To define the hepatic epithelioid hemangioendothelioma (HEH) among the other primary vascular liver tumours. To recognise the radiological appearanceof the tumour and toidentify some imaging features that will narrow down thedifferential diagnosis.
Primary vascular tumors of the liver in adult patients include hemangioma , epithelioid hemangioendothelioma , angiosarcoma and hemangiopericytoma. Some of these are benign and common,
others are rare and low-grade malignant tumors,
Angiosarcoma andhemangipericytoma are very uncommon and agressive lesions. The hepatic epithelioid hemangioendothelioma (HEH) is developing from the vascular elements of mesenchymal tissue.
Imaging findings OR Procedure details
Imaging findings Modalities: US,
CT (nonenhanced and enhanced),
T1C+ sequences) PET-FDG,
arteriography. Ultrasound: On ultrasoundHEH presents as multiples peripheral hypoechoic masses or mixed hypo-hyperechoic masses,
with a hypoechoic rim.
( Fig. 5 , Fig. 6 ) In diffuse lesions,
US shows areas of overall decreased echogenicity that contain,
in some cases,
calcified foci. There is no correlation between sonographic pattern and the size of the lesion. CT:...
Final diagnosis of HEH requires a tumor biopsy,
followed by histopathologic findings.The prognosis depends on whether extrahepatic metastases are present at the time of diagnosis.
Extrahepatic involvement includes the peritoneal lymph nodes,
omentum and mesentery and may be associated with calcification.
Thoracic disease (intrapulmonary or pleural),
cutaneous or intramuscular metastases may be observed in some cases.( Fig. 15 ) In the absence of extrahepatic disease,
radical resection is an...
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