Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Nov 7;22(41):9247-9250.
doi: 10.3748/wjg.v22.i41.9247.

Hepatic epithelioid hemangioendothelioma: Dilemma and challenges in the preoperative diagnosis

Hai-Jie Hu  1 , Yan-Wen Jin  1 , Qiu-Yang Jing  1 , Anuj Shrestha  1 , Nan-Sheng Cheng  1 , Fu-Yu Li  1
Affiliations
Case Reports

Hepatic epithelioid hemangioendothelioma: Dilemma and challenges in the preoperative diagnosis

Hai-Jie Hu et al. World J Gastroenterol. .

Abstract

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare category of vascular tumor with uncertain malignant potential. It commonly presents nonspecific and variable clinical manifestations, ranging from asymptomatic to hepatic failure. In addition, laboratory measurements and imaging features also lack specificity in the diagnosis of HEHE. The aim of the present study is to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging. In these patients, HEHE should at least be considered in the differential diagnosis.

Keywords: Challenges; Diagnosis; Dilemma; Hepatic epithelioid hemangioendothelioma; Vascular tumors.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors declared that there is no conflict of interest related to this study.

Figures

Figure 1
Figure 1
Abdominal contrast-enhanced computerized tomography findings. Abdominal contrast-enhanced computerized tomography (CT) revealed multiple low density nodular lesions scattered in the liver parenchyma, involving the right lobe and left medial segment, with inhomogeneous enhancement.
Figure 2
Figure 2
Contrast-enhanced ultrasonography findings. Contrast-enhanced ultrasonography indicated multiple hypoechoic nodules with peripheral hyper-enhancement during the arterial phase and hypo-enhancement during the portal phase.
Figure 3
Figure 3
PET-CT findings. PET-CT showed that the hepatic masses had low glycometabolism.
Figure 4
Figure 4
Pathological findings. Pathological investigations identified hepatic epithelioid hemangioendothelioma: A: Hematoxylin-eosin staining revealed abnormal hyperplasia of fibrous tissue combined with vessel-like formations, with scattered neoplastic epithelioid cells; B: Immunohistochemistry showed that the tumor was positive for CD34; C: Immunohistochemistry showed that the tumor was positive for CD31.
See this image and copyright information in PMC

Comment on

  • World J Gastroenterol. 211(9):702.

References

    1. Campione S, Cozzolino I, Mainenti P, D’Alessandro V, Vetrani A, D’Armiento M. Hepatic epithelioid hemangioendothelioma: Pitfalls in the diagnosis on fine needle cytology and “small biopsy” and review of the literature. Pathol Res Pract. 2015;211:702–705. - PubMed
    1. Makhlouf HR, Ishak KG, Goodman ZD. Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of 137 cases. Cancer. 1999;85:562–582. - PubMed
    1. Ishak KG, Sesterhenn IA, Goodman ZD, Rabin L, Stromeyer FW. Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. Hum Pathol. 1984;15:839–852. - PubMed
    1. Mistry AM, Gorden DL, Busler JF, Coogan AC, Kelly BS. Diagnostic and therapeutic challenges in hepatic epithelioid hemangioendothelioma. J Gastrointest Cancer. 2012;43:521–525. - PubMed
    1. Uchimura K, Nakamuta M, Osoegawa M, Takeaki S, Nishi H, Iwamoto H, Enjoji M, Nawata H. Hepatic epithelioid hemangioendothelioma. J Clin Gastroenterol. 2001;32:431–434. - PubMed

MeSH terms

Substances