2024 Volume 57 Issue 12 Pages 614-624
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular origin tumor. About one-third of patients with HEHE have synchronous distant metastases at the time of diagnosis, but there have been few reports of cases with sternal metastasis. The patient was an 80-year-old woman who was admitted with an asymptomatic liver tumor that was incidentally detected on coronary CT. The tumor was 80 mm in diameter with an enhanced margin and was located in the lateral segment of the liver. FDG-PET/CT showed increased FDG uptake in the liver tumor and sternum. The bone lesion was diagnosed as EHE by sternal biopsy, while the liver tumor was suspected to be a resectable intrahepatic cholangiocarcinoma. Laparoscopic left hemi-hepatectomy was performed. Histopathologically, the liver tumor was consistent with the pathology of the sternum lesion, as well as that of a lymph node in the hepatoduodenal ligament that was resected for sampling during surgery. Therefore, the final diagnosis was HEHE with sternal and lymph node metastases. The patient was discharged on the 8th postoperative day. As of 10 months since the operation, there has been no recurrence. Our experience suggests that FDG-PET/CT may be useful for preoperative evaluation for HEHE because distant metastases of HEHE are not unusual and target organs are diverse.
