPearls Publishing; 2020.

  4. Sánchez-Fructuoso AI. Everolimus: an update on the mechanism of action, pharmacokinetics and recent clinical trials. Expert Opin Drug Metab Toxicol. 2008;4(6):807-19. https://doi.org/10.1517/17425255.4.6.807

  5. Freixo C, Ferreira V, Martins J, Almeida R, Caldeira D, Rosa M, et al. Efficacy and safety of sirolimus in the treatment of vascular anomalies: a systematic review. J Vasc Surg. 2020;71(1):318-27. https://doi.org/10.1016/j.jvs.2019.06.217

  6. Thabusum DA, Rajesh N, Reddy RS, Ramesh T, Ravikanth M. Epithelioid haemangioma - a diagnostic dilemma. Br J Med Med Res. 2015;6(10):1032-9. https://doi.org/10.9734/BJMMR/2015/15144

  7. Zhang SL, Liang L, Ji Y, Wang ZM, Zhou YH. The benefit of everolimus in recurrent/epithelioid angiosarcoma patients: case reports and literature review. Oncotarget. 2017;8(55):95023-9. https://doi.org/10.18632/oncotarget.21832

  8. Zheng JW, Zhou Q, Yang XJ, Wang YA, Fan XD, Zhou GY, et al. Treatment guideline for hemangiomas and vascular malformations of the head and neck. Head Neck. 2010;32(8):1088-98. https://doi.org/10.1002/hed.21274

  9. Santini-Araujo E, Kalil RK, Bertoni F, Park YK, editors. Tumors and tumor-like lesions of bone for surgical pathologists, orthopedic surgeons and radiologists. London: Springer; 2015. p. 479-85. https://doi.org/10.1007/978-1-4471-6578-1

  10. Hassan Y, Osman AK, Altyeb A. Noninvasive management of hemangioma and vascular malformation using intralesional bleomycin injection. Ann Plast Surg. 2013;70(1):70-3. https://doi.org/10.1097/SAP.0b013e31824e298d

  11. Akdeniz N, Kösem M, Çalka O, Bilgili SG, Metin A, Gelincik I. Intralesional bleomycin for angiolymphoid hyperplasia. Arch Dermatol. 2007;143(7):841-4. https://doi.org/10.1001/archderm.143.7.841

  12. MacKeigan JP, Krueger DA. Differentiating the mTOR inhibitors everolimus and sirolimus in the treatment of tuberous sclerosis complex. Neuro Oncol. 2015;17(12):1550-9. https://doi.org/10.1093/neuonc/nov152

  13. Ozeki M, Nozawa A, Kanda K, Hori T, Nagano A, Shimada A, et al. Everolimus for treatment of pseudomyogenic hemangioendothelioma. J Pediatr Hematol Oncol. 2017;39(6):e328-31. https://doi.org/10.1097/MPH.0000000000000778

  14. Uno T, Ito S, Nakazawa A, Miyazaki O, Mori T, Terashima K. Successful treatment of kaposiform hemangioendothelioma with everolimus. Pediatr Blood Cancer. 2015;62(3):536-8. https://doi.org/10.1002/pbc.25241

  15. Franz DN, Belousova E, Sparagana S, Bebin EM, Frost M, Kuperman R, et al. Everolimus for subependymal giant cell astrocytoma in patients with tuberous sclerosis complex: 2-year open-label extension of the randomised EXIST-1 study. Lancet Oncol. 2014;15(13):1513-20. https://doi.org/10.1016/S1470-2045(14)70489-9

  16. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228-47. https://doi.org/10.1016/j.ejca.2008.10.026

  17. Bissler JJ, Franz DN, Frost MD, Belousova E, Bebin EM, Sparagana S, et al. The effect of everolimus on renal angiomyolipoma in pediatric patients with tuberous sclerosis being treated for subependymal giant cell astrocytoma. Pediatr Nephrol. 2018;33(1):101-9. https://doi.org/10.1007/s00467-017-3806-1

Published
2021-06-15
How to Cite
1.
Aisyi M, Syarif AH, Mukarramah DA, Hermawan R, Iriani D. Everolimus for the treatment of epithelioid hemangioma: a case report. Med J Indones [Internet]. 2021Jun.15 [cited 2024Apr.26];30(4):301-5. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/5036
Section
Case Report/Series