A Case of Epithelioid Hemangioendothelioma of the Liver with Difficulty in Preoperative Diagnosis

Ryutaro Mori¹⁾, Masaru Miura¹⁾, Tetsuya Takahashi¹⁾, Yoshiro Obi¹⁾, Ken Yamanaka¹⁾, Tetsuo Abe¹⁾, Saiko Nakashita²⁾, Hideaki Fujimoto²⁾ and Kyoichi Nakamura³⁾

Department of Surgery¹⁾, Department of Gastroenterology²⁾, Department of Pathology³⁾, Yokohama Red Cross Hospital

A 67-year-old woman admitted for a liver tumor detected incidentally by computed tomography (CT) was found in further CT to have a 4×2.5 cm mass at segment 7 of the liver, whose margin was enhanced in the early phase. Magnetic resonance imaging showed a low-intensity mass in T1-weighted imaging and a partially high-intensity mass in T2-weighted imaging. Angiography showed pale tumor staining with hypervascularity in the margin of the tumor. We suspected atypical cholangial cell carcinoma, and conducted right hepatic lobectomy. The tumor was white, clear, and elastically soft, with spiculation. Histopathologically, it showed invasion to the glison sheath with marked hyalinized stroma. The final diagnosis was epithelioid hemangioendothelioma of the liver. We review 63 cases of epithelioid hemangioendothelioma of the liver reported in the Japanese literature. Of these, only 13 were resectable. Preoperative diagnosis of this tumor is generally difficult.

Key words
epithelioid hemangioendothelioma, liver, resection

Reprint requests
Ryutaro Mori Department of Surgery, Yokohama Red Cross Hospital
2-85 Negishi-cho, Naka-ku, Yokohama, 231-0863 JAPAN

Accepted
November 26, 2003

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