Often, hemangioendotheliomas are made up of cells that are inactive and so the tumour grows very slowly.

However, sometimes the tumours are made up of cells that are more active (atypical or malignant). These cells look different when examined under the microscope and may be more likely to spread to other sites of the body (metastasize).

Therefore, the clinical course is unpredictable and different treatment modalities are offered depending on the patients condition.

Some cases are totally asymptomatic (no adverse symptoms), for more that 15 or 20 years – although routine tests should be performed as a precaution in case the indolent tumours become active.

A percentage of HEs may recur at the original site, or in close proximity.

Almost a third of epithelioid hemangioendotheliomas develop metastases in regional lymph nodes or in the lungs, liver or bones. HOWEVER - some cases of hemangioendothelioma have been known to go into spontaneous remission.

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