Primary Hepatic Epithelioid Hemangioendothelioma Diagnosed by Partial Hepatectomy: A Case Report

Abstract

A 31-year-old woman was admitted to our hospital for the treatment of multiple hepatic tumors, which were detected using computed tomography (CT) at a local hospital when she was undergoing treatment for gastroenteritis. Her physical examination and laboratory data did not reveal any abnormal findings. CT showed multiple delay-enhanced and slightly ring-enhanced tumors in the liver, with diameters of 5-50mm. Magnetic resonance imaging (MRI) showed similar findings as those obtained using CT. Gastrointestinal endoscopy revealed negative results; however, we considered the presence of multiple metastatic liver tumors. We performed a liver biopsy, but this did not provide sufficient evidence for a diagnosis. Therefore, we performed partial hepatectomy to confirm the diagnosis. The resected specimen revealed multiple, white-colored, solid masses. With hematoxylin and eosin (HE) staining, mostly hepatic cells were not detected, which revealed hyaline and fibrotic degeneration. The tumor cells had invaded the sinusoid irregularly, as detected with positive CD34 and CD31 stains. The patient was finally diagnosed with hepatic epithelioid hemangioendothelioma. After surgery, she was not administered any medication, but remained alive for 1 year and 4 months with no changes observed in the liver tumors.