Computed Tomography and Magnetic Resonance Imaging Findings of a Malignant Hepatic Epithelioid Hemangioendothelioma: A Rare Case of Solitary Small Nodular Form.

Soo-Heui Baek,Jung-Hee Yoon

doi:10.1177/2324709613504549

Abstract

We report the case of a rare solitary small nodular form of malignant hepatic epithelioid hemangioendothelioma in a patient followed by computed tomography and gadoxetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging with histological analysis. This case showed early peripheral septal and nodular enhancement and delayed centripetal enhancing pattern with capsular retraction, mimicking peripheral cholangiocarcinoma, inflammatory pseudotumor, or metastases. The histological and immunohistochemical findings were diagnostic of a malignant hepatic epithelioid hemangioendothelioma.

Highlights

Epithelioid hemangioendothelioma (EHE) is a rare, low- to intermediate-grade malignant vascular tumor that originates from the soft tissue, visceral organs, bone, lung, brain, and small intestines.[1]
A specific diagnosis for the nodular type is difficult without a biopsy because the radiologic findings are similar to those for some hepatic metastases
We most intrahepatic tumors are commonly associated with mass effects that result in contour bulging, 2.0% to 2.8% of tumors may show capsular retraction.[5,6]

Summary

Introduction

Epithelioid hemangioendothelioma (EHE) is a rare, low- to intermediate-grade malignant vascular tumor that originates from the soft tissue, visceral organs, bone, lung, brain, and small intestines.[1]. The diffuse form of EHE has more specific diagnostic criteria, and peripheral location and capsular retraction are hallmarks of hepatic EHE. We present a case of a rare solitary small nodular form of malignant hepatic EHE.

Results

Conclusion