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Case Reports
. 2022 Jun 21;14(6):e26155.
doi: 10.7759/cureus.26155. eCollection 2022 Jun.

Hepatic Epithelioid Hemangioendothelioma With Unique Metastasis to the Superior Vena Cava Found on CT Imaging: A Case Study

Charles A Bisbee 2nd  1 , Logan Burstiner  2 , Hristina Natcheva  2
Affiliations
Case Reports

Hepatic Epithelioid Hemangioendothelioma With Unique Metastasis to the Superior Vena Cava Found on CT Imaging: A Case Study

Charles A Bisbee 2nd et al. Cureus. .

Abstract

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare malignant tumor of vascular origin. Classically, HEHE is typically associated with imaging demonstrating multifocal heterogeneously enhancing hepatic nodules and histologic examination revealing mixed epithelioid and dendritic cells in a proliferative fibrous stromal background. While generally described as a low-to-intermediate grade indolent tumor, it is essential to establish the presence or absence of extrahepatic spread when considering transplant candidacy. We describe one case study in which a transplant was denied to a unique metastatic pattern of HEHE to the superior vena cava. This is a previously unreported location of metastasis of HEHE and may serve to broaden our current understanding of potential metastatic sites for this disease.

Keywords: hepatic epithelioid hemangioendothelioma; liver transplantation; metasasis; superior vena cava; vascular malignancy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial view of a CT abdomen/pelvis showing capsular retraction (red arrow) as well as the “lollipop sign” (white arrow)
CT: Computed Tomography
Figure 2
Figure 2. Axial view of a CT abdomen/pelvis showing a hepatic lesion with multiple calcifications present (white arrows)
CT: Computed Tomography
Figure 3
Figure 3. Axial view of an MRI abdomen T-2 weighted imaging showing numerous hyperintense hepatic lesions
MRI: Magnetic Resonance Imaging
Figure 4
Figure 4. Axial view of an MRI abdomen T-1 weighted imaging taken one minute post contrast showing a hepatic lesion with peripheral enhancement (white arrow)
MRI: Magnetic Resonance Imaging
Figure 5
Figure 5. Axial view of a CT chest showing an eccentric, partially calcified, hypodense nodule (1.1 x 1.4 cm, white arrow) abutting and encroaching into the lower SVC
CT: Computed Tomography, SVC: Superior Vena Cava
Figure 6
Figure 6. Coronal view of a CT chest showing another view of the eccentric, partially calcified, hypodense nodule (1.1 x 1.4 cm, white arrow) abutting and encroaching into the lower SVC
CT: Computed Tomography, SVC: Superior Vena Cava
See this image and copyright information in PMC

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