Intraoperative Use of Indocyanine Green Fluorescence Imaging for Detecting Superficial Liver Hemangioendothelioma

Hepatic epithelioid hemangioendothelioma (HEH) is
a rare vascular tumor of endothelial origin with low or
intermediate grade malignancy. Lesions are frequently
subcapsular in up to 74.3% of the cases, according to
a recent study. It may be related to the use of oral
contraceptives, viral hepatitis, alcohol abuse, history of
ethylene exposure, and trauma. Indocyanine green fluorescence imaging technique is routinely used in our robotic liver procedures as it is an
incorporated technique in the robotic platforms. It is important
to ascertain negative surgical margins and identify
ischemic segment, sector, or hemiliver during anatomic
liver resections and in the detection of superficial liver
tumors as already pointed out by other authors, but we
strongly recommend its use during surgery for HEH.