Abstract
A 63-year-old woman, who had undergone an abdominoperineal resection with lymph node dissection for carcinoma of the rectum at 44 years of age was found to have multiple liver nodules on a followup abdominal ultrasound examination, and was admitted to our hospital. Abdominal CT scan revealed multiple low-density nodules in the liver. Angiography showed pale nodules stained with hypervascularity at the margin. Metastatic tumors or hepatic cell carcinoma were suspected, and although a fine-needle biopsy of the liver was performed, it was impossible to make a definite diagnosis. Laparotomy was performed to enable an excisional biopsy. The excised tumor appeared white and clear, and it was elastic and soft to palpation. Histological examination revealed cytoplasmic vacuoles representing vascular lumina, some of which contained erythrocytes. Immunohistochemical studies revealed that the tumor cells were positive for factor VIII-related antigen and CD34, and the final diagnosis was epithelioid hemangioendothelioma. The postoperative course was uneventful, and no increase in the size and number of tumors has been observed to date, 20 months after the operation.
