Computed tomography imaging features of hepatic perivascular epithelioid cell tumor: A report of two cases and Review of the Literature

Abstract

Background: Perivascular Epithelioid Cell tumor (PEComa) is an uncommon tumor of mesenchymal origin which can arise at a variety of visceral and soft tissue sites, most frequently in the uterus whereas particularly uncommon in liver,only 8% of PEComa cases. Here, we present two pathologically proven cases of PEComa of the liver, retrospectively discuss the clinical, imaging, histological features and review the literature. Case presentation: Case 1: A 54-year-old female patient with intermittent epigastric discomfort for 2 years and aggravated for 5 days.The laboratory examinations were normal. Computed Tomography (CT) showed the lesions were located on the right lobe. The discomfort had resolved after surgery and PEComa was diagnosed after pathological examination of the surgical specimen. The patient has been followedup for 5 years without recurrence. Case 2: A 30-year-old woman was found to have a mass of liver incidentally during regular physical examination after breast cancer surgery. On contrast enhancement CT, a well demarcated mass was found. After operation, pathological diagnosis was established as malignant PEComa of the right liver. Neither primary recurrence nor metastasis was found during the 2-year follow-up. Conclusion: The CT imaging manifestations of liver PEComa have certain characteristics. When the tumor density is not uniform or contains fat, and thickening vascular shadow appears around the lesion, combined with clinical and laboratory examination, suggestive diagnosis can be made.