A rare case of hepatic epithelioid hemangioendothelioma misdiagnosed as liver cancer

作者：Liu, Fen^*; Tian, Li; Ai, Fei-Yan; Yuan, Wei; Tang, An-Liu; Jiang, Hua; Shen, Shou-Rong; Wang, Xiao-Yan

来源：International Journal of Clinical and Experimental Medicine, 2017, 10(3): 5504-5509.

• Hepatic epithelioid hemangioendothelioma
• computed tomography
• magnetic resonance imaging

Hepatic epithelioid hemangioendothelioma (HEHE) is a malignant vascular endothelium-derived tumor featuring the histological characteristics of epithelial and vascular endothelial cells. The disease is very rare, with insidious onset. Its etiology and pathogenesis is not clear. Because of its complex and nonspecific clinical manifestations, HEHE is often misdiagnosed as liver cancer or other liver diseases. We report a case who had no specific symptoms and was initially diagnosed as liver cancer, but was finally confirmed to be HEHE by pathology. The patient's main clinical manifestations were abdominal distention and chronic large volume bloody ascites. Computed tomography and magnetic resonance imaging (MRI) scan of the patient's liver suggested abnormal multiple liver nodules, peritoneal and omental lesions. Positron emission tomography-computed tomography indicated the possibility of liver cancer. This case was clinically suspected of liver cancer, but CT and MRI imaging features did not support it. By transumbilical endoscopic surgery (TUES) and ultrasound-guided liver biopsy, we finally diagnosed HEHE at late stage, with extensive peritoneum and omentum metastasis. Like others reported, diagnosis of HEHE can be challenging. In our case, although it has the imaging features of vascular lesions, but was not correctly identified due to the absence of experience of radiologists and physicians resulted by its rare incidence. By presenting this case and extracting the image features, we aim to raise the awareness of HEHE in the future.

• 出版日期2017
• 单位中南大学