Q: My daughter is 19 years old. She is suffering from haemangioendothelioma. She has been operated thrice. Why does it happen again & again? Please advise.

A:Haemangioendothelioma belongs to a group of blood vessel neoplasms that arise from venous or capillary vessels. With respect to their histological appearance and their biological behaviour, these tumours are intermediate between benign and malignant tumours. About 10% of them may be associated with other developmental anomalies. They are of several types (kaposiform, epitheloid, retiform, infantile and spindle cell) and may occur in anywhere on the skin, lung, liver, breast, lymph nodes, intestines etc. as an enlarging mass. The treatment is by wide surgical excision, with more than half of all cases recurring at the operative site or several centimetres distant. Those tumours with significant cellular atypia and mitotic activity are associated with more aggressive clinical behaviour, but not all tumours, which metastasise, have these changes at initial biopsy. About 1/3rd of epitheloid haemangioendotheliomas spread to regional lymph nodes, lungs, liver or bones. The spindle cell haemangioendothelioma is rarely associated with metastasis but has a higher rate of local recurrence than does the epitheloid variant of this tumour.