Abstract
ObjectiveTo determine common imaging findings of hepatic epithelioid hemangioendothelioma on magnetic resonance images.Materials and MethodsA search was made of three institutional databases between January 2000 and August 2012. Seven patients (mean age, 47 years; range, 21-66 years; 6 women) with pathology-confirmed diagnosis of hepatic epithelioid hemangioendothelioma who had undergone magnetic resonance imaging were identified. None of the patients had received any treatment for hepatic epithelioid hemangioendothelioma at the time of the initial magnetic resonance imaging examination.ResultsHepatic epithelioid hemangioendothelioma tumors appeared as focal masses in 7/7 patients, greater than 5 in number, with a coalescing lesion in 1/5, and peripheral localization in 6/7. Capsular retraction was present in 4/7, and was associated with peripherally located lesions. Early ring enhancement was appreciated in the majority of lesions in 7/7 patients. Centripetal progressive enhancement was shown in 5/7 patients on venous phase that exhibited a distinctive thick inner border of low signal on venous phase images, and a central core of delayed enhancement. Small lesions did not show this.ConclusionThe combination of multifocal round-configuration lesions that are predominantly peripheral and exhibit early peripheral ring enhancement and late appearance of an inner thick border of low signal and central core of high signal may represent an important feature for hepatic epithelioid hemangioendothelioma.
Highlights
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular neoplasm of endothelial origin that may arise in various soft tissues and visceral organs[1,2]
Serum alpha-fetoprotein and alkaline phosphatase tests were available on the computer information system in four and five patients, respectively
The HEHE tumors appeared as focal masses, greater than 5 in number, in 7/7 patients, and peripheral localization in 6/7
Summary
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular neoplasm (incidence 1/1,000,000) of endothelial origin that may arise in various soft tissues and visceral organs[1,2]. It was first described in 1982 by Weiss et al[2], 7. MD, PhD, Department of Pathology & Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 8. MD, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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