Hemangioendotelioma epitelióide de pleura Epithelioid hemangioendothelioma of the pleura

Relata-se o caso de um paciente exposto profissionalmente a asbesto por dez anos e portador de um tumor pleural muito raro, o hemangioendotelioma epitelióde. O paciente apresentava derrame pleural serohemorrágico, sem evidência de células neoplásicas e com predomínio de linfócitos. A biópsia pleural por agulha revelou processo inflamatório crônico inespecífico, com áreas de tecido mixóide. A videotoracoscopia mostrou nódulos difusos nas pleuras parietal e visceral. A biópsia revelou neoplasia mesenquimal e eram semelhantes às áreas focais observadas na primeira biópsia. O estudo imunohistoquímico demonstrou a presença dos marcadores vasculares CD31, CD34 e Fator VIII, caracterizando a origem vascular do tumor. O paciente foi tratado com cisplatina e ectoposide, tendo o óbito ocorrido três meses após o diagnóstico.<br>Epithelioid hemangioendothelioma (EHE), a very uncommon pleural tumor, was diagnosed in a 61-year-old man with work-related exposure to asbestos. Serohemorrhagic pleural effusion was diagnosed in the work-up of this patient, whose complaints were chest pain and weight loss. A lymphocytic predominance was present in the effusion, but no malignant cells were seen; pleural needle biopsy disclosed only a non-specific inflammatory process. Video thoracoscopy revealed nodules in parietal and visceral pleurae. A biopsy revealed a mesenchymal neoplasm; vascular markers CD 31, CD 34 and VIII factor were present; therefore, diagnosis of HE was accepted. The tumor was not responsive to cisplatin or etoposide and the patient died 3 months after the diagnosis